Ante- and postnatal diagnostics and complex treatment of congenital cytomegalovirus infection

Рогозина, Н В; Васильев, В. В.; Grineva, A.A.; Михайлов, А. В.; Каштанова, Т. А.; Романовский, А. Н.; Иванова, Р. А.; Romanova, Elena S.; Ушакова, Г. М.

doi:10.21508/1027-4065-2019-64-6-89-93

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…Предполагаемая частота врожденной ЦМВИ среди новорожденных варьирует от 0,2% до 6,1% во всем мире [2][3][4]. Встречаемость заболевания в Соединенных Штатах Америки, Канаде, Австралии и Западной Европе составляет 5-7 случаев на 1000 новорожденных.…”

Section: Introductionunclassified

“…Встречаемость врожденного инфекционного заболевания (ВИЗ), ассоциированного с ЦМВ, неуклонно растет и регистрируется чаще, чем синдром Дауна, фетальный алкогольный синдром и расщепление позвоночника (spina bifida) [3]. В России частота врожденной ЦМВИ достигает 2,8% и варьирует в зависимости от исследуемых групп [4].…”

Section: Introductionunclassified

“…Заражение плода ЦМВ возможно как при первичном инфицировании неиммунной беременной, так и при реактивации латентной инфекции [4]. В популяциях с высокой распространенностью ЦМВ (≥90%) почти все ВИЗ связаны с повторным инфицированием матерей.…”

Section: Introductionunclassified

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Modern concepts of the mechanisms of congenital cytomegalovirus infection development

Васильев

Рогозина²,

Markin³

2023

jour

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The review presents modern information of domestic and foreign authors about possible pathogenetic mechanisms of the virus effect on the fetus in the case of cytomegalovirus infection in pregnant women. Immunosuppressive changes, which are a feature of the physiological course of pregnancy, create favorable conditions for the development of active cytomegalovirus infection. The virus’s ability to infect a wide range of cells in vivo and trigger a set of molecular mechanisms causes changes in placental cell differentiation, which plays a key role in transplant transmission. The processes of formation of chronic placental insufficiency, which leads to hypoxia of the fetus and to delay of intrauterine development, are separately highlighted. The literary data on non-specific metabolic changes of the mother and placental activation of proinflammatory cytokines (TNF-α, IL-1β, IL2, IL-6 and IL-8), which occur in cytomegalovirus infection and are of significant importance in formation of hypoxia of the fetus have been analyzed.In addition, the role of individual cells in preventing intrauterine infection is examined, namely the deciduous macrophages with antiviral activity, the deciduous natural killers and their activated toll-like receptors. The article also discusses the genetic predisposition to the development of manifest forms of EID, including the relationship of polymorphism of TLR2 and Arg753Gln genes with an increased risk of intrauterine infection of the fetus CMV.Characteristic properties of the virus are pronounced genetic diversity, the ability to life-long persistence in various human organs and tissues (secretory glands, lymphatic cells, kidneys, etc.) and replication without cell damage, as well as suppressing cellular immunity. The article describes the issues of genotyping of virus and the relationship of some genotypes with certain organ pathology in newborns.

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Section: Introductionunclassified

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Modern concepts of the mechanisms of congenital cytomegalovirus infection development

Васильев

Рогозина²,

Markin³

2023

jour

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Case report: congenital cytomegalovirus infection

Balykova

Верещагина

Ледяйкина

et al. 2020

jour

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Background. This review article surveys literature data on the methods of timely diagnosis and treatment of congenital cytomegalovirus infection (CMVI) in newborn infants. In recent years CMVI has become a subject of numerous global-scale studies. Such increased interest in CMVI is due to the fact that the consequences of congenital CMVI have a social impact. Description of clinical case. A clinical case of congenital manifest cytomegalovirus infection is described. The infant was diagnosed with CMVI on the 10th day of life. Complex therapy was prescribed in accordance with the protocol of management of congenital CMVI which led to positive dynamics. Conclusion. By today, an algorithm for detection and treatment of CMVI which brings positive results has been worked out. However, it is essential to keep in mind the long-term sequelae of CMVI and devote close attention to dispensary follow-up of such patients.

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Cytomegalovirus infection in immunocompetent pregnant women: clinical manifestations and management tactics

Рогозина

Васильев

Bezverhaja³

et al. 2022

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Objective: to analyze clinical manifestations, diagnostic and therapeutic approaches to management of pregnant women with cytomegalovirus infection for optimization of clinical and laboratory diagnostics and reduction of risks of congenital cytomegalovirus infection in the postnatal period.Materials and methods: in the article describe results a retrospective study the pregnancy course of 92 women who had 94 children with a confirmed congenital manifest form of cytomegalovirus infection. The inclusion criteria in main group were women aged 18-40 years and presence the results of examination for TORCH-syndrome in the first trimester of pregnancy, negative results for HIV. Markers of cytomegalovirus infection were determined by PCR (blood, vaginal secretions) and serologically (IgM, IgG to CMV-infection).Findings: the study showed that acute cytomegalovirus infection was documented during pregnancy in 18.4% of cases, and recrudescence of CMV-infection only in 33.6% of cases. Acute cytomegalovirus infection was asymptomatic in 35.3% of patients, the rest had nonspecific symptoms in the form of fatigue and headache, cholestasis was registered in 35.2% of cases, whereas with recrudescence of cytomegalovirus infection, catarrhal symptoms in the form of rhinitis and pharyngitis prevailed 42,8% cases, p<0,05. 15 people received therapy during pregnancy: 2 of them – antiviral (valgancyclovir), 11 – immunocorrective (interferon2alfa) and 2 – pathogenetic therapy (blood transfusion to the fetus for anemia). Based on the literature data and obtained by analyzing management tactics of the observed pregnant women, an algorithm for the management of pregnant women with cytomegalovirus infection was created.Conclusion: the study made it possible to substantiate algorithm of diagnosis and tactics management of cytomegalovirus infection in immunocompetent pregnant women and gave recommendations for obstetricians and gynecologists about alertness regarding cytomegalovirus infection.

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Ante- and postnatal diagnostics and complex treatment of congenital cytomegalovirus infection

Cited by 7 publications

References 11 publications

Modern concepts of the mechanisms of congenital cytomegalovirus infection development

Modern concepts of the mechanisms of congenital cytomegalovirus infection development

Case report: congenital cytomegalovirus infection

Cytomegalovirus infection in immunocompetent pregnant women: clinical manifestations and management tactics

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