scholarly journals Potential Biomarkers for Predicting Congenital Cytomegalovirus Infection

2018 ◽  
Vol 19 (12) ◽  
pp. 3760 ◽  
Author(s):  
Kenji Tanimura ◽  
Hideto Yamada

Early diagnosis and treatment of infants with symptomatic congenital cytomegalovirus (CMV) infection may improve neurological outcomes. For this reason, prenatal detection of newborns at high risk for congenital CMV infection is important. A polymerase chain reaction (PCR) assay for CMV DNA in the amniotic fluid is the gold standard for the diagnosis of intrauterine CMV infection; however, amniocentesis is an invasive procedure. Recently, we have found that the presence of CMV DNA in the maternal uterine cervical secretion is predictive of the occurrence of congenital CMV infection in CMV immunoglobulin M (IgM)-positive pregnant women. In contrast, we have suggested that maternal serological screening for primary CMV infection using CMV-specific immunoglobulin G (IgG), the IgG avidity index, or CMV-specific IgM overlooks a number of newborns with congenital CMV infection. We will review current knowledge of the potential biomarkers for predicting congenital CMV infection.

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Yoko Kobayashi ◽  
Ichiro Morioka ◽  
Tsubasa Koda ◽  
Yuji Nakamachi ◽  
Yoko Okazaki ◽  
...  

AbstractNeurological outcomes differ considerably between symptomatic and asymptomatic infants with congenital cytomegalovirus (CMV) infection. Our objective was to characterize laboratory markers in symptomatic newborns in comparison with asymptomatic newborns with congenital CMV infection.Ten newborns with symptomatic and 13 newborns with asymptomatic congenital CMV infection were included in this 3-year prospective cohort study. Total immunoglobulin M (IgM), CMV-IgM, CMV antigenemia, and CMV-DNA in blood and urine were measured and their positive rates and quantitative values compared between the symptomatic and asymptomatic groups.Fifty percent of newborns in the symptomatic group were positive based on total IgM; this was significantly lower than in the asymptomatic group (100%). Quantitative total IgM values were significantly lower, and there were significantly more copies of CMV-DNA in the blood of symptomatic newborns than in asymptomatic newborns (median values for total IgM: 14 vs. 43 mg/dL and blood CMV-DNA: 3.2×10Low total IgM values and high blood CMV loads were associated with the presence of symptoms in newborns with congenital CMV infection.


2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto

AbstractWe describe a case of congenital cytomegalovirus (CMV) infection transmitted by an immunocompetent woman infected before conception with continuous hyper CMV-immunoglobulin M (IgM). A 33-year-old woman whose CMV-IgM levels were stable more than 8 months before conception was referred at 35 gestational weeks due to fetal unilateral cerebral ventriculomegaly. The maternal serum CMV-IgG was 61.7 U/mL, and the CMV-IgM was 3.89 U/mL. An infant girl weighing 2297 g was delivered transvaginally. The neonate was found to have congenital CMV infection. After delivery, the high maternal CMV-IgM level has continued for more than 2 years. In conclusion, although continuous hyper CMV-IgM is rare, the infants of infected women may develop congenital infection. It is our hope that the information provided in the present case will further aid clinicians in counseling patients who find themselves in this situation.


Author(s):  
Samileh Noorbakhsh ◽  
Mohammad Farhadi ◽  
Faezeh Haghighi ◽  
Sara Minaeian ◽  
Morteza Haghighi Hasanabad

Background and Objectives: Cytomegalovirus (CMV) constitutes the most common viral cause of congenital infections in newborns worldwide. There are a significant number of asymptomatic newborns with congenital CMV infection in Iran, which may develop long-term sequelae of infection. Unfortunately, limited data exsists from Iran on the rate of congenital CMV infection among neonates. The current study was aimed to investigate the prevalence of congenital CMV infection among Iranian neonates by testing Guthrie cards. Materials and Methods: Guthrie cards were collected from infants within 2 weeks of life, and total DNA was extracted from samples by thermal shock and evaluated for CMV DNA using nested-PCR assay. CMV infection in newborns was confirmed through a commercial CMV PCR kit. Infected infants underwent further evaluation at the hospital. Results: CMV infection was identified in four of 1174 infants (0.34%) which is approximately 3 cases per 1000 live births. Infected infants were asymptomatic at birth and had a normal hearing status similar to other children. There were no factors in relation with CMV infection among newborns. Conclusion: According to the results of this study, infected infants with congenital CMV infection could identify at early stage by testing Guthrie cards (within 21 days of life). Furthermore, since there is a lack of CMV knowledge in our popula- tion, educating and effective counseling by obstetricians/ gynecologists to the pregnant women are recommended.  


2012 ◽  
Vol 141 (10) ◽  
pp. 2187-2191 ◽  
Author(s):  
A. Y. YAMAMOTO ◽  
R. A. C. CASTELLUCCI ◽  
D. C. ARAGON ◽  
M. M. MUSSI-PINHATA

SUMMARYCongenital cytomegalovirus (CMV) infection rates increase with maternal seroprevalence due to transmission from maternal non-primary infection. CMV seroprevalence estimates of pregnant women are needed for planning strategies against congenital CMV transmission. We aimed to determine the age-specific prevalence of serum antibodies for CMV in a representative age-stratified sample of unselected pregnant women from a Brazilian population. A total of 985 pregnant women, aged 12–46 years (median 24 years), were enrolled. Overall CMV seroprevalence was 97% (95% confidence interval 95·8–98·0), with age-specific (years) prevalence as follows: 12–19 (96·3%), 20–24 (97·7%), 25–29 (97·1%), and 30–46 (96·7%). CMV seroprevalence is almost universal (97%) and is found at similar levels in pregnant women of ages ranging from 12 to 46 years. Because high CMV seroprevalence is found even in women of a younger age in this population, this finding suggests that the majority of primary CMV infections occur early, in infancy or childhood. As a consequence, vaccines currently under development to prevent primary infection may not be a solution for the prevention of congenital CMV infection in this population.


2015 ◽  
Vol 36 (4) ◽  
pp. 153 ◽  
Author(s):  
Wendy J van Zuylen

Human cytomegalovirus (CMV) is the most common non-genetic cause of congenital disability. As a herpesvirus that infects the majority of the population, CMV is able to establish a lifelong latent infection in the host. Any time during pregnancy, a primary CMV infection, reactivation of latent CMV or a new viral strain can infect the placenta and the developing foetus, resulting in congenital CMV infection. Each year, an estimated 2000 children are born with congenital CMV infection in Australia, leaving ~500 children with permanent disabilities such as hearing or vision loss, or mental disability. Despite the clinical importance of congenital CMV, there is limited awareness and knowledge in the medical and general community about congenital CMV infection. This article reviews the global epidemiology and clinical features of maternal and congenital CMV infections.


PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 862-866 ◽  
Author(s):  
W. Daniel Williamson ◽  
Gail J. Demmler ◽  
Alan K. Percy ◽  
Francis I. Catlin

Congenital cytomegalovirus (CMV) infection is a major public health problem because 30 000 to 40 000 neonates with the infection are born each year in the United States. Although 90% of the congenitally infected infants are asymptomatic at birth, evidence is accumulating that these infants are at risk for audiologic, neurologic, and developmental sequelae. The current study describes the audiologic outcome of 59 infants with asymptomatic congenital CMV infection compared with 26 control infants. Eight of 59 infected infants had congenital sensorineural hearing loss (SNHL) but none of the control subjects did. Longitudinal audiologic assessments revealed that 5 of the 8 infants had further deterioration of their SNHL; a ninth infant with initially normal hearing experienced a unilateral SNHL during the first year of life, with further deterioration subseguently. The frequency of SNHL was similar for infected infants born to mothers with recurrent CMV infections during pregnancy (2 of 9) and for those born to mothers who experienced primary CMV infections (5 of 26). There was a significant difference between the occurrence of hearing loss in infected infants with normal computed tomographic scans (2 of 40) compared with those with either periventricular radiolucencies (4 of 13) or calcifications (1 of 3). Children with SNHL often have no identified cause of the loss; thus, it is likely that many of these children had asymptomatic congenital CMV infection. Given the progressive nature of SNHL associated with asymptomatic congenital CMV infection, longitudinal audiologic assessments are mandatory.


2021 ◽  
Vol 1 (2) ◽  
pp. 001-007
Author(s):  
Therese-Mary William

Congenital Cytomegalovirus (CMV) infection is one of major public health concerns and one of the most frequent congenital infections worldwide. Congenital CMV infection is under-diagnosed in the majority of asymptomatic pregnant women due to its self-limited non-specific symptoms and unimplemented screening program. It also can go undetected at birth because in affected newborns are often asymptomatic; however, they manifest serious morbidities later in life. Primary CMV infections are associated with the highest in-utero transmission with estimated rates of 30–35% . Transmission occurs less frequently in secondary maternal infections at approximately 1.1–1.7%. There are growing evidences that early treatment with the antiviral therapy in newborns with congenital CMV infection can reduce sensorineural hearing loss (SNHL) and the substantial long-term neurodevelopmental disabilities. There is increased interest in establishing a prophylactic CMV vaccines that can protect seronegative mothers from primary infection and also to augment the immune response in seropositive women in order to prevent reactivation or re-infection. Saliva PCR assay can be used to screen newborns within the first 3 weeks of age instead of Dried blood spots (DBS), liquid-saliva PCR assay sensitivity is “100%” higher than DBS sensitivity “35%-100%" as not all infants have detectable viraemia at birth. Suggestive strategies to reduce the burden of congenital CMV disease and ensure better outcomes are; establishing a screening programme for pregnant mothers, developing prophylactic CMV vaccines, early therapeutic intervention in pregnant women and newborns and to replace DBS with Saliva PCR assay in screening newborns.


2018 ◽  
Vol 43 (2) ◽  
pp. 77-81
Author(s):  
Munira Jahan ◽  
Nahida Sultana ◽  
Ridwana Asma ◽  
Shahina Tabassum ◽  
Md. Nazrul Islam

Cytomegalovirus (CMV) is a frequent cause of congenital infection in humans in all regions of the world. In contrast to most congenital viral infections, congenital CMV infection and disease have been consistently demonstrated in populations with a high seroprevalence. Three hundred pregnant women were studied prospectively in their 1st, 2nd and 3rd trimester to determine the seroprevalence and seroconversion of CMV in pregnancy. After birth, babies were also tested for anti CMV IgM to determine the rate of birth prevalence. Anti CMV IgG and IgM tests were performed by chemiluminescence methods. All 300 (100%) pregnant women were anti CMV IgG positive and 180 (60%) were subsequently anti CMV IgM positive during different trimesters of pregnancy. Birth prevalence of CMV IgM antibody was 1.3% among babies of anti CMV IgM positive mothers whereas none in CMV IgM negative mothers (OR 1.01, 95% CI .996-1.027).It may be concluded that CMV IgG seroprevalence is high among Bangladeshi pregnant women and the rate of CMV reactivation is also high during pregnancy. Despite protection by maternal immunity a certain percent of babies acquire congenital CMV infection.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013049 ◽  
Author(s):  
Ehab Abdelmoniem Albanna ◽  
Randa Saddek Abd El-latif ◽  
Hend Alsayed Sharaf ◽  
Maha Kamal Gohar ◽  
Basem Mohamed Ibrahim

Objectives: This study aimed to compare polymerase chain reaction (PCR) and IgM detection using enzyme linked immune-sorbent assay (ELISA) in diagnosis of congenital cytomegalovirus (CMV) infection.   Methods: This study was conducted from May 2009 to December 2010. Urine and blood samples were collected from 94 neonates with suspected congenital CMV infection. Serum and part of urine samples were stored at -20°C freezer, until the serologic and PCR tests were achieved. A 94 fresh urine samples were processed for cell culture. Nineteen (20.2%) out of 94 urine samples were proven positive for CMV infection by viral culture. For comparing PCR and IgM ELISA we used tissue culture technique as a reference, the 19 positive samples on culture (CMV group) and 20 negative samples (control group) were included in the comparison. Some characteristics of CMV and control groups were compared including sex, age, birth weight, gestational age < 37 and small for gestational age. Clinical and laboratory abnormalities were also compared in both groups.   Results: This study showed that the sensitivity and specificity of PCR in relation to viral culture were 100% and 100% respectively, there was excellent agreement between both tests (Kappa coefficient was 1 and P=0.000). On the other hand, the sensitivity of IgM CMV ELISA in relation to viral culture was 63.2% and the specificity was 85%. There was good agreement between both tests (Kappa coefficient was 0.48 and P=0.002). By comparing CMV and control groups, there were high statistically significant differences between both groups as regard the birth weight, gestational age < 37 and small for gestational age items (P= 0.00, 0.03 and 0.01 respectively). There were statistically insignificant differences as regarding the clinical and laboratory abnormalities detected for neonates of both groups. In this study jaundice (63%) and hepato-splenomegaly (42%) were the most common clinical signs in both groups.   Conclusion: PCR is more sensitive and specific technique for detection of congenital CMV infection than CMV IgM ELISA. Being more cost effective, less cumbersome and less time consuming in relation to viral culture, PCR may be used in detection of congenital CMV infection.


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