Intestinal manifestations of postnatal and congenital cytomegalovirus infection in term and preterm infants

Goelz, Rangmar; Hamprecht, Klaus; Klingel, Karin; Poets, Christian F.

doi:10.1016/j.jcv.2016.08.289

Cited by 33 publications

(28 citation statements)

References 40 publications

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“…A first case report on immunohistochemically proven manifestation of postnatally acquired HCMV colitis of a term infant was published recently [6]. Goelz et al [7] could document volvulus as an additional severe HCMV-associated intestinal disease in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Human Cytomegalovirus Reactivation During Lactation: Impact of Antibody Kinetics and Neutralization in Blood and Breast Milk

Lazar¹,

Rabe²,

Goelz

et al. 2020

Nutrients

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Human cytomegalovirus (HCMV) is shed into breast milk in nearly every seropositive woman during lactation. This reactivation shows mostly a self-limited, unimodal course. The dynamics and functional role of HCMV-specific-IgG in breast milk and in plasma during reactivation are unknown. Milk whey viral loads were monitored with real-time PCR in 18 HCMV-seropositive mothers over two months postpartum. HCMV-antibody binding assays (ECLIA) and antigen-specific immunoblotting were performed from plasma and corresponding milk samples. Epithelial-cell-specific neutralization was used to analyze functional antibodies in plasma- and whey-pools. Viral loads in milk whey showed unimodal courses in 15 of 18 mothers with peak viral loads around one month postpartum. HCMV-specific-IgG-antibodies increased significantly in plasma and milk whey during reactivation. The mean levels of plasma IgG were about 275-fold higher than in whey. Only antibodies against tegument protein p150 were continuously expressed in both compartments. Anti-glycoprotein-B1 IgG-antibodies were variably expressed in whey, but continuously in plasma. Neutralization assays showed 40-fold higher NT-50 values in plasma compared to whey at two months postpartum. During reactivation, HCMV-specific-IgG reactivities and neutralizing capacities are much lower in whey than in plasma. Therefore, their specific role in the decrease and discontinuation of virus-shedding in milk remains unclear.

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Section: Introductionmentioning

confidence: 99%

Human Cytomegalovirus Reactivation During Lactation: Impact of Antibody Kinetics and Neutralization in Blood and Breast Milk

Lazar¹,

Rabe²,

Goelz

et al. 2020

Nutrients

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“…Overall, the three infants had 10 sepsis evaluations performed with one infant having CMV detected in all four sepsis evaluations (Table 3, Figure 2). Although previous studies have associated postnatal CMV detection with a severe sepsis-like syndrome [6], necrotizing enterocolitis [3,4], BPD [1,2] and mortality, the infants in this study mostly had temperature instability and respiratory signs. In addition, detection of CMV was associated with significantly lower platelet counts at the time of the sepsis evaluation (Table 2), and two infants developed severe BPD.…”

Section: Discussionmentioning

confidence: 68%

“…Postnatal detection of cytomegalovirus (CMV) among infants in the neonatal intensive care unit (NICU) has been associated with a sepsis-like syndrome as well as bronchopulmonary dysplasia (BPD), necrotizing enterocolitis and even death [1][2][3][4][5][6]. Acquisition of CMV by infants in the NICU also results in asymptomatic infection and usually occurs by ingestion of unpasteurized human milk [7].…”

Section: Introductionmentioning

confidence: 99%

Detection of cytomegalovirus in saliva from infants undergoing sepsis evaluation in the neonatal intensive care unit: the VIRIoN-C study

Ronchi

Ouellette

Mejías

et al. 2018

Journal of Perinatal Medicine

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“…The association between pCMV infection and bowel inflammation, including NEC, strictures, volvulus and colitis, is well documented 24–29. Monitoring CMV viral loads in babies with NEC and ensuring that tissue resected intraoperatively is histologically evaluated for CMV is necessary to confirm pCMV-mediated disease.…”

Section: Clinical Presentationmentioning

confidence: 99%

Postnatally acquired cytomegalovirus infection in extremely premature infants: how best to manage?

Kadambari

Whittaker

Lyall

2019

Arch Dis Child Fetal Neonatal Ed

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Postnatal cytomegalovirus (pCMV) infection is a common viral infection typically occurring within the first months of life. pCMV refers to postnatal acquisition of CMV rather than postnatal manifestations of antenatal or perinatal acquired CMV. pCMV is usually asymptomatic in term infants, but can cause symptomatic disease in preterm (gestational age <32 weeks) and very low birth weight (<1500 g) infants resulting in sepsis, pneumonia, thrombocytopaenia, neutropaenia, hepatitis, colitis and occasionally death. There are significant uncertainties regarding the management of premature infants with pCMV disease which is in part due to our limited understanding of the natural history of this disease. This review describes the current epidemiology and clinical manifestations of pCMV disease which should alert clinicians to test for CMV and also outlines a strategy to manage the condition.

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Intestinal manifestations of postnatal and congenital cytomegalovirus infection in term and preterm infants

Cited by 33 publications

References 40 publications

Human Cytomegalovirus Reactivation During Lactation: Impact of Antibody Kinetics and Neutralization in Blood and Breast Milk

Human Cytomegalovirus Reactivation During Lactation: Impact of Antibody Kinetics and Neutralization in Blood and Breast Milk

Detection of cytomegalovirus in saliva from infants undergoing sepsis evaluation in the neonatal intensive care unit: the VIRIoN-C study

Postnatally acquired cytomegalovirus infection in extremely premature infants: how best to manage?

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