Managing challenges in congenital CMV: current thinking

Jones, Christine E; Bailey, Heather; Bamford, Alasdair; Calvert, Anna; Dorey, Robert B; Drysdale, Simon B.; Khalil, Asma; Heath, Paul T; Lyall, Hermione; Ralph, Kate Monica Isabel; Sapuan, Shari; Vandrevala, Tushna; Walter, Simone; Whittaker, Elizabeth; Wood, Sharon

doi:10.1136/archdischild-2022-323809

Cited by 14 publications

(7 citation statements)

References 31 publications

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“…Global prevalence of cCMV is 0.67% ( 11 ). In Sub-Saharan Africa, the prevalence rates of cCMV ranges from 1.4% in the Ivory Coast ( 12 ) to 6% in Burkina Faso ( 13 ).…”

Section: Epidemiology Of Ccmvmentioning

confidence: 99%

“…Screening newborn infants for cCMV is not current practice in most countries, but pilot programmes have started recently in Canada and the Unites States using dried blood spot samples ( 11 ). Targeted screening of infants at higher risk of cCMV is practised in some HICs, e.g., screening of infants with growth restriction, born less than 30 weeks gestational age, or infants with failed newborn hearing screening ( 19 , 20 , 50 , 51 ).…”

Section: Screening For Ccmvmentioning

confidence: 99%

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Congenital cytomegalovirus in Sub-Saharan Africa—a narrative review with practice recommendations

Payne,

Barnabas

2024

Front. Public Health

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Cytomegalovirus (CMV) is the most common cause of congenital infection internationally, occurring in 0.67% of births, and increasingly recognised as a major public health burden due to the potential for long-term neurodevelopmental and hearing impairment. This burden includes estimates of 10% of childhood cerebral palsy and up to 25% of childhood deafness. In Sub-Saharan Africa, where CMV-seroprevalence is almost ubiquitous, prevalence of congenital CMV (cCMV) is higher than the global average, and yet there is a dearth of research and initiatives to improve recognition, diagnosis and treatment. This narrative review outlines the epidemiology and clinical presentation of cCMV, discusses issues of case identification and treatment in Sub-Saharan Africa, and recommends a framework of strategies to address these challenges. Considering the significant burden of cCMV disease in this setting, it is undoubtably time we embark upon improving diagnosis and care for these infants.

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“…Global prevalence of cCMV is 0.67% ( 11 ). In Sub-Saharan Africa, the prevalence rates of cCMV ranges from 1.4% in the Ivory Coast ( 12 ) to 6% in Burkina Faso ( 13 ).…”

Section: Epidemiology Of Ccmvmentioning

confidence: 99%

Section: Screening For Ccmvmentioning

confidence: 99%

Congenital cytomegalovirus in Sub-Saharan Africa—a narrative review with practice recommendations

Payne,

Barnabas

2024

Front. Public Health

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“… a Association between congenital CMV infection and preterm birth is not confirmed ( 22 ). Adapted from Jones et al ( 5 ). …”

Section: Diagnosis Of CMV Infection In Pregnancymentioning

confidence: 99%

“… a Available at: https://clinicaltrials.gov/ct2/show/study/NCT01649869 . Modified from Jones et al ( 5 ). …”

Section: Prevention and Treatment Of Congenital CMV Infectionmentioning

confidence: 99%

“…Knowledge has been increased during the years, but there are still gray areas that necessitate further evaluation and research to enhance clinical management. These findings were subject to recent expert evaluation ( 3 – 5 ). However, this review builds upon this existing knowledge by incorporating novel evidence and proposing avenues for future investigation.…”

Section: Introductionmentioning

confidence: 99%

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Congenital cytomegalovirus infection: the state of the art and future perspectives

Salomè,

Corrado,

Mazzarelli

et al. 2023

Front. Pediatr.

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Congenital cytomegalovirus (cCMV) infection is the most common congenital infection, with an estimated incidence of approximately one in 200 infants in high-income settings. Approximately one in four children may experience life-long consequences, including sensorineural hearing loss and neurodisability. Knowledge regarding prevention, diagnosis, and treatment increased in the recent years, but some challenges remain. In this review, we tried to summarize the current knowledge on both the obstetrical and pediatric areas, while also highlighting controversial aspects and future perspectives. There is a need to enhance awareness among the general population and pregnant women through specific information programs. Further research is needed to better define the classification of individuals at birth and to have a deeper understanding of the long-term outcomes for so defined children. Finally, the availability of valaciclovir medication throughout pregnancy, where appropriate, has prompted the assessment of a universal serological antenatal screening. It is recommended to establish a dedicated unit for better evaluation and management of both mothers and children.

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Association Between Self‐Reported Infections and Seropositivity Among Pregnant Women With Gastroschisis: A Case Control Study, With Emphasis on Chlamydia trachomatis

Feldkamp,

Baum‐Jones,

Enioutina

et al. 2024

Birth Defects Research

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BackgroundGastroschisis is a birth defect with the greatest risk among women <20 years of age.MethodsPregnant women attending the University of Utah's Maternal‐Fetal Medicine Diagnostic Center between 2011 and 2017 for either their routine diagnostic ultrasound or referral were recruited (cases: pregnant women with fetal gastroschisis, n = 53 participated/57, 93%; controls: pregnant women without fetal abnormalities, n = 102 participated/120, 85%). A clinic coordinator consented and interviewed women and obtained a blood sample and prenatal medical records. We evaluated self‐reported maternal characteristics, risk factors, and infections. To assess pathogen seropositivity we used Serimmune's Serum Epitope Repertoire Analysis validated 35 pathogen panels and Chlamydia trachomatis and compared seropositivity to self‐report and prenatal medical record screening to assess sensitivity.ResultsCases were more likely to report a younger age at sexual debut (p = <0.01), more sexual partners (p = 0.02), being unmarried (p < 0.01), changing partners between pregnancies (p = <0.01), smoking cigarettes (<0.01), and a recent sexually transmitted infection (STI) (p = 0.02). No differences were observed for self‐report of illicit drug use or periconceptional urinary tract infections. Cases had a higher seropositivity for cytomegalovirus (p = 0.01). No differences were observed for herpes simplex I, II, or Epstein–Barr. Though based on small numbers, C. trachomatis seropositivity was highest in cases (17%) compared to controls (8.8%) with the highest proportion observed in case women <20 years of age (cases 33%; controls 0%). Any STI (self‐report or seropositivity) was also highest among cases <20 years of age (cases 47%; controls 0%). Among C. trachomatis seropositive women, self‐report and prenatal medical record sensitivity was 27.8% and 3%, respectively.ConclusionsCases were more likely to engage in behaviors that can increase their risk of exposure to sexually transmitted pathogens. Case women <20 years of age had the highest proportion of C. trachomatis seropositivity and any STI. Prenatal medical records and self‐report were inadequate to identify a recent chlamydial infection whereas, the SERA assay is a novel approach for evaluating subclinical infections that may impact the developing embryo.

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Managing challenges in congenital CMV: current thinking

Cited by 14 publications

References 31 publications

Congenital cytomegalovirus in Sub-Saharan Africa—a narrative review with practice recommendations

Congenital cytomegalovirus in Sub-Saharan Africa—a narrative review with practice recommendations

Congenital cytomegalovirus infection: the state of the art and future perspectives

Association Between Self‐Reported Infections and Seropositivity Among Pregnant Women With Gastroschisis: A Case Control Study, With Emphasis on Chlamydia trachomatis

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