Cytomegalovirus DNA detection in pregnant women with a high IgG avidity index: a valuable tool for diagnosing non-primary infections?

Karageorgou, Ioulia; Kossyvakis, Athanasios; Jiménez, Juan; García, Irene; Mentis, Alexios‐Fotios A.

doi:10.1080/14767058.2022.2038130

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…IgM testing during pregnancy may result in false-positive results, especially due to cross-reactions with other viruses, such as Epstein–Barr, herpes simplex, and varicella-zoster, or autoimmune diseases [ 25 , 26 ]. If IgM antibodies are present, DNA PCR detection, IgG, and IgG antibody avidity must be investigated [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

An Overview of Cytomegalovirus Infection in Pregnancy

et al. 2022

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The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital infection. General information regarding this viral infection and potential related medical conditions was provided, considering the issues of maternal infection during pregnancy, transmission to the fetus, and associated congenital infection management. Prenatal diagnosis includes maternal serum testing and the confirmation of the infection in amniotic fluid or fetal blood. Additionally, prenatal diagnosis requires imaging techniques, ultrasound, and complementary magnetic resonance to assess cortical and extracortical anomalies. Imaging findings can predict both fetal involvement and the postnatal prognosis of the newborn, but they are difficult to assess, even for highly trained physicians. In regard to fetal sequelae, the early diagnosis of a potential fetal infection is crucial, and methods to decrease fetal involvement should be considered. Postnatal evaluation is also important, because many newborns may be asymptomatic and clinical anomalies can be diagnosed when sequelae are permanent.

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Section: Resultsmentioning

confidence: 99%

An Overview of Cytomegalovirus Infection in Pregnancy

et al. 2022

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Cytomegalovirus antibody level and progression of chronic heart failure

Shilov,

Berezikova,

Mayanskaya

et al. 2024

Sibirskij nauchnyj medicinskij zhurnal

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This study demonstrates the relationship between IgG titer to cytomegalovirus (CMV) and the proinflammatory cytokine TNF-α and IL-1β concentration, the prognosis after hospitalization of patients due to decompensation of chronic heart failure (CHF) during 24 months of observation. Material and methods. We examined 132 patients with CHF of ischemic etiology (age 59.0 [54.0; 63.5] year, median [lower quartile; upper quartile]), hospitalized for CHF decompensation. Patients were included in the study after stabilization of CHF decompensation before discharge from the hospital. Subsequently, patients were prospectively monitored for 24 months. Upon inclusion in the study, TNF-α, IL-1β plasma concentration was determined, before discharge from the hospital and after 24 months – the titer of IgG antibodies to CMV. Results. The titer of IgG to CMV in the cohort of patients was 1356 [835; 1931] units/ml. Patients were divided into tertiles 1, 2 and 3 with an antibody titer of less than 923, from 923 to 1811 and more than 1811 units/ml, respectively (44 persons in each group). Individuals from the tertile 3 group were more likely to have IV functional class CHF (p = 0.025), and also had a higher content of pro-inflammatory cytokines (p = 0.001 for TNF-α and p = 0.019 for IL-1β), and the number of hospitalizations due to decompensation of CHF, worsening functional class of CHF and deaths during 24 months of observation than in patients of tertile 1. Conclusions. With an increased level of IgG to CMV in patients with CHF, there is an increase in the concentration of pro-inflammatory cytokines and the risk of adverse cardiovascular events within 24 months after an episode of CHF decompensation compared to patients with lower antibody levels. The activity of the inflammatory process, which is influenced by CMV infection, on the background of immunosuppression in patients with CHF, is likely an important trigger for the progression of cardiovascular pathology and mortality.

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Cytomegalovirus-Specific Hyperimmune Immunoglobulin Administration for Secondary Prevention after First-Trimester Maternal Primary Infection: A 13-Year Single-Center Cohort Study

Karofylakis,

Thomas,

Kavatha

et al. 2024

Viruses

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Primary cytomegalovirus infection during pregnancy has a high risk of vertical transmission, with severe fetal sequelae mainly associated with first-trimester infections. We conducted a retrospective analysis of 200 IU/kg cytomegalovirus-specific hyperimmune globulin (HIG), used in first-trimester maternal primary infections for congenital infection prevention. The primary outcome was vertical transmission, defined as neonatal viruria or positive amniocentesis if pregnancy was discontinued. HIG, initially administered monthly and since 2019 biweekly, was discontinued in negative amniocentesis cases. Women declining amniocentesis and positive amniocentesis cases with normal sonography were offered monthly HIG until delivery as a treatment strategy. The total transmission rate was 29.9% (32/107; 10 pregnancy terminations with positive amniocentesis, 18 completed pregnancies with positive amniocentesis and 4 declining amniocentesis). Maternal viremia was the only factor associated with fetal transmission (OR 4.62, 95% CI 1.55–13.74). The transmission rate was not significantly different whether HIG was started during the first or second trimester (28.2% vs. 33.3%; p = 0.58), or between monthly and biweekly subgroups (25.7% vs. 37.8%, p = 0.193). Pre-treatment maternal viremia could inform decisions as a predictor of congenital infection.

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Cytomegalovirus DNA detection in pregnant women with a high IgG avidity index: a valuable tool for diagnosing non-primary infections?

Cited by 3 publications

References 30 publications

An Overview of Cytomegalovirus Infection in Pregnancy

An Overview of Cytomegalovirus Infection in Pregnancy

Cytomegalovirus antibody level and progression of chronic heart failure

Cytomegalovirus-Specific Hyperimmune Immunoglobulin Administration for Secondary Prevention after First-Trimester Maternal Primary Infection: A 13-Year Single-Center Cohort Study

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