Antiviral treatment in congenital HCMV infection: The six-year experience of a single neonatal center in Poland

Jedlińska-Pijanowska, Dominika; Czech‐Kowalska, Justyna; Kłodzińska, Magdalena; Pietrzyk, Aleksandra; Michalska, E.; Gradowska, Kinga; Dobrzańska, Anna; Kasztelewicz, Beata; Gruszfeld, Dariusz

doi:10.17219/acem/125427

Cited by 6 publications

(4 citation statements)

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“…A previous study indicated that the efficacy of valganciclovir was the same as that of ganciclovir in CCMVI, and that valganciclovir monotherapy allowed for shorter hospital stays. 5 The present report suggests, for the first time, that oral valganciclovir therapy might be a useful alternative to intravenous ganciclovir therapy in neonates with CMVP, if they can tolerate enteral feeding. The accumulation of similar neonatal cases is needed to estimate the efficacy of oral valganciclovir therapy for CCMVP.…”

mentioning

confidence: 64%

Valganciclovir therapy for a neonate with congenital cytomegalovirus pneumonitis

Kanda

Shimizu

Hoshina

et al. 2021

Pediatrics International

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mentioning

confidence: 64%

Valganciclovir therapy for a neonate with congenital cytomegalovirus pneumonitis

Kanda

Shimizu

Hoshina

et al. 2021

Pediatrics International

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“…In the nineties, treatment consisted of intravenous ganciclovir. As the oral bioavailability of ganciclovir is too low, it should be administered intravenously, which entails a higher risk of infections 37,38 . Given the complications and logistical challenges associated with long‐term intravenous access, the need for oral administration resulted in the use of valganciclovir.…”

Section: Discussionmentioning

confidence: 99%

“…As the oral bioavailability of ganciclovir is too low, it should be administered intravenously, which entails a higher risk of infections. 37,38 Given the complications and logistical challenges associated with long-term intravenous access, the need for oral administration resulted in the use of valganciclovir. Over the years, not only a change in route of administration has occurred but treatment has also been prolonged.…”

Section: Discussionmentioning

confidence: 99%

The Effect of (Val)ganciclovir on Hearing in Congenital Cytomegalovirus: A Systematic Review

et al. 2022

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Objective To search for existing evidence of a beneficial effect of (val)ganciclovir on hearing in children with congenital cytomegalovirus (cCMV) infection and to identify future research questions. Study Design Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, searches were performed in PUBMED, EMBASE, and WEB OF SCIENCE on December 15, 2021. Methods Studies providing ear‐specific hearing results after treating children with cCMV‐related hearing loss with (val)ganciclovir were retained. A meta‐analysis [Peto odds ratio (OR), Review Manager 5.3] was performed to compare hearing outcome between treated and untreated children. The National Institutes of Health tool was used for quality assessment and heterogeneity was assessed with I2 statistics. Results Eighteen studies with a total of 682 treated patients were included for the systematic review. Our meta‐analysis showed that treating symptomatic children with hearing loss resulted in more hearing improvement [Peto OR 7.72, 95% confidence interval (CI) 3.08–19.34] and less hearing deterioration (Peto OR 0.23, 95% CI 0.10–0.57). Relative to an improvement and deterioration rate of 9.4% and 28.2% in an untreated group, the rate of the treated group was 44.5% and 6.3%, respectively. Conclusions There is sufficient evidence in literature to support treatment with (val)ganciclovir of children with symptomatic cCMV and hearing loss. However, still today, there is insufficient evidence of the potential beneficial role of (val)ganciclovir on hearing outcome of children with isolated hearing loss, late‐onset hearing loss, and asymptomatic cCMV. The urgent need for future prospective, randomized clinical trials still exists. A standardization of definitions and treatment protocols would create uniformity in future studies. Laryngoscope, 132:2241–2250, 2022

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“…Demonstration of HCMV DNA has emerged as the diagnostic criteria for HCMV infection [16], for PCR assays' high sensitivity and specificity. In particular, quantification of the HCMV DNA copies is a powerful means for assaying viral activity, evaluating antiviral efficacy, and determining the severity of infection [13,17]. Blood, urine, and saliva can be used as samples for PCR screening of HCMV DNA, but their detection rates are different [14].…”

Section: Introductionmentioning

confidence: 99%

Human cytomegalovirus glycoprotein B genotypic distributions and viral load in symptomatic infants

Mu,

Qiao,

Zou

et al. 2023

J Infect Dev Ctries

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Introduction: HCMV infection is widespread in humans. This retrospective study aimed to explore the relationship between human cytomegalovirus (HCMV) glycoprotein B (gB) genotype distribution, viral load, and the demographic and clinical features of symptomatic infants. The detection rate of HCMV in blood and urine samples was also compared. Methodology: Retrospective data from 265 infants who underwent urine HCMV DNA testing were analyzed. The viral load and gB genotype were detected in 91 HCMV positive infants by quantitative fluorescence polymerase chain reaction (PCR) and DNA sequencing, respectively. Results: The positive rate of HCMV infection was 46.04% (122/265) in all infants, and increased rapidly with age. Among the 91 infants investigated, liver function abnormality was the most common diagnosis (34/91, 37.36%), followed by pneumonia (21/91, 23.07%). Sequence analysis of gB yielded two genetic subtypes: the most prevalent gB3 (47/91, 51.65%), followed by gB1 (44/91, 48.35%). The gB3 HCMV infection was more prevalent in infants aged 0-2 months than in infants aged 3-12 months (χ2 = 4.38, p = 0.0364). The data showed that ALT and AST levels were significantly higher in the anti-HCMV IgM+IgG– group than in the anti-HCMV IgM+IgG+ and IgM-IgG+ groups. In addition, this study showed that the detection rate of HCMV DNA in the blood was significantly lower than that in the urine (χ2 = 6.7131, p = 0.0096). Conclusions: This study presents the HCMV infection status of infants and its relationship with their demographic characteristics and clinical manifestations. In addition, this study suggests that urinary PCR is the most appropriate assay for detecting HCMV infections.

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Antiviral treatment in congenital HCMV infection: The six-year experience of a single neonatal center in Poland

Cited by 6 publications

References 0 publications

Valganciclovir therapy for a neonate with congenital cytomegalovirus pneumonitis

Valganciclovir therapy for a neonate with congenital cytomegalovirus pneumonitis

The Effect of (Val)ganciclovir on Hearing in Congenital Cytomegalovirus: A Systematic Review

Human cytomegalovirus glycoprotein B genotypic distributions and viral load in symptomatic infants

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