Birth Prevalence and Natural History of Congenital Cytomegalovirus Infection in a Highly Seroimmune Population

被引:206
作者
Mussi-Pinhata, Marisa M. [1 ]
Yamamoto, Aparecida Y. [1 ]
Brito, Rosangela M. Moura [1 ]
Isaac, Myriam de Lima [2 ]
de Carvalho e Oliveira, Patricia F. [1 ]
Boppana, Suresh [3 ,4 ]
Britt, William J. [3 ,4 ,5 ]
机构
[1] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Pediat, Sao Paulo, Brazil
[2] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Ophtalmol Otolaryngol Head & Neck Surg, Sao Paulo, Brazil
[3] Univ Alabama Birmingham, Sch Med, Dept Pediat, Birmingham, AL USA
[4] Univ Alabama Birmingham, Sch Med, Dept Microbiol, Birmingham, AL USA
[5] Univ Alabama Birmingham, Sch Med, Dept Neurobiol, Birmingham, AL USA
基金
美国国家卫生研究院;
关键词
INFANTS BORN; NEWBORN-INFANTS; RISK-FACTORS; DIAGNOSIS; EPIDEMIOLOGY; BLOOD; TRANSMISSION; PREGNANCY; AVIDITY; MOTHERS;
D O I
10.1086/600882
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. The natural history of congenital cytomegalovirus (CMV) infection is scarcely known in populations with high maternal CMV seroprevalence. This study evaluated the birth prevalence, clinical findings at birth, and hearing outcome in CMV-infected children from such a population. Methods. Consecutively born infants were screened for the presence of CMV in urine and/or saliva specimens during the first 2 weeks after birth. Neonatal clinical findings were recorded, and CMV-infected children were tested to document hearing function during follow-up. A subset of mothers of CMV-infected infants were prenatally tested for the presence of anti-CMV immunoglobulin G antibodies. Results. Congenital CMV infection was confirmed in 87 (1.08%; 95% confidence interval [CI], 0.86%-1.33%) of 8047 infants. Seven infants (8.1%; 95% CI, 3.3%-15.9%) had at least 1 clinical finding suggestive of CMV infection, and 4 (4.6%; 95% CI, 1.3%-11.3%) had 13 findings of systemic disease. Sensorineural hearing loss was found in 5 (8.6%; 95% CI, 2.9%-19.0%) of 58 children tested at a median age of 21 months. Bilateral profound hearing loss was observed in 2 children, and the hearing threshold was 160 decibels in all 5 children with hearing loss, including 2 children born to mothers with probable nonprimary CMV infection. Conclusions. The results of this large newborn screening study in a population with high CMV seroimmunity provide additional evidence that congenital CMV disease occurs in populations with high seroprevalence rates, with a similar incidence of CMV-related hearing loss to that reported in the offspring of women from populations in developed countries with lower rates of seroimmunity to CMV.
引用
收藏
页码:522 / 528
页数:7
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