Fetal infection with human cytomegalovirus. Strategies for prevention and therapy

The prevalence of congenital human cytomegalovirus (HCMV) infection is the highest of all congenital infectious diseases and in Germany is approximately 0.2%. Of these congenital infections approximately 12 % are symptomatic with a high percentage of long-term severe sequelae and 13% of asymptomatic infants develop hearing loss. For prevention four strategies are presented: hygiene, passive and active immunization and antiviral therapy. For a long time only hygienic intervention measures were considered to be effective but now there is increasing knowledge about the use of HCMV hyperimmunoglobulin for the prevention and therapy of fetal infections in HCMV-infected pregnant women; however, published randomized trials are lacking. A vaccine for active immunization will not be available in the foreseeable future. There are only limited pharmacokinetic data for valaciclovir.