Diagnóstico de infecção congênita e perinatal por citomegalovírus utilizando a reação em cadeia da polimerase

Yamamoto, Aparecida Yulie; Aquino, Víctor Hugo; Figueiredo, LF Poli de; Mussi-Pinhata, Marisa Márcia

doi:10.1590/s0037-86821998000100003

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…Para tanto, seria necessário estabelecer um método laboratorial que apresentasse vantagens operacionais para utilização em larga escala. A PCR com detecção do vírus na urina, utilizada neste estudo, oferece algumas dessas vantagens como rapidez, praticidade, sensibilidade e especificidade adequada comparada com o isolamento viral em cultura de fibroblastos humanos, considerado método padrão para diagnóstico da infecção congênita por CMV 15,26 . O custo para realização de um teste pela PCR, método utilizado de rotina no local deste estudo, seria em torno de 13 dólares, totalizando gastos com material para coleta da amostra, reagentes e recursos humanos para realização do teste.…”

Section: Discussionunclassified

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Prevalence and clinical aspects of congenital cytomegalovirus infection

Yamamoto¹,

Figueiredo²,

Mussi-Pinhata³

1999

J Pediatr (Rio J)

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Objectives: The objectives of the present study were to determine the prevalence of congenital CMV infection, as well as to evaluate the importance of this agent as cause of congenital disease, and to describe the clinical manifestations in children attended at a General Hospital in Ribeirão Preto, SP, Brazil. Population and methods: A first group including 189 newborns and their mothers was evaluated for the prevalence of the congenital CMV infection. A second group including 130 newborns and 74 infants who presented clinical manifestations of congenital disease were also investigated to evaluate the importance of the CMV as a cause of this disease and to describe the clinical findings. Diagnosis of congenital CMV infection was established by detecting the virus using viral isolation in tissue culture, polymerase chain reaction DNA amplification in urine samples and detection of specific anti-CMV IgM and IgG by immunofluorescence indirect test. Results: The prevalence of congenital CMV infection was 2.6% and the prevalence of CMV antibodies in mothers was 95%. In the first group, none of the 5 congenitally infected presented clinical apparent disease at birth, although one of them had intracranial calcifications. In the second group, CMV was recognized as a causative of congenital disease in 12 children (5.9%). Of these, 10(83%) were identified after the neonatal period. The clinical findings included hepatosplenomegaly (75%), jaundice with direct hyperbilirubinemia (42%), neurologic disease consisting of microcephaly and intracranial calcifications in 42% of these children. Conclusions: The prevalence of congenital CMV infection was similar to that reported in other studies about highly immune populations. Infants with asymptomatic congenital CMV infection may have diseases of the central nervous system that are not clinically evident at birth, such as punctate calcifications. CMV infected patients who are symptomatic at birth have a multisystem disease, and the differential diagnosis of any newborn with clinical abnormalities including involvement of the hepatobiliary, hematopoietic and central nervous systems should include congenital CMV infection. CMV was an important agent of these abnormalities, and the majority of symptomatic patients were identified after the neonatal period, making the diagnosis more difficult.

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Section: Discussionunclassified

“…Os CMV mostraram ser agentes importantes na etiologia dessas afecções, e a grande maioria das crianças sintomáticas foram identificadas após o período neonatal, dificultando um diagnóstico definitivo. [23][24][25][26][27][28]: infecção por citomegalovírus, infecção congênita por citomegalovírus, citomegalovirose congênita.…”

Section: Introductionunclassified

Prevalence and clinical aspects of congenital cytomegalovirus infection

Yamamoto¹,

Figueiredo²,

Mussi-Pinhata³

1999

J Pediatr (Rio J)

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“…To exclude congenital CMV infection, a sterile urine sample was obtained from all newborn infants at a median age of 1 day (range 1-5 days) for virus isolation by human fibroblast culture and by a multiplex polymerase chain reaction (PCR), using the primer pairs MIE gene (amplification of a 435-bp sequence of CMV DNA that codes for a portion of the major immediate-early antigen), and gB (296 bp) and gH (215 bp), which amplify parts of the glycoprotein B and glycoprotein H genes, respectively [Yamamoto et al, 1998]. Urine samples with at least two amplified CMV genomic fragments were considered positive.…”

Section: Detectionmentioning

confidence: 99%

Placental transfer of naturally acquired, maternal cytomegalovirus antibodies in term and preterm neonates

Mussi-Pinhata¹,

Pinto²,

Yamamoto³

et al. 2002

Journal of Medical Virology

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Maternal antibodies may protect the fetus and neonate against severe forms of CMV-caused disease, therefore this study investigated the efficiency of the placental transfer of naturally acquired, maternal total anti-cytomegalovirus (CMV) IgG and neutralizing antibodies at different gestational ages. The study was conducted on 182 healthy CMV-seropositive Brazilian mothers and their 196 infants who were not infected congenitally with CMV, as determined by CMV detection in urine. The study groups were composed of 44 infants aged 28-30 weeks; 51 infants aged 31-33 weeks; 62 infants aged 34-36 weeks, and 39 infants of gestational age > or = 37 weeks. Quantitative detection of total CMV IgG was carried out using EIA and virus neutralizing titers were determined by a microneutralization assay in sera from mothers and infants. CMV IgG levels and neutralizing titers of the infants correlated with maternal levels (r=0.873 and r=0.841, respectively). The efficiency of placental transfer of these antibodies was enhanced significantly as gestation progressed until 34-36 weeks, when values similar to those of full-term infants (90-100%) were found. Transfer ratios were significantly higher for neutralizing compared to total CMV IgG antibodies at gestational age 31-33 weeks (100% vs. 84%, respectively) and at gestational age 28-30 weeks (75% vs. 60%, respectively). We conclude that placental transfer of naturally acquired maternal CMV neutralizing and total CMV IgG antibodies are similarly efficient above 34 weeks of gestational age. At less than 34 weeks of gestational age, transfer of neutralizing antibodies may be favored and these antibodies reach the neonatal serum of 99% of these premature infants.

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“…Foram encontradas 30 mulheres com a presença do HCMV na secreção cervical. A detecção desse vírus em fluidos corporais teria uma indicação muito importante relacionada ao diagnóstico de infecção congênita ou perinatal em urina de recém-nascidos, proporcionando a intervenção com recursos terapêuticos que podem minimizar a gravidade dos casos e, no caso das infecções congênitas, possibilitando diminuir a intensidade das sequelas 25 . A detecção na secreção cervical diagnosticaria a mulher excretando ativamente o vírus, porém não discriminaria entre infecção primária e reativação, o que poderia ser feito em um acompanhamento de soroconversão durante a gestação 26 .…”

Section: Discussionunclassified