Ganciclovir therapy of congenital human cytomegalovirus hepatitis

Stronati, Mauro; Mg, Revello; Cerbo, Rosa Maria; Furione, Milena; Rondini, G; Gerna, Giuseppe

doi:10.1111/j.1651-2227.1995.tb13641.x

Cited by 24 publications

(8 citation statements)

References 7 publications

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“…The use of ganciclovir therapy for congenital CMV infection and disease has generally been reported to be safe and well-tolerated, and has appeared to be useful in ameliorating the severity of focal, endorgan disease, including pneumonitis and hepatitis. [16][17][18][19][20][21][22][23] We therefore strongly recommend that ganciclovir therapy should be used in the setting of life-threatening CMV infection, particularly when end-organ disease is documented by culture or histopathologic analysis. Ganciclovir therapy was initiated relatively late in the course of the infant described in this report, in part because the role of CMV as an etiologic agent for the fetal hydrops was not suspected until the infant was several days of age, and had been clearly demonstrated to have other stigmata of congenital CMV infection, including hepatic, hematologic, and neurologic disease.…”

Section: Discussionmentioning

confidence: 99%

Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant

et al. 2005

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We report a case of fatal congenital cytomegalovirus (CMV) disease in a 695 gm, 29 weeks estimated gestational age premature infant. The newborn presented with hydrops fetalis, an unusual presentation of congenital CMV infection. In spite of ganciclovir therapy, the infant succumbed to his illness. Autopsy findings revealed the presence of widespread CMV disease, including pneumonitis, enteritis, and myocarditis. Congenital CMV infection should be considered in the differential diagnosis of hydrops fetalis.

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Section: Discussionmentioning

confidence: 99%

Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant

et al. 2005

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“…However, in all studies a reduction in or temporary cessation of virus excretion was observed during therapy. In a case of ganciclovir therapy of congenital HCMV hepatitis, viremia was the first parameter to become negative, followed by antigenemia during the first 2 weeks of treatment (271). Clearance of virus from urine required an additional week of treatment.…”

Section: Treatment Of Congenital Infectionmentioning

confidence: 99%

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

2002

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Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy

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“…We further identified 13 case reports, comprising 16 children in all [1,3,11,13,14,18,26,29,30,32,[34][35][36], three case series [19,28,33] together including 20 patients, and present data from two larger studies, comparing different treatment regimens.…”

Section: Resultsmentioning

confidence: 97%

Selecting neonates with congenital cytomegalovirus infection for ganciclovir therapy

et al. 2006

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All reported patients presented with central nervous system manifestation of CMV infection. Only the randomized controlled study showed a reduction of hearing deterioration in the treated group. Published predictors of hearing loss in congenitally CMV infected children allow identification of candidates that might benefit from treatment. Studies so far are promising but of insufficient number to make evidence based recommendations about indications for treatment of congenital CMV. As such, studies are very difficult to conduct and treatment of infants at high risk of hearing loss may appear justified. There is scientific data to help clinicians in selecting a subgroup of infants that is at higher risk of hearing deterioration and therefore might benefit the most from ganciclovir therapy.

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Ganciclovir therapy of congenital human cytomegalovirus hepatitis

Cited by 24 publications

References 7 publications

Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant

Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

Selecting neonates with congenital cytomegalovirus infection for ganciclovir therapy

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