Comparative Serial Virologic and Serologic Studies of Symptomatic and Subclinical Congenitally and Natally Acquired Cytomegalovirus Infections

Abstract

Infants with congenitally (38) and natally (17) acquired cytomegalovirus infection were prospectively studied by means of virologic and multiple serologic assays. These infections were characterized by chronic viral excretion (measured in years). The quantity of virus excreted in the urine during early infancy was significantly greater in infants who acquired infection in utero, particularly amon those born with overt disease; thereafter, all three groups (congenital symptomatic, congenital asymptomatic, and natal) excreted similar amounts of virus. The patterns of antibody responses, particularly the fluorescent antibody response to the early antigen and the complement-fixing antibody response, further indicated that congenitally infected infants (especially symptomatic ones) bear a greater antigenic burden than do natally infected infants. From a diagnostic standpoint, the test for fluorescent antibody to the late antigen was the most sensitive assay, whereas the test for complement-fixing antibody proved to be the least useful, The indirect hemagglutination assay, although performed only in infants with natal infection, was only slightly less sensitive than the fluorescent antibody procedure; by the former technique, diagnostic rises were detected in all but one infant after the onset of viruria.

The status of CMV as a human pathogen

“…Disease correlates with high viral titres (Stagno et al 1975). No clear dissociation has been shown between damage to the ear or brain and it must remain likely that both organs can be affected by virus lysis although immunopathological processes can also be implicated (Griffiths et al 1982).…”

“…It may be unilateral or bilateral and may be profound (Hanshaw, Dudgeon & Marshall, 1985;Pass et al 1980). Children with high CMV titres in the urine are at increased risk of hearing loss (Stagno et al 1975) but immunopathological processes may also be involved (Griffiths et al 1982).…”

Longitudinal fluctuations in cytomegalovirus load in bone marrow transplant patients: relationship between peak virus load, donor/recipient serostatus, acute GVHD and CMV disease

“…18 In other patient populations at risk of HCMV disease, quantification of HCMV load has provided another risk factor for HCMV disease. Specifically, cross-sectional and longitudinal studies have indicated the importance of monitoring HCMV load in congenitally infected infants, 19 renal transplant recipients [20][21][22] and HIV infected patients. 23,24 There is, however, a paucity of information on longitudinal fluctuations in cytomegalovirus load in the bone marrow transplant patient.…”

On the Possibilities of Laboratory Verification of Cytomegalovirus Infection in Children

“…Возможная зависимость между цитомегаловирус-ассоциированным заболе-ванием и вирусной нагрузкой описана еще в 1975 г. в работах S. Stagno и соавт., использовавших куль-туру клеток [28]. Эти данные были впоследствии подтверждены S.Walter и соавт.…”