Diagnosis and Screening for Cytomegalovirus Infection in Pregnant Women in Cuba as Prognostic Markers of Congenital Infection in Newborns 2007-2008

被引:18
作者
Kouri, Vivian [1 ]
Correa, Consuelo B. [1 ]
Verdasquera, Denis [1 ]
Ariel Martinez, Pedro [1 ]
Alvarez, Alina [1 ]
Aleman, Yoan [1 ]
Perez, Lissette [1 ]
Golpe, Maria A. [2 ]
Someilan, Tatiana [2 ]
Chong, Yodila [2 ]
Fresno, Clara [2 ]
Navarro, Maria A. [2 ]
Perez, Elsa [2 ]
Moro, Ivonne [2 ]
Sanchez, Rita [3 ]
Llanusa, Celia [3 ]
Melin, Pierrette [4 ]
机构
[1] Inst Trop Med Pedro Kouri, Dept Virol, Havana, Cuba
[2] Genet Dept Municipal, Old Havana, Central Havana, Cuba
[3] Genet Prov Dept Havana City, Havana, Cuba
[4] Univ Hosp Liege, Dept Med Microbiol, Liege, Belgium
关键词
congenital Infection; HCMV; Cuba; seroprevalence; viral excretion; PCR; pregnant women; HEARING-LOSS; IGG-AVIDITY; CMV INFECTION; SEROPREVALENCE; INFANTS; MOTHERS; DNA; SEROCONVERSION; TRANSMISSION; PREVALENCE;
D O I
10.1097/INF.0b013e3181eb7388
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Human cytomegalovirus (HCMV) has established itself as the most significant cause of congenital infection in the developed world. The objective of this research was prenatal identification of pregnant women at risk for developing active infection due to HCMV as well as to diagnose congenitally infected newborns. Methods: A diagnostic algorithm based on specific immunoglobulin G (IgG), IgM, and, IgG avidity was used to screen serum from 1131 pregnant women enrolled prospectively from 3 municipalities from Havana City, Cuba during 2007-2008. Qualitative multiplex nested PCR and quantitative real time-based PCR testing for HCMV DNA were performed on urine and saliva specimens from women detected with active infection and from their newborns. Results: Most women were seropositive to HCMV (92.7%), with 2.38% (27 women) having active infection. Primary infection was detected in 20 pregnant women (1.77%) while 7 patients (0.62%) had active nonprimary infection. HCMV DNA was detected in specimens from 9 of the 27 pregnant women by both PCR methods. HCMV congenital infection was diagnosed in 12 (1.06%) of the 26 live children born from 25 mothers with active infection, for a vertical transmission rate of 46.2%. Two fetal deaths were reported from 2 women with active infection; furthermore 2 newborns were symptomatic at birth and 2 showed sequelae during the follow-up done until 6 months age. Conclusions: Mothers with active infection during the pregnancy and with HCMV excretion had significant risks, RR = 1.16 and RR = 1.35, respectively, to have congenitally infected children.
引用
收藏
页码:1105 / 1110
页数:6
相关论文
共 42 条
[1]  
Ahlfors K, 1999, SCAND J INFECT DIS, V31, P443, DOI 10.1080/00365549950163969
[2]   The detection of CMV in amniotic fluid and cervicovaginal smear samples by real-time PCR assay in prenatal diagnosis [J].
Biri A. ;
Bozdayi G. ;
Çiftçi B. ;
Dinç B. ;
Yücel A. ;
Rota S. .
Archives of Gynecology and Obstetrics, 2006, 273 (5) :261-266
[3]   Predictive value of maternal-IgG avidity for congenital human cytomegalovirus infection [J].
Bodéus, M ;
Goubau, P .
JOURNAL OF CLINICAL VIROLOGY, 1999, 12 (01) :3-8
[4]   Ability of three IgG-avidity assays to exclude recent cytomegalovirus infection [J].
Bodéus, M ;
Beulné, D ;
Goubau, P .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2001, 20 (04) :248-252
[5]   Symptomatic congenital cytomegalovirus infection in infants born to mothers with preexisting immunity to cytomegalovirus [J].
Boppana, SB ;
Fowler, KB ;
Britt, WJ ;
Stagno, S ;
Pass, RF .
PEDIATRICS, 1999, 104 (01) :55-60
[6]   Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. [J].
Boppana, SB ;
Rivera, LB ;
Fowler, KB ;
Mach, M ;
Britt, WJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (18) :1366-1371
[7]  
CABRERA ES, 1986, DETERMINACION ANTICU
[8]   Neonatal screening for congenital cytomegalovirus infections [J].
Casteels, A ;
Naessens, A ;
Gordts, F ;
De Catte, L ;
Bougatef, A ;
Foulon, W .
JOURNAL OF PERINATAL MEDICINE, 1999, 27 (02) :116-121
[9]   Prognostic markers of symptomatic congenital cytomegalovirus infection [J].
Castro Romanelli, Roberta Maia de ;
Magny, Jean Francois ;
Jacquemard, Francois .
BRAZILIAN JOURNAL OF INFECTIOUS DISEASES, 2008, 12 (01) :38-43
[10]   High perinatal seroprevalence of cytomegalovirus in northern Taiwan [J].
Chen, Mei-Huei ;
Chen, Pau-Chung ;
Jeng, Suh-Fang ;
Hsieh, Chia-Jung ;
Su, Feng-Chiao ;
Liao, Hua-Fang ;
Su, Yi-Ning ;
Lin, Shio-Jean ;
Hsieh, Wu-Shiun .
JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 2008, 44 (04) :166-169