Congenital Cytomegalovirus infection: advances and challenges in diagnosis, prevention and treatment

Abstract

Cytomegalovirus (CMV) is the most frequent cause of congenital infection worldwide, with an estimated incidence in developing countries of 0.6–0.7% of all live births. The burden of disease related to congenital CMV in substantial, as it is the leading non-genetic cause of sensorineural hearing loss and an important cause of neurodevelopmental disabilities in children. Despite its clinical significance, congenital CMV infection often goes undetected because the majority of infected infants are asymptomatic at birth and screening programs have not been substantially implemented. Other than behavioral measures, effective interventions aimed at the prevention of maternal infection and of mother-to-child transmission are lacking. Due to a convergence of recent advances in both diagnostic and therapeutic strategies in infants with congenital CMV, though, the field likely will be changing rapidly over just the next few years. Specifically, a highly-sensitive screening test with high throughput potential has been developed, and treatment of infants symptomatically infected with congenital CMV has proven to be well-tolerated and effective in improving long-term hearing and neurodevelopmental outcomes.This review highlights the clinical importance of congenital CMV infection, the developments in laboratory diagnostics, and the benefits of antiviral therapy. It also identifies the global efforts still required in the prevention of maternal infection and in the optimization of antiviral therapy to further reduce the burden of congenital CMV disease.

Congenital Cytomegalovirus Infection Diagnosis Case 24 Years Later While Following With The Cerebral Palsy Diagnosis

“…Since the incidence of congenital CMV infection parallels maternal seroprevalence, the estimated incidence in developing countries is even higher, between 1 and 5% of all live births [4]. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children [5].…”

“…The presentation in this latter group is a continuum of disease expression whose more common findings are petechiae, jaundice, hepatomegaly, splenomegaly, microcephaly, and other neurologic signs. Laboratory and imaging findings include thrombocytopenia, transaminitis, and direct hyperbilirubinemia, chorioretinitis, and neuroimaging abnormalities indicative of central nervous system (CNS) involvement [4]. 70% of the congenital CMV infection cases are reported that they may have microcephaly, and that half of these cases may have periventricular calcifications in Brain CT [8].…”

“…CMV is a highly prevalent infectious agent in the general population, and the rates of the cero positivity in adult women range from between 40% (in most European countries) and 90% (in most African and Asian countries) [2,3]. Congenital CMV infection cases constitute only 5% to 10%, and are asymptomatic in birth with the diagnosis of preterm births i.e., 5-10, intrauterine, microcephaly, chorioretinitis, hepatomegaly, splenomegaly, sensorineural hearing loss, hyperbilirubinemia, retardation in liver functioning tests and petechiae [4]. This study presents a 24-year-old male case diagnosed with congenital CMV infection while following the patient with the case of cerebral palsy, mental retardation and epilepsy diagnosis.…”

Cytomegalovirus Infection in Infants: Course Variants, Modern Approaches to Therapy (Clinical Cases)

“…Это одна из наиболее частых из диагностируемых внутриутробных инфекций: про-тективные антитела к вирусу ЦМВИ обнаруживаются у 80% населения старше 35 лет, что свидетельствует о перенесенной подавляющим большинством латентной (бессимптомной) форме этой инфекции [1]. По другим данным, удельный вес серопозитивных матерей (имею-щих протективные антитела) среди социально незащи-щенных слоев населения достигает 100% [2,3]. Тяжелые генерализованные формы ЦМВИ отмечаются только у иммунокомпрометированных пациентов (новорожден-ные при внутриутробном трансплацентарном зараже-нии, дети первых месяцев жизни, пациенты, получающие иммунодепрессанты).…”

“…Тяжелые генерализованные формы ЦМВИ отмечаются только у иммунокомпрометированных пациентов (новорожден-ные при внутриутробном трансплацентарном зараже-нии, дети первых месяцев жизни, пациенты, получающие иммунодепрессанты). Не исключается интранатальное инфицирование (наличие вируса в вагинальном секрете) [1,2]. При постнатальном инфицировании возможны контактный или алиментарный (в т.ч.…”