The Outcome of Congenital Cytomegalovirus Infection in Relation to Maternal Antibody Status

Abstract

The presence of maternal antibody to CMV before conception provides substantial protection against damaging congenital CMV infection in the newborn. Primary maternal infection during pregnancy is associated with more severe sequelae of congenital CMV infection.

RhoB is a component of the human cytomegalovirus assembly complex and is required for efficient viral production

“…1,2 HCMV infection in pregnant women is also the leading viral cause of congenital abnormalities and mental retardation in newborns. 3,4 HCMV pathogenesis largely depends on the effect of the viral proteins on the host cell.…”

Human Cytomegalovirus Promotes Survival of Infected Monocytes via a Distinct Temporal Regulation of Cellular Bcl-2 Family Proteins

“…In contrast, HCMV infection leads to significant morbidity and mortality in the immunocompromised. HCMV is an important opportunistic pathogen in AIDS patients (16)(17)(18)(19)(20), is a leading infectious cause of complications in transplant recipients (21-28), and causes severe neurological disease in congenitally infected neonates (29)(30)(31)(32)(33)(34).HCMV pathogenesis and disease result from viral spread to multiple organ sites following primary HCMV infection, a process which appears to be a critical step in the viral persistence strategy, as it allows for the establishment of lifelong persistence within the host, as well as for viral shedding and spread to additional hosts (1,35,36). Monocytes are the primary blood-borne targets for HCMV infection and are thought to be centrally involved in the hematogenous dissemination of the virus to target organ systems (37-41).…”

“…In contrast, HCMV infection leads to significant morbidity and mortality in the immunocompromised. HCMV is an important opportunistic pathogen in AIDS patients (16)(17)(18)(19)(20), is a leading infectious cause of complications in transplant recipients (21)(22)(23)(24)(25)(26)(27)(28), and causes severe neurological disease in congenitally infected neonates (29)(30)(31)(32)(33)(34).…”

Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection — United States, August 2016

“…Infants with abnormalities on initial hearing screen should be referred to an audiologist for a complete evaluation. Later development of hearing loss in infants without other clinical findings has been observed in other congenital infections (15); however, the likelihood that an infant with congenital Zika virus infection without clinical findings consistent with congenital Zika syndrome and with an initial normal hearing screen will develop hearing loss is unknown. ABR testing of infants at age 4-6 months can be considered, although the risk from sedation needs to be taken into account.…”

“…Families and caregivers will also need regarding outcomes associated with congenital Zika virus infection. Infants with congenital infections, such as cytomegalovirus (CMV) and rubella, can develop a range of clinical manifestations, including hearing loss, seizures, neurodevelopmental delays and diabetes mellitus later in life (15,16), even without apparent clinical manifestations of congenital infection at birth (17).…”