Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy

Rawlinson, William D.; Boppana, Suresh B.; Fowler, Karen B.; Kimberlin, David W.; Lazzarotto, Tiziana; Alain, Sophie; Daly, Kate; Doutre, Sara Menlove; Gibson, Laura; Giles, Michelle; Greenlee, Janelle; Hamilton, Stuart T.; Harrison, Gail J.; Hui, Lisa; Jones, Cheryl; Palasanthiran, Pamela; Schleiss, Mark R.; Shand, Antonia; Zuylen, Wendy J. van

doi:10.1016/s1473-3099(17)30143-3

Cited by 632 publications

(825 citation statements)

References 132 publications

Supporting

Mentioning

707

Contrasting

Unclassified

Order By: Relevance

“…Noise exposure from sustained headphone use shows inconsistent associations especially at younger ages with likely individual differences in susceptibility to noise-induced hearing loss 34 35. Other avenues of exploration include risk factors for non-communicable diseases (eg, inflammation and adiposity as outlined in the Introduction),12–15 36 ear diseases (eg, otitis media), infections (eg, congenital cytomegalovirus)37 and genetics (eg, late-onset genetic losses, polygenic influences and mitochondrial DNA mutations) 38. Trials are needed to determine whether reducing the effects of slight and mild hearing losses (eg, school building design, sound field systems, teaching styles) improve functional and learning outcomes 39.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

et al. 2018

View full text Add to dashboard Cite

show abstract

“…More research is necessary to determine the dose effect and viral clearance after valganciclovir in very premature infants. In the literature there's agreement to start antiviral treatment in infants with a symptomatic congenital CMV disease [16], but treatment of asymptomatic congenital or postnatal CMV is still controversial and under debate. Nevertheless, 7.2% -21% infants with an asymptomatic congenital infection will have permanent sequelae, predominantly sensorineural hearing loss [1] [20].…”

Section: Discussionmentioning

confidence: 99%

Toxicity and Viral Load in Urine during Valganciclovir Therapy in Premature Infants

Boesveld¹,

Straaten²,

Hemels³

2017

View full text Add to dashboard Cite

Cytomegalovirus (CMV) infection is the most important cause of mental retardation and sensorineural hearing loss. Antiviral treatment with valganciclovir, a relatively new but potential toxic oral drug, is recommended to prevent further hearing deterioration. In this retrospective cohort study we evaluated the relation between the dose of valganciclovir and the reduction of CMV viral load, as well as the toxicity. All neonates with gestational age <32 weeks with CMV infection treated with oral valganciclovir (30 mg/kg/day) were included. Time interval to reach CMV viral load below detection level (<250 copies/ml) was determined. Toxicity was measured by plasma trough levels, thrombocytopenia and leukopenia. Data of 6 infants, median gestational age 252 weeks, were analyzed. Time interval between start of therapy and viral load below detection level was 25 -54 days. In total, 37 through plasma samples were analyzed. Of these, 28 were in the normal range, 3 above and 6 under the target concentration. Mild transient leukopenia occurred in 1 infant. No thrombocytopenia occurred. Conclusion: Antiviral treatment of CMV infection with oral valganciclovir results in adequate plasma through levels. Also, a progressive reduction of viral load in the urine below detection level was reached within 25 -54 days, without serious short time side effects.

show abstract

“…The diagnosis of CMV infection can be performed in the following ways: (a) exclusion of congenital CMV infection—urine CMV‐DNA test was performed at admission, and there was no definite infection <2 weeks after birth; (b) BM CMV(+)—CMV‐DNA > 500 copies/mL in the BM fed to pathologically jaundiced infants was detected by real‐time fluorescence quantitative polymerase chain reaction( RT‐FQ‐PCR); (c) BM‐acquired CMV infection—after 2 weeks of CMV(+) BM feeding in non‐congenital CMV infection infants, CMV infection was indicated by positive plasma CMV‐DNA, peripheral blood mononuclear cell (PBMC) CMV‐DNA, urine CMV‐DNA, or serum CMV‐IgM; (d) CMV‐IgM test—performed with a fully automatic chemiluminescence analyzer and matching reagents (Liaison); (e) CMV‐DNA test—the reagents (Hunan Sansure Biotech Inc) and RT‐FQ‐PCR method (ABI 7500 fluorescence PCR amplifier; Applied Biosystems) were used; CMV‐DNA was extracted, amplified, and analyzed strictly according to the procedures stipulated in the kit manual; and (f) a positive result was defined as a typical S growth curve of CMV‐DNA, and the laboratory results showed CMV‐DNA > 500 copies/mL; otherwise, the result was negative. CMV‐IgM ≥ 18 U/mL indicated positive, and CMV‐IgM < 18 U/mL indicated negative.…”

Section: Methodsmentioning

confidence: 99%

“…As a weak pathogen, CMV is not usually pathogenic in the population with normal immune function, and most cases of CMV infection are asymptomatic. CMV generally causes serious consequences in the immunosuppressed population, particularly fetuses and neonates with developmental immunodeficiencies . CMV infection is frequently seen in mothers, and CMV can be excreted via breastmilk (BM) in 13%‐27% of cases.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of breastmilk‐acquired cytomegalovirus infection in jaundiced infants

Hou¹,

Liu²,

Fan³

et al. 2020

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background Our objective was to evaluate the prevalence and different diagnostic methods of breastmilk (BM)‐acquired cytomegalovirus (CMV) infection in a pathologically jaundiced cohort. Methods A total of 400 infants confirmed with pathological jaundice at The People's Hospital of Qingyang City were screened for BM‐acquired CMV infection between February 2018 and February 2019. A total of 300 infants were finally enrolled in our study. CMV infection was confirmed by detecting both CMV‐DNA in various samples using FQ‐PCR and CMV‐IgM with chemiluminescence. Clinical and other laboratory data were collected from these infants during their hospitalization or regular visits. Results Ninety‐eight (32.67%) subjects were confirmed to be BM CMV‐DNA–positive, and 18 (18.37%) were diagnosed with a BM‐acquired CMV infection. All 18 (100%) infants with a BM‐acquired CMV infection were CMV‐DNA–positive in urine, while 5 (27.78%) cases and 11 (61.11%) cases were confirmed in plasma and peripheral blood mononuclear cells (PBMCs), respectively. Only 6 (33.33%) infants were CMV‐IgM–positive. Birthweight, direct bilirubin, aspartate aminotransferase, and the viral load in BM of the BM‐acquired CMV group were higher than those in the non‐infected group (P < .05). Low birthweight and viral load in BM were risk factors for BM‐acquired CMV infection. Detecting CMV‐DNA in urine samples exhibited better performance than the other methods for screening BM‐acquired CMV infections. Conclusions Our study found a high prevalence of BM‐acquired CMV infection in jaundiced infants, and detecting CMV‐DNA in a urine sample was the most sensitive method for disease screening.

show abstract

Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy

Cited by 632 publications

References 132 publications

Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

Cross-sectional epidemiology of hearing loss in Australian children aged 11–12 years old and 25-year secular trends

Toxicity and Viral Load in Urine during Valganciclovir Therapy in Premature Infants

High prevalence of breastmilk‐acquired cytomegalovirus infection in jaundiced infants

Contact Info

Product

Resources

About