Transfusion-related Cytomegalovirus Infection Among Very Low Birth Weight Infants in an Endemic Area

Abstract

This study investigated the incidence of acquired cytomegalovirus (CMV) infection in very low birth weight infants (VLBWI) given CMV seropositive blood, and sought to determine whether filtering and irradiation of blood products could help prevent CMV infection and the time required to clear passively-derived anti-CMV IgG among 80 VLBWI transfused with filtered-irradiated blood, 20 VLBWI transfused with nonfiltered-nonirradiated blood and 26 nontransfused VLBWI. CMV IgG and IgM values were obtained from all blood products prior to transfusions, and from VLBWI at birth until the infants became seronegative. Urine was obtained for CMV culture at birth and every 3-4 weeks until 12 weeks after the final transfusion. The incidence of CMV IgG seropositivity among the 126 infants at birth and the blood products given were 96% and 95%, respectively. The incidence of acquired CMV infection was 4/100 (4%) in the transfused group: 2/80 (2.5%) and 2/20 (10%) in the filtered-irradiated and nonfiltered-nonirradiated transfusion groups, respectively. Approximately 9-10 months elapsed to clear passively acquired CMV IgG. The irradiation and filtering of the blood products did not seem to decrease the transfusion-related CMV infection rate in Korea among VLBWI, however, further validation is recommended in a larger cohort of infants.

Infectious Causes of Necrotizing Enterocolitis

“… 151 , 152 Given their immunocompromised status, premature infants are at particular risk for postnatal infection from breast milk (transmission rates 5%–37%) 153 , 154 , 155 or via transfused blood products. 156 , 157 , 158 , 159 Among immunocompromised patients, CMV enteritis is common and marked by diarrhea, hematochezia, and toxic megacolon. 160 In infants, however, CMV enteritis is unusual; the virus is a disputed player in the development of NEC.…”

Assignment of cytomegalovirus infection status in infants awaiting solid organ transplant: Viral detection methods as adjuncts to serology

“…The CMV OD data from our cohort suggest that passive maternal CMV IgG clears before 12 months, as the CMV‐seropositive infants in the 12‐ to 18‐month group all had higher OD values (>1 AU/mL) which would be expected with true CMV infection as opposed to with waning passive maternal antibody, and had median CMV OD that was very similar to our comparison group of seropositive adult blood donors. A study of 121 CMV seropositive very low birthweight preterm Korean infants documented a mean age of sero‐reversion of 5.5 months, with 97.5% of infants becoming seronegative by 10 months of age, but these results may not be generalizable to full‐term infants who would be expected to have a higher CMV IgG titer at birth . A Chinese study investigating the kinetics of CMV IgG levels in serial samples in 40 infants born to CMV‐seropositive mothers found that 8 infants cleared maternal CMV IgG between 3.5 and 8 months of age, and the other 32 infants had decreasing levels of CMV IgG over the first 3.5 months and then had significantly higher levels at 8 months, consistent with true infection prior to 8 months of age .…”

Resistin Effect on HCT-116 Colorectal Cancer Cells Proliferation and Telomerase Expression

“…Abovementioned strategies seem appropriate, although, some even speculate that these strategies cannot prevent reactivation of preexisting CMV in recipients, especially in immunosuppressed patients (12).…”