Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: A two-regimen experience

Nigro, Giovanni; Scholz, Horst; Bartmann, U.

doi:10.1016/s0022-3476(94)70327-2

Cited by 123 publications

(59 citation statements)

References 23 publications

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“…Gancivlovir has been studied for symptomatic infants in order to reduce sequels as chorioretinitis, thrombocytopenia and anemia. Greater benefits are proved to be related to hearing improvement, although doses and duration of treatment are not already defined [25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Prognostic markers of symptomatic congenital cytomegalovirus infection

Romanelli¹,

Jf²,

Jacquemard³

2008

Braz J Infect Dis

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The objective of this research was to identify maternal and fetal characteristics as prognostic markers of congenital cytomegalovirus (CMV) infection. This is a descriptive study of 13 cases of congenital CMV infection referred to Institute de Puericulture et Perinatologie de Paris (IPP) from January 2005 to October 2006. Amniotic fluid puncture was performed to research CMV polimerase chain reaction (PCR). Cordocentesis and cord blood samples at delivery were also analyzed to determinate fetal platelets count, GGT, ASAT, ALAT, CMV-DNA and IgM antibody. Variables of symptomatic and asymptomatic infants were then compared. Data were analyzed by SPSS -15.0. Mean gestational age of amniocentesis was 24.6 weeks and there was no difference of mean viral load in amniotic fluid considering infant features. Mean gestational age of cordocentesis was 26.1 weeks. There were no statistical differences of fetal viral load, IgM, platelets, GGT, ASAT and ALAT analyzed at cordocentesis samples, but at delivery, mean values of IgM and ASAT of fetal blood were increased in symptomatic ones (p= 0.03 for both parameters). When considering groups with normal and abnormal parameters, ASAT of cordon samples was also increased in symptomatic infants (p= 0.02). Sensibility, specificity, positive and negative predictive value of fetal ultrasound anomalies to detect symptomatic infants were, respectively, 80%, 62.5%, 57.1% and 83.3%. Thus, identification of markers of CMV symptomatic infants should be aimed. Prenatal diagnosis, identification and follow up of congenital CMV infected infants are important to consider treatment for symptomatic infants, trying to avoid or reducing some possible sequels.

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Section: Discussionmentioning

confidence: 99%

Prognostic markers of symptomatic congenital cytomegalovirus infection

Romanelli¹,

Jf²,

Jacquemard³

2008

Braz J Infect Dis

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“…The first reports of the use of ganciclovir therapy for congenital CMV infection date to the late 1980s (75,206). In subsequent reports (16,60,76,117,124,175,185,186,220,272), ganciclovir has been shown to be generally safe and well tolerated when used in newborns and has appeared to be useful in the management of severe, focal end-organ disease (pneumonitis, hepatitis, etc.) in infants.…”

Section: Interventions Antiviral Drugsmentioning

confidence: 99%

Neuropathogenesis of Congenital Cytomegalovirus Infection: Disease Mechanisms and Prospects for Intervention

2009

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SUMMARY Congenital cytomegalovirus (CMV) infection is the leading infectious cause of mental retardation and hearing loss in the developed world. In recent years, there has been an improved understanding of the epidemiology, pathogenesis, and long-term disabilities associated with CMV infection. In this review, current concepts regarding the pathogenesis of neurological injury caused by CMV infections acquired by the developing fetus are summarized. The pathogenesis of CMV-induced disabilities is considered in the context of the epidemiology of CMV infection in pregnant women and newborn infants, and the clinical manifestations of brain injury are reviewed. The prospects for intervention, including antiviral therapies and vaccines, are summarized. Priorities for future research are suggested to improve the understanding of this common and disabling illness of infancy.

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“…The relative resistance of gpCMV to ganciclovir compared with human CMV8 has made interpretation of the clinical relevance of such studies problematic. There is an increasing amount of evidence that antiviral treatment against CMV is beneficial and can improve the hearing [64][65][66] . Combination treatment consisting of prednisone and acyclovir resulted in an earlier hearing recovery and less extensive cochlear destruction than either of the drugs alone [67] .…”

Section: Drug Treatmentmentioning

confidence: 99%

Do Viruses Cause Inner Ear Disturbances?

Pyykkö

Zou

2008

ORL

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The association of viral infection to inner ear disease is controversial. Experiments on animals show that several viruses are capable of causing hearing loss, if applied into the perilymph. Some of these have specific affinity to the cellular type of the inner ear, as sensory epithelia and cochlear nerve. Some viruses as adenoviruses and Coxsackie virus B have specific CAR receptors that are identified in different cell types, whereas other act by attaching onto nonspecific cellular surface receptors. Some viruses such as varicella zoster virus (VZV) do not cause disease in rodents. We assessed 273 patients with clinical, serological, neuro-otologic and endoscopic evaluations. Of the 273 patients, 43 served as control subjects. The patients either had Ménière’s disease (n = 158), recurrent vertigo of unknown etiology (n = 56), or hearing loss (n = 17). Antibodies against neurotropic and common viruses were evaluated. VZV, influenza B, CBV5 and RSV titers were significantly elevated in patients with inner ear disease when compared with the control group. In analyzing the internal relationship, VZV and influenza B were intercorrelated. We did not find a correlation between hearing loss and viral titers. In conclusion, VZV, Coxsackie virus B5 and influenza B virus may be the main causes of inner ear disorder. The spiral and Scarpa’s ganglion are potential sites harboring viral DNA for possible latent infection.

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Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: A two-regimen experience

Cited by 123 publications

References 23 publications

Prognostic markers of symptomatic congenital cytomegalovirus infection

Prognostic markers of symptomatic congenital cytomegalovirus infection

Neuropathogenesis of Congenital Cytomegalovirus Infection: Disease Mechanisms and Prospects for Intervention

Do Viruses Cause Inner Ear Disturbances?

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