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Seroprevalence and risk factors for cytomegalovirus infection among pregnant women in southern Taiwan, 2014–2015. Taiwan J Obstet Gynecol 2022; 61:323-328. [DOI: 10.1016/j.tjog.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 11/24/2022] Open
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2
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Letamendia-Richard E, Périllaud-Dubois C, de La Guillonnière L, Thouard I, Cordier AG, Roque-Afonso AM, de Luca D, Benachi A, Vauloup-Fellous C. Universal newborn screening for congenital cytomegalovirus infection: feasibility and relevance in a French type-III maternity cohort. BJOG 2021; 129:291-299. [PMID: 34726316 DOI: 10.1111/1471-0528.16992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Evaluation of relevance and feasibility of universal newborn congenital cytomegalovirus infection (cCMVI) screening in saliva. DESIGN Retrospective, population-based cohort study. SETTING Clamart, France, 2016-2020. POPULATION All neonates born consecutively in our level III maternity unit. METHODS CMV PCR in saliva for all neonates at birth, and, if positive, CMV PCR in urine to confirm or exclude cCMVI. Prospective and retrospective characterisation of maternal infections. ROC curve analysis to assess saliva PCR performances. Acceptability of screening among staff members evaluated by a survey. MAIN OUTCOME MEASURES Number of cCMVI neonates; number of expected and unexpected cCMVI. RESULTS Among 15 341 tested neonates, 63 had cCMVI (birth prevalence of 0.4%, 95% CI 0.3-0.5). In 50% of cases, maternal infection was a non-primary infection (NPI) during pregnancy. cCMVI was expected or suspected (maternal primary infection [PI], antenatal or neonatal signs) in 24/63 neonates (38%), and unexpected in 39/63 neonates (62%). The best CMV saliva threshold to predict cCMVI was 356 (2.55 log) copies/ml [95% CI 2.52 log-3.18 log], with an area under the ROC curve of 0.97. Over 90% of the 72 surveyed staff members reported that the screening was easy and quick. No parent refused the screening. CONCLUSIONS Universal screening for cCMVI with CMV PCR on saliva samples is feasible and highly acceptable to parents and healthcare providers. Over half (62%) of the cases had no prenatal/neonatal signs of cCMVI or a maternal history of CMV infection during pregnancy and would probably not have been diagnosed without universal screening. TWEETABLE ABSTRACT In 62% of congenital cytomegalovirus infection cases, only universal neonatal screening in saliva can detect infection.
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Affiliation(s)
- E Letamendia-Richard
- Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, Paris Saclay University Hospital, APHP, Clamart, France
| | - C Périllaud-Dubois
- IAME, INSERM U1137, Université de Paris, Paris, France.,Division of Virology, Dept of Biology and Medical Genomics, Sorbonne University Hospital, APHP, Paris, France
| | - L de La Guillonnière
- Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, Paris Saclay University Hospital, APHP, Clamart, France
| | - I Thouard
- Division of Virology, Dept of Biology Genetics and PUI, Paris Saclay University Hospital, APHP, Villejuif, France
| | - A-G Cordier
- Division of Obstetrics and Gynaecology, Dept of Perinatal Medicine, Paris Saclay University Hospital, APHP, Clamart, France.,3PHM, U1139 INSERM, Université de Paris, Paris, France
| | - A-M Roque-Afonso
- Division of Virology, Dept of Biology Genetics and PUI, Paris Saclay University Hospital, APHP, Villejuif, France.,INSERM U1193, Université Paris Saclay, Villejuif, France
| | - D de Luca
- Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, Paris Saclay University Hospital, APHP, Clamart, France.,Pathophysiology and Therapeutic Innovation-INSERM U999 Unit, Université Paris Saclay, Paris, France
| | - A Benachi
- Division of Obstetrics and Gynaecology, Dept of Perinatal Medicine, Paris Saclay University Hospital, APHP, Clamart, France
| | - C Vauloup-Fellous
- Division of Virology, Dept of Biology Genetics and PUI, Paris Saclay University Hospital, APHP, Villejuif, France.,INSERM U1193, Université Paris Saclay, Villejuif, France
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3
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Seror V, Leruez-Ville M, Ӧzek A, Ville Y. Leaning towards Cytomegalovirus serological screening in pregnancy to prevent congenital infection: a cost-effectiveness perspective. BJOG 2021; 129:301-312. [PMID: 34651405 DOI: 10.1111/1471-0528.16966] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/24/2021] [Accepted: 10/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of prenatal detection of congenital cytomegalovirus (cCMV) following maternal primary infection in the first trimester within standard pregnancy follow-up or involving population-based screening (serological testing at 7 and 12 weeks of gestation), with or without secondary prevention (valaciclovir) in maternal CMV primary infection. DESIGN Cost-effectiveness study from the perspective of the French national health insurance system. SETTING Cost-effectiveness based on previously published probability estimates and associated plausible ranges hypothetical population of 1,000,000 pregnant women. POPULATION Hypothetical population of 1,000,000 pregnant women. METHODS Cost-effectiveness of detecting fetal cCMV in terms of the total direct medical costs involved and associated expected outcomes. MAIN OUTCOME MEASURES Detection rates and clinical outcomes at birth. RESULTS Moving to a population-based approach for targeting fetal CMV infections would generate high monetary and organizational costs while increasing detection rates from 15% to 94%. This resource allocation would help implementing horizontal equity according to which individuals with similar medical needs should be treated equally. Secondary prevention with valaciclovir had a significant effect on maternal-fetal CMV transmission and clinical outcomes in newborns, with a 58% decrease of severely infected newborns for a 3.5% additional total costs. Accounting for women decision-making (amniocentesis uptake and termination of pregnancy in severe cases) did not impact the cost-effectiveness results. CONCLUSIONS These findings could fuel thinking on the opportunity of developing clinical guidelines to rule identification of cCMV infection and administration of in-utero treatment. These findings could fuel the development of clinical guidelines on the identification of congenital CMV infection and the administration of treatment in utero. TWEETABLE ABSTRACT CMV serological screening followed by valaciclovir prevention may prevent 58% to 71% of severe cCMV cases for 38 € per pregnancy.
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Affiliation(s)
- V Seror
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,Institut Hospitalier Universitaire (IHU) - Méditerranée Infection, Marseille, France
| | - M Leruez-Ville
- Virology Laboratory, Hôpital Necker-Enfants Malades, AP-HP, National Reference Centre for Herpesviridae, Paris, France.,EA7328, Institut Imagine, Université de Paris, Paris, France
| | - A Ӧzek
- EA7328, Institut Imagine, Université de Paris, Paris, France.,Maternity, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Y Ville
- EA7328, Institut Imagine, Université de Paris, Paris, France.,Maternity, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
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Cytomegalovirus infection in pregnancy - An update. Eur J Obstet Gynecol Reprod Biol 2020; 258:216-222. [PMID: 33454510 DOI: 10.1016/j.ejogrb.2020.12.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
Cytomegalovirus (CMV) is a ubiquitous DNA virus with a global seroprevalence of 83 %. It is the most common pathogen causing teratogenic congenital infection. It is therefore a major public health concern. Maternal infection is associated with congenital CMV (cCMV), the leading cause of non-genetic sensorineural hearing loss. cCMV also causes impairment of cognitive development and cerebral palsy. Transmission of CMV occurs through direct contact with bodily fluids such as saliva, urine or semen from someone who is actively shedding the virus. Transmission rates are higher after primary infection with the rate of transmission increasing with gestational age. Severe fetal effects are however more common when infection occurs before 20weeks. Past infection does not confer immunity to mother or protect the fetus. cCMV may present with cerebral or extracerebral abnormalities on ultrasound, fetal growth restriction and fetal loss. Diagnosis of primary maternal CMV in pregnancy should be based on seroconversion in pregnancy (de novo appearance of virus-specific immunoglobulin G (IgG) in the serum of pregnant women who were previously seronegative) or on detection of specific immunoglobulin M (IgM) and IgG antibodies in association with low IgG avidity. Prenatal diagnosis of fetal CMV is imperfect and based on amniocentesis performed at least 8 weeks after presumed maternal infection and after 17 weeks of gestation. Hygiene information and education of pregnant women is currently the most effective strategy for prevention of CMV infection. The role of vaccines, antiviral drugs and immunoglobulins remains unproven.
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Treatment of Cytomegalovirus Anterior Uveitis at a North American Tertiary Center With Oral Valganciclovir. Cornea 2020; 39:584-589. [PMID: 32068609 DOI: 10.1097/ico.0000000000002251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE Cytomegalovirus is an increasingly recognized cause of anterior uveitis. We present clinical features of cytomegalovirus anterior uveitis (CMVAU) and outcomes of oral valganciclovir treatment at a tertiary referral center in North America. METHODS This is a retrospective case series review (2002-2014) of immunocompetent patients with CMVAU treated with valganciclovir 900 mg BID and subsequent maintenance dosing of ≤450 mg BID. Most patients were prescribed topical corticosteroids concurrently. Diagnostic evaluations and clinical features at baseline and follow-up were reviewed. Resolution time, maintenance of quiescence, and adverse events were assessed. RESULTS Eighteen eyes of 16 patients were included. The mean age of diagnosis was 41 years. At diagnosis, mean best-corrected visual acuity was 0.30 LogMAR and mean intraocular pressure (IOP) was 18.4 mm Hg; 14 eyes (78%) had an active anterior chamber (AC) cell, 8 (44%) had circinate keratic precipitates, and 6 (33%) had iris atrophy. The mean follow-up duration was 48 months. Fourteen eyes of 12 patients were available for the 12-month follow-up; patients demonstrated improvement in best-corrected visual acuity (difference: -0.21 LogMAR, 95% CI -0.33 to -0.09; P = 0.003), AC cell (OR = 0.10, 95% CI 0.02-0.41; P = 0.002), and IOP (difference: -4.21 mm Hg, 95% CI -7.98 to -0.44; P = 0.03) compared with baseline. One patient experienced a serious adverse event likely due to valganciclovir. Thirteen eyes experienced recurrence of inflammation: 7 (54%) on prophylactic dose of valganciclovir and 6 (46%) after stopping. CONCLUSIONS Valganciclovir appears effective and safe for treating CMVAU in this retrospective case series. Long-term antiviral prophylaxis does not abolish recurrences, although it may possibly reduce their frequency when compared with no prophylaxis.
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Porobic-Jahic H, Skokic F, Ahmetagic S, Piljic D, Jahic R, Petrovic J. Cytomegalovirus Infection in Pregnancy - Our Experiences. Med Arch 2020; 73:149-153. [PMID: 31404123 PMCID: PMC6643335 DOI: 10.5455/medarh.2019.73.149-153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Introduction Cytomegalovirus (CMV) infection is ubiquitous. It affects all age groups, and its clinical picture ranges from mild to severe, especially as a congenital infection in neonates. Aim To determine frequency of CMV infection in pregnant women in Tuzla Canton (TC) and the risk factors that lead to the infection. Methods This prospective study included 300 pregnant women from TC aged 18 to 42 years. CMV serology was performed on all participants, and in case of acute infection additionally IgG avidity test. Participants also completed the questionnaire on the risk factors for CMV infection. Results The median age of the 300 women was 28 ±4.97 years. There were 161participants (53.6%) who classified their environment as urban and 295 (98.33%) were married. More than half of the women had completed secondary school 168 (56%). Positive IgG antibodies to CMV had 280 (93.0%) women. Positive IgM and IgG antibodies had 9 (3.0%) participants, but all of them had high IgG avidity, which indicates reinfection or recurrent CMV infection. There was a statistically significant higher number of seropositive participants living in rural areas than those living in urban areas (p= 0.048). Also, there was significantly higher percentage of positive anti-CMV IgG in pregnant women with lower education (p=0.04). Conclusion In our region there is high seropositivity rates of IgG antibodies to CMV in pregnant women. No case of primary CMV infection was proven. The risk factors for CMV infection have been proven to be rural environment and lower level of education.
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Affiliation(s)
- Humera Porobic-Jahic
- Clinic for Infectious Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Fahrija Skokic
- Clinic for Pediatric Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Sead Ahmetagic
- Clinic for Infectious Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Dilista Piljic
- Clinic for Infectious Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Rahima Jahic
- Clinic for Infectious Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Jasminka Petrovic
- Clinic for Infectious Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
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Study the Impact of Cytomegalovirus (CMV) Infection and the Risk Factor for Liver Dysfunction in Saudi Patients. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.3.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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8
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N'Diaye DS, Launay O, Picone O, Tsatsaris V, Azria E, Rozenberg F, Schwarzinger M, Yazdanpanah Y. Cost-effectiveness of vaccination against cytomegalovirus (CMV) in adolescent girls to prevent infections in pregnant women living in France. Vaccine 2018; 36:1285-1296. [PMID: 29397227 DOI: 10.1016/j.vaccine.2018.01.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 12/15/2017] [Accepted: 01/16/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND CMV infections are the most frequent congenital infections worldwide. AIM Assess the cost-effectiveness of vaccination strategies of adolescent girls vs. current practice (hygiene counseling) to prevent CMV seroconversions during pregnancy in France. METHOD A Markov decision-tree model simulated overtime the trajectory of a single fictive cohort of 390,000 adolescent women aged 14 years old, living in France. Impact of vaccination was explored until the end of their reproductive live 40 years later. STRATEGIES COMPARED: "S1: No vaccination" (current practice); "S2: Routine vaccination"; "S3: Screening and vaccination of the seronegative". MODEL PARAMETERS Seroconversion rate without vaccination (0.035%/pregnant woman-week); fetal transmission risk (41%). Vaccine vs. no vaccination: a 50% decrease in maternal seroconversions. OUTCOMES Quality-Adjusted Life-Years (QALYs) of the cohort-born babies; discounted costs; Incremental Cost-Effectiveness Ratio (ICER). RESULTS S2 was the most effective strategy (with 35,000 QALYs gained) and the most expensive (€211,533,000); S1 was the least effective and least costly (€75,423,000). ICERs of strategy S3 vs. S1, and S2 vs. S3 were 6,000€/QALY gained (95% uncertainty range [2700-13,300]) and 16,000€/QALY [negative ICER (S3 dominated by S2) - 94,000] gained, respectively; highly cost-effective because ICER < 1∗France's GPD/capita = €30,000. SENSITIVITY ANALYSIS If the seroprevalence was >62% (vs. 20% in the base case), S3 would become the most efficient strategy. CONCLUSION In France, systematic vaccination of adolescent girls was the most efficient strategy to prevent maternal seroconversions. If the population was less than 62% immune, systematic screening and vaccination of susceptibles would become the most cost-effective approach.
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Affiliation(s)
- D S N'Diaye
- INSERM, IAME, UMR 1137, UFR de Médecine, 75018 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
| | - O Launay
- Department of Infectious Diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; INSERM CIC 1417, Paris, France.
| | - O Picone
- Service de gynécologie obstétrique et médecine de la reproduction, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; EA2493, UFR des sciences de la santé Simone-Veil, UVSQ, 78180 Montigny-le-Bretonneux, France.
| | - V Tsatsaris
- Port Royal Maternity, Department of Gynecology Obstetrics I, Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpital de Paris, Paris, France; INSERM, UMR-S 1139, Paris, France; PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
| | - E Azria
- Department of Obstetrics, Groupe Hospitalier Paris Saint Joseph, Paris Descartes University, Paris, France; Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
| | - F Rozenberg
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27, rue du Fbg Saint-Jacques, 75679 Paris cedex 14, France; Université Paris Descartes et Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Virologie, Paris, France; Institut Cochin, Inserm U1016, Université Paris Descartes, 22 rue Méchain, 75014 Paris, France.
| | - M Schwarzinger
- INSERM, IAME, UMR 1137, UFR de Médecine, 75018 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
| | - Y Yazdanpanah
- INSERM, IAME, UMR 1137, UFR de Médecine, 75018 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France; Infectious Diseases Department, Bichat-Claude Bernard Hospital, Paris, France.
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Anoh AE, Mossoun A, Akoua-Koffi C, Couacy-Hymann E, Pauly M, Leendertz SA, Kouakou N'goran E, Schubert G, Weiss S, Hofmann J, Leendertz FH, Ehlers B. Seroprevalence of Cytomegalovirus Infection Among a Rural Population of Côte d'Ivoire. Viral Immunol 2018; 30:54-57. [PMID: 28055519 DOI: 10.1089/vim.2016.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a betaherpesvirus that can be pathogenic to humans. In particular, immunocompromised patients can develop life-threatening symptoms. In the present study, HCMV seroprevalence was investigated in a rural population of Western Côte d'Ivoire. Plasma samples collected from 166 apparently healthy subjects living in 8 villages surrounding the Taï Forest National Park were tested for anti-HCMV immunoglobulin G and M antibody with two commercial enzyme-linked immunosorbent assays. Prevalence of anti-HCMV IgG and IgM antibody was 100% and 5.4%, respectively. Anti-HCMV IgM positive was 10.2% (5/49) of the children and adolescents and 3.4% (4/117) of the adults. This observed decrease of IgM seropositivity and the seroprevalence difference between males and females (3.8% vs. 6.1%) was not statistically significant. In plasma of one IgM-positive participant, a low CMV load was detected indicating low-level replication. A second IgM-positive participant showed signs of local CMV replication. The other seven IgM-positive plasma samples likely reacted nonspecifically or due to polyclonal stimulation. Taken together, the results indicate that HCMV infection is hyperendemic in Côte d'Ivoire.
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Affiliation(s)
- Augustin Etile Anoh
- 1 CHU de Bouaké/Centre de Recherche pour le Développement, Université Alassane Ouattara de Bouake , Bouake, Côte d'Ivoire.,2 UFR Biosciences, Université Félix Houphouët Boigny , Abidjan, Côte d'Ivoire
| | - Arsène Mossoun
- 2 UFR Biosciences, Université Félix Houphouët Boigny , Abidjan, Côte d'Ivoire.,3 LANADA/Laboratoire Central de Pathologie Animale , Bingerville, Côte d'Ivoire
| | - Chantal Akoua-Koffi
- 1 CHU de Bouaké/Centre de Recherche pour le Développement, Université Alassane Ouattara de Bouake , Bouake, Côte d'Ivoire
| | | | - Maude Pauly
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany .,5 Division 12 "Measles, Mumps, Rubella and Viruses Affecting Immune-Compromised Patients," Robert Koch Institute, Berlin, Germany
| | - Siv-Aina Leendertz
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | | | - Grit Schubert
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Sabrina Weiss
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Jörg Hofmann
- 6 Labor Berlin, Department of Virology, and Institut of Medical Virology, Charité University Medicine Berlin , Berlin, Germany
| | - Fabian H Leendertz
- 4 Project P3 "Epidemiology of Highly Pathogenic Microorganisms," Robert Koch Institute, Berlin, Germany
| | - Bernhard Ehlers
- 5 Division 12 "Measles, Mumps, Rubella and Viruses Affecting Immune-Compromised Patients," Robert Koch Institute, Berlin, Germany
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Siennicka J, Dunal-Szcepaniak M, Trzcińska A, Godzik P, Rosińska M. High Seroprevalence of CMV Among Women of Childbearing Age Implicates High Burden of Congenital Cytomegalovirus Infection in Poland. Pol J Microbiol 2017; 65:425-432. [PMID: 28735326 DOI: 10.5604/17331331.1227668] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cytomegaloviruses are common worldwide, with variable frequency of infections. The infection in pregnancy may lead to pregnancy loss or serious sequelae for the child. To understand the risk posed by CMV in Poland we conducted cross-sectional study on women aged 15-49 basing on existing serum bank. Age dependent incidence, the rates of congenital infection and sequelae were modelled from sero-prevalence, literature and demographic data. The overall anti-CMV IgG prevalence was 81.9% increasing from 74.3% in <30 years old to 94.3% in subjects 45+ years old. The lowest incidence was estimated at the age of 15 and the highest at the age 34 (3.8 and 8.95 respectively/100 women/year). The estimated rate of cCMV varies from 22.4 to 37.2 per 1000 live birth depending on the assumptions made. The proportion of cases due to secondary infection ranged from 34.8% to 49.9% accordingly.
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Affiliation(s)
- Joanna Siennicka
- Department of Virology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Milena Dunal-Szcepaniak
- Department of Virology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Agnieszka Trzcińska
- Department of Virology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Paulina Godzik
- Department of Virology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Magdalena Rosińska
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
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11
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Chibwe E, Mirambo MM, Kihunrwa A, Mshana SE. Magnitude of the Cytomegalovirus infection among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania. BMC Res Notes 2017; 10:489. [PMID: 28931421 PMCID: PMC5607485 DOI: 10.1186/s13104-017-2813-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Despite, Cytomegalovirus (CMV) infection being associated with a potential risk to the fetus, there is limited data from Tanzania and many other developing countries regarding the epidemiology and the impact of CMV infections. This cross-sectional study was conducted between December 2014 and June 2015 among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania to investigate the magnitude and associated factors of CMV infection. Methods The specific CMV IgM and IgG antibodies were detected using indirect enzyme linked immunosorbent assay (ELISA). Demographic and clinical data were collected using pre-tested data collection tool. Data were analysed using STATA version 13. Results A total of 261 pregnant women with median age of 20 (IQR 19–25) years and mean gestation age of 17 ± 7.8 weeks were enrolled. The seroprevalence of CMV IgG antibodies was 193(73.9%; 95% CI 67.2–79.6) while that of CMV IgM antibodies was 0.4%. As the age increased by one unit the IgG seroprevalence was found to increase by 0.3% (95% CI 0.13–0.47, p = 0.001) whereas the risk of being IgG positive increased by 24%. On multivariable logistic regression analysis only urban residence (OR 6.329, 95% CI 2.885–13.887, p < 0.001) was found to independently predict CMV IgG seropositivity. Regarding the outcomes of previous pregnancies the history of miscarriage independently predicted IgG seropositivity (OR 5.6, 95% CI 1.29–24.178, p = 0.021). The IgM seropositive woman had fatal outcome of the term delivery of the baby with microcephaly and spinal-bifida. Conclusion Cytomegalovirus seroprevalence among pregnant women residing in urban areas of Mwanza city, Tanzania is high and is associated with poor pregnancy outcomes. There is a need to emphasize routine screening of CMV in order to establish the impact of CMV during pregnancy.
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Affiliation(s)
- Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.
| | - Albert Kihunrwa
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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12
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Gawad AA, Hashish M, Abaza A, El-Kayal A. Cytomegalovirus Immunoglobulin G Avidity Index among Blood Donors in Alexandria, Egypt. Cent Eur J Public Health 2017; 24:314-320. [PMID: 28095288 DOI: 10.21101/cejph.a4157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 10/13/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM Transfusion transmitted diseases (TTD) are a major challenge to transfusion services all over the world. Cytomegalovirus (CMV) is considered one of the main viruses associated with blood transfusion. As CMV screening is not included in routine screening tests done for donated blood in blood banks in Egypt, the detection of CMV Immunoglobulin G (IgG) avidity needs to be tested for being a useful tool to diagnose recent infection among blood donors. The aim of this work was to study CMV IgG avidity index (AI) among blood donors. METHODS A total of 88 blood samples were collected from the non-remunerated volunteer blood donors who attended the Alexandria Regional Blood Transfusion Centre. A quantitative enzyme linked immunosorbent assay for the avidity detection of the specific IgG antibodies to CMV in human serum samples was used. RESULTS Eighty five studied blood donors (96.6%) were positive for CMV IgG. Eighty one donors (95.3%) showed high avidity (>45.0%). Regarding the remaining four CMV IgG positive donors; three had medium avidity (<45.0%) and only one had a low avidity of <25.0%. A moderate agreement of 42.4% was found between IgG concentration and avidity. CONCLUSIONS CMV seroprevalence was found to be high among volunteer blood donors, where age and gender were statistically significant factors associated with CMV IgG concentration. The use of the avidity assay as a screening tool for CMV among blood donors is highly suggested. The exclusion of the low and medium AI units will ensure the availability of a safe stock of blood units, hence eliminating the risk of CMV transmission to vulnerable groups.
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Affiliation(s)
- Aleya Abdel Gawad
- Microbiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Mona Hashish
- Microbiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Amani Abaza
- Microbiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Aisha El-Kayal
- Alexandria Regional Blood Transfusion Centre, Alexandria, Egypt
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Risk Factors for Congenital Cytomegalovirus Infection Following Primary and Nonprimary Maternal Infection. Clin Infect Dis 2017; 65:398-404. [DOI: 10.1093/cid/cix337] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/10/2017] [Indexed: 11/15/2022] Open
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Davis NL, King CC, Kourtis AP. Cytomegalovirus infection in pregnancy. Birth Defects Res 2017; 109:336-346. [PMID: 28398680 PMCID: PMC11063757 DOI: 10.1002/bdra.23601] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 08/17/2016] [Accepted: 11/07/2016] [Indexed: 11/06/2022]
Abstract
Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding. Intrauterine transmission can lead to congenital CMV infection, a leading cause of permanent hearing and vision loss and neurological disability among children. Congenital CMV transmission rates are as high as 50% in women who acquire primary CMV infection during pregnancy, and less than 2% in women with nonprimary infection. There is no licensed CMV vaccine. Good hygiene practices and avoiding intimate contact with young children (e.g., kissing on the mouth and sharing utensils) have been suggested as an approach to prevent maternal primary CMV infection during pregnancy, but remains an unproven method of reducing the risk of congenital CMV infection. Approximately 1 in 10 infants who acquire CMV in utero will have clinical signs at birth, and an additional 10 to 15% will go on to develop late-onset sequelae. Antiviral treatment prenatally and postnatally has not proven effective at preventing congenital or postnatal CMV infection, and is not recommended for routine clinical care. However, antiviral treatment when initiated in the first month of life for symptomatic congenital CMV infection is recommended for improved neurodevelopmental and audiologic outcomes. Birth Defects Research 109:336-346, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole L. Davis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Caroline C. King
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Athena P. Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
Cytomegalovirus (CMV) infection remains the leading cause of congenital virus infection in developed countries. Measuring the national prevalence of this infection, especially among women of childbearing age, is of great value to estimate the risk of congenital CMV infection, as well as to identify risk groups that should be targeted for behavioural interventions and/or vaccination once a CMV vaccine finally becomes available. In order to fulfil these objectives, a seroprevalence survey was conducted in 2010, using a nationally representative, population-based sample of 2536 people aged between 15 and 49 years, living in metropolitan France and attending private microbiological laboratories for blood testing. All blood samples were analysed in the same laboratory and screened for CMV-specific IgG using an enzyme-linked immunoassay technique (Elisa PKS Medac Enzyme immunoassay). The overall point estimate of CMV infection seroprevalence for individuals aged 15-49 years was 41.9%. The estimates were higher in women than in men (respectively 45.6% and 39.3%), and people born in a non-Western country were more likely to be CMV seropositive than those born in France or in another Western country (93.7% vs. 37.7%). Our results showed that a substantial percentage of women of childbearing age in France are CMV seronegative and therefore at risk of primary CMV infection during pregnancy. Educational measures and future vaccine are key issues to prevent infection in pregnant women and congenital CMV disease.
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Influence of parity and sexual history on cytomegalovirus seroprevalence among women aged 20-49 years in the USA. Int J Gynaecol Obstet 2016; 135:82-5. [PMID: 27401134 DOI: 10.1016/j.ijgo.2016.03.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/10/2016] [Accepted: 06/17/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the influence of parity, as a proxy for exposure to children, and sexual history on cytomegalovirus (CMV) seroprevalence. METHODS Data were retrospectively analyzed from women aged 20-49 years who were tested for CMV immunoglobulin G antibodies in the 1999-2004 National Health and Nutrition Examination Survey, a nationally representative survey of the US population. Logistic regression was used to determine independent variables associated with CMV seroprevalence. RESULTS Among 3710 women, the age-adjusted CMV seroprevalence was 61.3% (95% CI 58.9%-63.6%). In age-adjusted univariate analysis, women who had given birth at least once had higher overall CMV seroprevalence (66.0%, 95% CI 63.1%-68.9%) than did those who had not given birth (49.0%, 95% CI 44.4%-53.7%; P<0.001). In multivariate logistic analysis, higher CMV seroprevalence was independently associated with number of live births (each additional birth: adjusted odds ratio [aOR] 1.2, 95% CI 1.1-1.3), age at first sexual intercourse (<18 vs ≥18years: aOR 1.3, 95% CI 1.1-1.6), lifetime sexual partners (≥10 vs <10: aOR 1.4, 95% CI 1.1-1.9), and herpes type 2 seropositivity (aOR 1.9, 95% CI 1.5-2.6) after controlling for age, race/Hispanic origin, place of birth, poverty index, and education. CONCLUSION Among US women of reproductive age, parity and sexual exposures were independently associated with increased CMV seroprevalence.
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Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe. PLoS One 2015; 10:e0145470. [PMID: 26693714 PMCID: PMC4687935 DOI: 10.1371/journal.pone.0145470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) is the most prevalent congenital viral infection and thus places an enormous disease burden on newborn infants. Seroprevalence of maternal antibodies to CMV due to CMV exposure prior to pregnancy is currently the most important protective factor against congenital CMV disease. The aim of this study was to identify potential predictors, and to develop and evaluate a risk-predicting model for the maternal CMV serostatus in early pregnancy. METHODS Maternal and paternal background information, as well as maternal CMV serostatus in early pregnancy from 882 pregnant women were analyzed. Women were divided into two groups based on their CMV serostatus, and were compared using univariate analysis. To predict serostatus based on epidemiological baseline characteristics, a multiple logistic regression model was calculated using stepwise model selection. Sensitivity and specificity were analyzed using ROC curves. A nomogram based on the model was developed. RESULTS 646 women were CMV seropositive (73.2%), and 236 were seronegative (26.8%). The groups differed significantly with respect to maternal age (p = 0.006), gravidity (p<0.001), parity (p<0.001), use of assisted reproduction techniques (p = 0.018), maternal and paternal migration background (p<0.001), and maternal and paternal education level (p<0.001). ROC evaluation of the selected prediction model revealed an area under the curve of 0.83 (95%CI: 0.8-0.86), yielding sensitivity and specificity values of 0.69 and 0.86, respectively. CONCLUSION We identified predictors of maternal CMV serostatus in early pregnancy and developed a risk-predicting model based on baseline epidemiological characteristics. Our findings provide easy accessible information that can influence the counseling of pregnant woman in terms of their CMV-associated risk.
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Puhakka L, Sarvikivi E, Lappalainen M, Surcel HM, Saxen H. Decrease in seroprevalence for herpesviruses among pregnant women in Finland: cross-sectional study of three time points 1992, 2002 and 2012. Infect Dis (Lond) 2015; 48:406-10. [DOI: 10.3109/23744235.2015.1123290] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Voigt S, Schaffrath Rosario A, Mankertz A. Cytomegalovirus Seroprevalence Among Children and Adolescents in Germany: Data From the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), 2003-2006. Open Forum Infect Dis 2015; 3:ofv193. [PMID: 26817022 PMCID: PMC4724754 DOI: 10.1093/ofid/ofv193] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/01/2015] [Indexed: 11/13/2022] Open
Abstract
CMV seroprevalence increases with age and is significantly associated with migration background, country of origin, and place of birth. We identified the birth order of siblings, breastfeeding, early day care attendance and living in East Germany as further risk factors. Background. Congenital cytomegalovirus (CMV) infection can cause severe birth defects. The majority of children with congenital CMV are born to CMV-seropositive women; however, transmission from mother to fetus and resulting defects are more likely to occur when mothers experience seroconversion during pregnancy. The objective of this study was to provide a population-based estimate of CMV seropositivity and to identify factors that correlate with the detection of CMV-immunoglobulin (Ig)G antibodies. Methods. Cytomegalovirus-specific IgG antibodies were determined by enzyme-linked immunosorbent assay in 13 876 serum samples from children and adolescents (aged 1–17 years). Cytomegalovirus seroprevalence was correlated with children's age, gender, migration background, country of origin, place of birth, socioeconomic status, breast feeding, daycare attendance, order and number of siblings, and residence in East versus West Germany. Results. Age-adjusted seroprevalence was 27.4% (95% confidence interval, 25.8–29.0). Cytomegalovirus seroprevalence increased with age (21.5% at ages 1–2; 32.0% at ages 14–17). Cytomegalovirus seropositivity was significantly associated with migration background, country of origin and place of birth, and (among migrants only) with low socioeconomic status. Risk factors for CMV acquisition included the birth order of siblings, breastfeeding, early daycare attendance, and living in East Germany. Conclusions. In Germany, CMV seroprevalence increases with age, irrespective of gender. These data highlight risk factors associated with seroprevalence and help to identify a target age for the application of a CMV vaccine.
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Affiliation(s)
- Sebastian Voigt
- Departments of Infectious Diseases; Department of Pediatric Oncology/Hematology/SCT, Charité-Universitätsmedizin, Berlin, Germany
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Shigemi D, Yamaguchi S, Otsuka T, Kamoi S, Takeshita T. Seroprevalence of cytomegalovirus IgG antibodies among pregnant women in Japan from 2009-2014. Am J Infect Control 2015; 43:1218-21. [PMID: 26277571 DOI: 10.1016/j.ajic.2015.06.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/21/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human cytomegalovirus (CMV) is a major cause of congenital infection. The seroprevalence of maternal CMV IgG antibodies among Japanese women is decreasing. In this study, we assessed the rate of and risk factors for CMV infection. This article includes a description of a method for the prevention of CMV infection. METHODS Medical records of 7,074 women who delivered a baby at our hospital were retrospectively reviewed. For seronegative patients, preventive educational materials were provided, and CMV IgG antibody levels were reassessed during late pregnancy. Congenital infection in neonates from seroconverted mothers was determined by urine analysis. RESULTS The overall CMV IgG seropositivity rate was 69.1%. The prevalence of CMV IgG increased with age and parity. In a multivariate logistic regression analysis, parity remained an independent determinant of CMV IgG seropositivity. The seroconversion rate for CMV IgG antibody during pregnancy was 0.37%. Neonatal congenital CMV infection occurred in 37.5% of seroconverted women. The risk of primary CMV infection in mothers during their first pregnancy was 7.0%, with an average follow-up period of 2.1 years. CONCLUSION We found that parity was an independent determinant of CMV IgG seropositivity, suggesting that child-rearing may be a high risk factor for maternal CMV infection. The provision of information on hygiene may be an effective and inexpensive method for preventing CMV infection.
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Expression of NKp30, NKp46 and DNAM-1 activating receptors on resting and IL-2 activated NK cells from healthy donors according to CMV-serostatus and age. Biogerontology 2015; 16:671-83. [PMID: 25991472 DOI: 10.1007/s10522-015-9581-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/07/2015] [Indexed: 01/01/2023]
Abstract
Human natural killer (NK) cells are innate lymphoid cells with capacity to kill tumor cells and virus-infected cells. According to the expression of CD56 and CD16 several NK cell subsets have been identified, a major CD56dimCD16+ subpopulation characterized by higher cytotoxic capacity, two CD56bright subsets (CD16-and CD16+) that represent different maturation stages and the fourth CD56-CD16+ subset that correspond to activated dysfunctional NK cells. Previous studies have shown quantitative changes in the frequency, phenotype and distribution of NK cell subsets depending on CMV-serostatus and age. We have analyzed the expression of NKp30, NKp46 and DNAM-1 NK activating receptors on resting and IL-2 activated NK cells from CMV-seronegative and seropositive healthy young donors and from CMV-seropositive elderly individuals. Our results showed that CMV-serostatus of healthy young donors is associated with phenotypic differences on both CD56bright and CD56dim NK cells with an increase of NKp46 and a decrease of NKp30 expression respectively. A reduced expression of DNAM-1 related to ageing and a lower NKp30 expression associated with CMV-seropositivity were observed. The expression of NKp46 and NKp30 was lower in CD57+ NK cells while the expression of DNAM-1 was increased. In vitro NK cell activation by IL-2 increased the expression of NKp46 and NKp30. In summary, both age and CMV-serostatus influence the expression of these cytotoxicity activating receptors that will have functional consequences. In elderly donors is difficult to isolate age from the effect of chronic CMV infection since in our study all elderly donors were CMV-seropositive. The possibility of modulating the expression of these activating receptors by cytokines such as IL-2 may open new opportunities for improving age-associated deterioration of NK cell function.
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Carrara J, N'Diaye DS, Azria E, Launay O, Rozenberg F, Yazpandanah Y, Tsatsaris V, Ayoubi JM, Picone O. Management of Cytomegalovirus Seroconversion during Pregnancy in France. Fetal Diagn Ther 2015; 39:4-12. [PMID: 25997482 DOI: 10.1159/000381850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 03/12/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Guidelines for the management of cytomegalovirus (CMV) infection of the fetus are rare. Our main objective was to evaluate how health care practitioners in France manage cases of CMV seroconversion during pregnancy. MATERIAL AND METHODS A questionnaire was e-mailed to health care practitioners potentially concerned by CMV seroconversion during pregnancy. They were asked if they would recommend amniocentesis, fetal cerebral MRI examination and fetal blood analysis (FBA), depending on the ultrasound results. They then had to indicate whether they would accept termination of pregnancy (TOP), depending on the results of these examinations. RESULTS A total of 380 health care practitioners responded, mainly obstetricians (73.9%) and midwives (20.2%). Overall, 57% of respondents recommended amniocentesis in the case of CMV seroconversion during the first trimester of pregnancy, ultrasound findings being normal. In cases of positive amniocentesis and a major ultrasound abnormality, 84.5% of respondents would perform cerebral MRI, and 44.4% would perform FBA. In this case, the rate of acceptance of TOP was not significantly different whether the examinations were normal (337/372, 90.6%) or not performed (339/374, 93.3%; p = 0.17). DISCUSSION Amniocentesis is too infrequently used and should be encouraged. The results of MRI and FBA are often not taken into account in the final decision concerning TOP. Guidelines are needed to clarify the management of CMV seroconversion during pregnancy.
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Affiliation(s)
- Julie Carrara
- INSERM, IAME, UMR 1137, Universitx00E9; Paris Diderot, Sorbonne Paris Citx00E9;, Paris, France
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Fowotade A, Okonko IO, Agbede OO, Suleiman ST. High seropositivity of IgG and IgM antibodies against cytomegalovirus (CMV) among HIV-1 seropositive patients in Ilorin, Nigeria. Afr Health Sci 2015; 15:1-9. [PMID: 25834524 DOI: 10.4314/ahs.v15i1.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a major public health problem in sub-saharan Africa. Cytomegalovirus (CMV) has been reported to enhance HIV replication and accelerate the progression of HIV infection to AIDS. OBJECTIVE This study reports on the high seropositivity of immunoglobulin (Ig) G and M antibodies against CMV and the risk factors for CMV infection among HIV/AIDS patients in Ilorin, Nigeria. METHOD A total of 180 consented HIV-1 seropositive patients (age-range 16-56 years; 108 females and 72 males) were consecutively recruited. Socio-demographic/behavioral data and 5 ml blood samples were collected from each patient. Plasma of each sample was assayed for anti-CMV IgG/IgM using a CMV IgG and IgM Enzyme Linked ImmunoSorbent Assay (ELISA) kit. RESULTS Twenty (11.1%) of the 180 HIV-1 seropositive subjects were positive for anti-CMV IgM antibody while 169(93.9%) were positive for anti-CMV IgG antibody. Age, marital status, number of sexual partners, CD4 cells counts and previous history of blood transfusion were the main correlates of CMV seropositivity among these patients. However, occupation, sex, highly active antiretroviral therapy (HAART) were not statistically associated with CMV seropositivity in this study. CONCLUSION This study has shown that greater percentages of HIV-1 seropositive patients had active CMV infection. It has further shown that CMV is hyperendemic in HIV-1 seropositive patients in Ilorin, Nigeria.
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Affiliation(s)
- Adeola Fowotade
- Department of Medical Microbiology & Parasitology, University College Hospital, Ibadan, Nigeria
| | - Iheanyi Omezuruike Okonko
- Medical Microbiology Unit, Department of Microbiology, University of Port Harcourt, P.M.B. 5323, Choba, East-West Road, Port Harcourt, Nigeria 500102
| | - Olajide Olubunmi Agbede
- Department of Medical Microbiology & Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - S T Suleiman
- Department of Medical Microbiology & Parasitology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Dogan K, Kafkasli A, Kaya C, Cengiz H. Seroprevalence and Seroconversion Rates of Cytomegalovirus pp65 Antigen and Cord Blood Screening of Pregnant Women in Malatya, Turkey. Eurasian J Med 2015; 45:88-91. [PMID: 25610259 DOI: 10.5152/eajm.2013.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 05/08/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The rates of seropositivity, seroconversion and fetal infection with human cytomegalovirus were analyzed in pregnant women and newborn cord blood in this study. The relationships between maternal age, parity, cytomegalovirus serology and polymerase chain reaction results were evaluated. MATERIALS AND METHODS A total of 217 pregnant women attended our pregnancy clinic between April 2004 and October 2005. During each trimester, 5 cc of maternal blood was obtained and 5 cc of cord blood was collected after birth. An enzyme-linked immunosorbent assay (ELISA) was used to assess these samples for the presence of human cytomegalovirus protein pp65 antigen (in leukocytes) and cytomegalovirus DNA (in plasma). RESULTS The mean age of the pregnant women in our study was 28.1±5.3 years. No seroconversion was observed. Among the pregnant women, 212 (97.7%) were IgG positive, and 29 (13.4%) were IgM positive. Five of the pregnant women were positive for IgM alone (2.3%), whereas 24 (11.3%) were positive for both IgM and IgG. The 29 IgM-positive patients were reevaluated using the polymerase chain reaction, and no seropositivity was found. None of the cord blood samples were IgM positive, whereas 211 (97.3%) were IgG positive. There was no significant correlation between parity and seropositivity (p=0.487). The relationship between human cytomegalovirus seropositivity and maternal age was evaluated by dividing the pregnant women into two groups, with a cut-off age of 35 years. There was a significant difference in seropositivity between these two groups (p=0.045). CONCLUSION Clearly, there is no need to screen pregnant women for Human cytomegalovirus (HCMV) in the Malatya region. Confirming serology results using the polymerase chain reaction and antigenemia testing to detect false positive results offers the advantage of avoiding unnecessary invasive interventions.
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Affiliation(s)
- Keziban Dogan
- Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, İstanbul, Turkey
| | - Ayse Kafkasli
- Department of Obstetrics and Gynecology, Özel Erdem Hastanesi, İstanbul, Turkey
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, İstanbul, Turkey
| | - Huseyin Cengiz
- Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, İstanbul, Turkey
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Grosjean J, Trapes L, Hantz S, Mengelle C, Virey B, Undreiner F, Messager V, Denis F, Marin B, Alain S. Human cytomegalovirus quantification in toddlers saliva from day care centers and emergency unit: a feasibility study. J Clin Virol 2014; 61:371-7. [PMID: 25183358 DOI: 10.1016/j.jcv.2014.07.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/25/2014] [Accepted: 07/30/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cytomegalovirus (CMV) infection is the most important cause of congenital viral infection in developed countries. In utero transmission occurs at higher rates in seronegative women during primary infection, especially those in contact with young children in day-care centers (DCC). Nevertheless data on variability of CMV excretion among children in French DCCs are lacking, and are important for public health planning. OBJECTIVES Our main objective was to assess the feasibility of a salivary sample in DCCs in order to study CMV excretion among toddlers. Our secondary aims were to assess prevalence of CMV excretion in children attending Hospital Emergency Unit (EU) in comparison with various types of DCCs and to validate the analytical chain for collected specimens. STUDY DESIGN Excretion of CMV in saliva was quantified using a real-time PCR assay in children aged from 3 months to 6 years old in EU and in DCC, with gB, gH and gN genotypes determined in infected children. Salivary sampling was performed using small sponges placed into a DNA conservation medium. Socio cultural and medical information were collected from attending parents. RESULTS A total of 625 children were included, with 256 from six DCCs and 369 from one EU. In DCCs, the acceptability of the procedure was 87.3% (95%CI 78.5-96.2) amongst parents and children, and in the EU, acceptability was higher at 97.6% (95%CI 95.5-98.9). CMV shedding overall prevalence was 21.7% (95%CI 17.6-26.2), with CMV shedding prevalence in DCCs of 51.9% (95%CI 22.8-81.1). CONCLUSION We validated the feasibility and acceptability of measuring CMV shedding in the saliva of French toddlers. The discrepancy between CMV infection rates in day care centers and in the general population (as sampled in the EU) indicates the need for a further study to determine risk factors and shedding levels in the DCC population.
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Affiliation(s)
- J Grosjean
- CHU Limoges, Bacteriology-Virology Department, Limoges, France; National Reference Center for Cytomegaloviruses, Limoges, France; Univ Limoges, Inserm UMR 1092, Faculté de Médecine, Limoges, France
| | - L Trapes
- CHU Limoges, Pediatric Emergency Unit, Limoges, France
| | - S Hantz
- CHU Limoges, Bacteriology-Virology Department, Limoges, France; National Reference Center for Cytomegaloviruses, Limoges, France; Univ Limoges, Inserm UMR 1092, Faculté de Médecine, Limoges, France
| | - C Mengelle
- CHU Toulouse, Virology Department, Toulouse, France
| | - B Virey
- Pediatrician, Association Française de Pédiatrie Ambulatoire, Dijon, France
| | - F Undreiner
- Pediatrician, Association Française de Pédiatrie Ambulatoire, Strasbourg, France
| | - V Messager
- CHU Limoges, Pediatric Emergency Unit, Limoges, France
| | - F Denis
- CHU Limoges, Bacteriology-Virology Department, Limoges, France; Univ Limoges, Inserm UMR 1092, Faculté de Médecine, Limoges, France
| | - B Marin
- CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistique, Limoges, France
| | - S Alain
- CHU Limoges, Bacteriology-Virology Department, Limoges, France; National Reference Center for Cytomegaloviruses, Limoges, France; Univ Limoges, Inserm UMR 1092, Faculté de Médecine, Limoges, France.
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Basha J, Iwasenko JM, Robertson P, Craig ME, Rawlinson WD. Congenital cytomegalovirus infection is associated with high maternal socio-economic status and corresponding low maternal cytomegalovirus seropositivity. J Paediatr Child Health 2014; 50:368-72. [PMID: 24593837 DOI: 10.1111/jpc.12502] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 11/26/2022]
Abstract
AIMS Human cytomegalovirus (CMV) is the leading infectious cause of congenital infection in developed countries. Globally, CMV seropositivity has been associated with low socio-economic status (SES); however, Australian data are lacking. Therefore, we examined the association between SES and CMV seroprevalence in children and pregnant women. METHODS Three groups were examined: 1, a prospective cohort of Australian children aged 0-15 years (n = 220); 2, a clinic-based sample of pregnant women (n = 778); and 3, a case series of infants and children (n = 219) with symptomatic congenital CMV infection. SES was determined using a postcode-based score from the Australian Bureau of Statistics.Group 1 was recruited from endocrinology clinics and follow-up at Prince of Wales Hospital and Children's Hospital at Westmead. Group 2 was recruited at the Royal Hospital for Women. Congenitally infected infants were identified through the Australian Paediatric Surveillance Unit. RESULTS CMV seroprevalence among all children was 20% (95% confidence interval (CI) 15-25%), and there was no association with SES (P = 0.58). Seroprevalence among pregnant women was 57% (53-60%), and higher rates of CMV seropositivity were associated with lower SES (P < 0.001). More congenital CMV cases were reported in the highest socio-economic groups (55%) than the lowest (9%) (P < 0.001). CONCLUSIONS A marked socio-economic gradient in CMV seroprevalence is evident in Australian pregnant women and cases of congenital CMV but not in unselected Australian children. These findings highlight the importance of a community-wide approach to CMV awareness and the potential for hygienic measures to reduce the burden of congenital CMV in Australia.
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Affiliation(s)
- James Basha
- Virology, Department of Microbiology, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia; School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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Aljumaili ZKM, Alsamarai AM, Najem WS. Cytomegalovirus seroprevalence in women with bad obstetric history in Kirkuk, Iraq. J Infect Public Health 2014; 7:277-88. [PMID: 24629348 DOI: 10.1016/j.jiph.2013.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 07/08/2013] [Accepted: 08/10/2013] [Indexed: 12/01/2022] Open
Abstract
The human cytomegalovirus (CMV) is a major cause of congenital infections. A case-control descriptive study was conducted in Kirkuk, Iraq to determine the seroprevalence of CMV in women with bad obstetric history (BOH) compared to women with a normal previous pregnancy. The CMV IgG and IgM seroprevalence was higher in women with BOH. The CMV IgG seroprevalence was significantly influenced by pregnancy, age, residence and level of education. In addition, the current CMV infection was significantly associated with pregnancy, age, residence and education. Large families (crowding index >3) exhibited higher seroprevalence for CMV IgM (8.3%) and IgG (98.3%), but odd ratio (OR) showed no significant association between family size and seropositivity. The CMV IgG seropositivity was higher in working women (100%) compared to housewives (95.4%). However, the CMV IgM (current infection) was 6.8% in housewives and was not detected in any working women (0%). The OR exhibited no significant association between occupation and both IgM and IgG levels.
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Affiliation(s)
| | - Abdulghani Mohamed Alsamarai
- Department of Medicine, Tikrit University College of Medicine, Tikrit, Iraq; Department of Microbiology, Tikrit University College of Medicine, Tikrit, Iraq; Asthma, Allergy Centre, Tikrit Teaching Hospital, Tikrit, Iraq
| | - Wesam Suhail Najem
- Department of Dermatology, Tikrit University College of Medicine, Tikrit, Iraq
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N’Diaye DS, Yazdanpanah Y, Krivine A, Andrieu T, Rozenberg F, Picone O, Tsatsaris V, Goffinet F, Launay O. Predictive factors of cytomegalovirus seropositivity among pregnant women in Paris, France. PLoS One 2014; 9:e89857. [PMID: 24587077 PMCID: PMC3933677 DOI: 10.1371/journal.pone.0089857] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 01/27/2014] [Indexed: 11/18/2022] Open
Abstract
Background Cytomegalovirus (CMV) is the most frequent cause of congenital infection. The objective of this study was to evaluate predictive factors for CMV seronegativity in a cohort of pregnant women in Paris, France. Methods Pregnant women enrolled in a prospective cohort during the 2009 A/H1N1 pandemic were tested for CMV IgG antibodies. Variables collected were age, geographic origin, lifestyle, work characteristics, socioeconomic status, gravidity, parity and number of children at home. A multivariate logistic regression model was used to identify independent predictive factors for CMV seropositivity. Results Among the 826 women enrolled, 389 (47.1%) were primiparous, and 552 (67.1%) had Metropolitan France as a geographic origin. Out of these, 355 (i.e. 57.0%, 95% confidence interval (CI): [53.6%–60.4%]) were CMV seropositive: 43.7% (95% CI:[39.5%–47.9%]) in those whose geographic origin was Metropolitan France and 84.1% in those with other origins (95% CI:[79.2%–88.3%]). Determinants associated with CMV seropositivity in a multivariate logistic regression model were: (i) geographic origin (p<0.001(compared with Metropolitan France, geographic origins of Africa adjusted odds ratio (aOR) 21.2, 95% CI:[9.7–46.5], French overseas departments and territories and other origin, aOR 7.5, 95% CI:[3.9–14.6], and Europe or Asia, aOR 2.2, 95% CI: [1.3–3.7]); and (ii) gravidity (p = 0.019), (compared with gravidity = 1, if gravidity≥3, aOR = 1.5, 95% CI: [1.1–2.2]; if gravidity = 2, aOR = 1.0, 95% CI: [0.7–1.4]). Work characteristics and socioeconomic status were not independently associated with CMV seropositivity. Conclusions In this cohort of pregnant women, a geographic origin of Metropolitan France and a low gravidity were predictive factors for CMV low seropositivity. Such women are therefore the likely target population for prevention of CMV infection during pregnancy in France.
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Affiliation(s)
- Dieynaba S. N’Diaye
- Infection, Antimicrobiens, Modélisation, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé et de la Recherche Médicale (INSERM), Université (Univ) Paris Diderot, Sorbonne Paris Cité, Paris, France
- Université Pierre et Marie Curie (UPMC) Univ Paris 06, École doctorale (ED)393, Paris, France
- * E-mail:
| | - Yazdan Yazdanpanah
- Infection, Antimicrobiens, Modélisation, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé et de la Recherche Médicale (INSERM), Université (Univ) Paris Diderot, Sorbonne Paris Cité, Paris, France
- Assistance-Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Bichat-Claude Bernard, Hôpitaux Universitaires Paris Nord Val de Seine (HUPNVS), Service des Maladies Infectieuses, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Anne Krivine
- AP-HP, Groupe Hospitalier Cochin–Broca–Hôtel Dieu, Département de Virologie, Paris, France
| | - Thibaut Andrieu
- INSERM Unité (U)953, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants, Université Pierre-et-Marie-Curie, Paris, France
| | - Flore Rozenberg
- AP-HP, Groupe Hospitalier Cochin–Broca–Hôtel Dieu, Département de Virologie, Paris, France
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
| | | | - Vassilis Tsatsaris
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- AP-HP, Hôpital Cochin, Maternité, Paris, France
| | - François Goffinet
- INSERM Unité (U)953, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants, Université Pierre-et-Marie-Curie, Paris, France
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- AP-HP, Hôpital Cochin, Maternité, Paris, France
- INSERM Centre d’Investigation Clinique (CIC) P0901, Paris, France
| | - Odile Launay
- Université Paris Descartes, Paris Sorbonne Cité, Paris, France
- INSERM, CIC BT505, Paris, France
- AP-HP, Hôpital Cochin, CIC de Vaccinologie Cochin-Pasteur, Paris, France
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Pembrey L, Raynor P, Griffiths P, Chaytor S, Wright J, Hall AJ. Seroprevalence of cytomegalovirus, Epstein Barr virus and varicella zoster virus among pregnant women in Bradford: a cohort study. PLoS One 2013; 8:e81881. [PMID: 24312372 PMCID: PMC3842274 DOI: 10.1371/journal.pone.0081881] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 10/27/2013] [Indexed: 12/16/2022] Open
Abstract
Objective To estimate the seroprevalence of cytomegalovirus (CMV), Epstein Barr virus (EBV) and varicella zoster virus (VZV) among pregnant women in Bradford by ethnic group and country of birth. Methods A stratified random sample of 949 pregnant women enrolled in the Born in Bradford birth cohort was selected to ensure sufficient numbers of White UK born women, Asian UK born women and Asian women born in Asia. Serum samples taken at 24-28 weeks’ gestation were tested for CMV IgG, EBV IgG and VZV IgG. Each woman completed a questionnaire which included socio-demographic information. Results CMV seroprevalence was 49% among the White British women, 89% among South Asian UK born women and 98% among South Asian women born in South Asia. These differences remained after adjusting for socio-demographic factors. In contrast, VZV seroprevalence was 95% among women born in the UK but significantly lower at 90% among South Asian women born in Asia. EBV seroprevalence was 94% overall and did not vary by ethnic group/country of birth. Conclusions Although about half of White British women are at risk of primary CMV infection in pregnancy and the associated increased risk of congenital infection, most congenital CMV infections are likely to be in children born to South Asian women with non-primary infection during pregnancy. South Asian women born in South Asia are at risk of VZV infection during pregnancy which could produce congenital varicella syndrome or perinatal chickenpox. Differences in CMV and VZV seroprevalence by ethnic group and country of birth must be taken into account when universal immunisation against these viruses is contemplated.
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Affiliation(s)
- Lucy Pembrey
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Pauline Raynor
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Paul Griffiths
- Centre for Virology, University College London Medical School, London, United Kingdom
| | - Shelley Chaytor
- Virology Department, Royal Free Hospital, London, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Andrew J. Hall
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Neirukh T, Qaisi A, Saleh N, Rmaileh AA, Zahriyeh EA, Qurei L, Dajani F, Nusseibeh T, Khamash H, Baraghithi S, Azzeh M. Seroprevalence of Cytomegalovirus among pregnant women and hospitalized children in Palestine. BMC Infect Dis 2013; 13:528. [PMID: 24206533 PMCID: PMC3830538 DOI: 10.1186/1471-2334-13-528] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 11/04/2013] [Indexed: 12/20/2022] Open
Abstract
Background Human Cytomegalovirus (HCMV) is the most common cause of congenital infections. The maternal immune status plays a major role in the likelihood of congenital infection. The aim of this study is to shed light on the seroprevalence of HCMV in pregnant women, hospitalized children and newborns including cases of congenital infections in Palestine. Methods We analyzed HCMV IgG and IgM test results that had been ordered for pregnant women, hospitalized children and newborns in the years 2006–2012 at Al-Makassed Islamic Charitable Hospital (MICH) in East Jerusalem. Furthermore, we reviewed the medical charts of newborns and HCMV IgM-positive children. Results HCMV IgG was positive in 96.6% of pregnant women, in 88% of hospitalized children and in 98.4% of hospitalized newborns. HCMV IgM was positive in 11.5% of pregnant women, in 11.7% of hospitalized children and in 2% of hospitalized newborns respectively. The HCMV avidity assay revealed that 95% of IgM-positive pregnant women had high avidity (>60%) indicating that most Palestinian women were undergoing a recurrent HCMV infection. Real time PCR on limited number of cases indicated that 62.5% of infants, mostly born to IgM-positive mothers and 83.3% of HCMV IgM-positive children had detectable HCMV DNA in their urine. Out of the 249 newborns tested during this study period, four (1.6%) were subjected to Gancyclovir treatment because of symptomatic congenital HCMV infection. Conclusions This is the first report to provide an insight into HCMV seroprevalence in Palestine. Despite the high rate of seropositivity, the importance of HCMV testing during pregnancy should not be underestimated. A comprehensive study with a long term follow-up examination of offspring born to HCMV IgM-positive mothers would be required to provide estimates of an accurate percentage of symptomatic congenital HCMV infection in Palestine.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Maysa Azzeh
- Central Laboratory, Al-Makassed Islamic Charitable Hospital, East Jerusalem, Palestine.
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Odland ML, Strand KM, Nordbø SA, Forsmo S, Austgulen R, Iversen AC. Changing patterns of cytomegalovirus seroprevalence among pregnant women in Norway between 1995 and 2009 examined in the Norwegian Mother and Child Cohort Study and two cohorts from Sor-Trondelag County: a cross-sectional study. BMJ Open 2013; 3:e003066. [PMID: 24078749 PMCID: PMC3787407 DOI: 10.1136/bmjopen-2013-003066] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To examine cytomegalovirus (CMV) seroprevalence and associated risk factors for CMV seropositivity in pregnant Norwegian women. DESIGN Cross-sectional study. SETTING The Norwegian Mother and Child Cohort Study (MoBa) in addition to two random samples of pregnant women from Sør-Trøndelag County in Norway. PARTICIPANTS Study group 1 were 1000 pregnant women, randomly selected among 46 127 pregnancies in the MoBa (1999-2006) at 17/18 week of gestation. Non-ethnic Norwegian women were excluded. Study groups 2 (n=1013 from 1995) and 3 (n=979 from 2009) were pregnant women at 12 weeks of gestation from Sør-Trøndelag County. OUTCOME MEASURES CMV seropositivity in blood samples from pregnant Norwegian women. RESULTS CMV-IgG antibodies were detected in 59.9% and CMV-IgM antibodies in 1.3% of pregnant Norwegian women in study group 1. Women from North Norway demonstrated a higher CMV-IgG seroprevalence (72.1%) than women from South Norway (58.5%) (OR 1.83, 95% CI 1.17 to 2.88). The CMV-IgG seroprevalence was higher among women with low education (70.5%) compared to women with higher education (OR 2.20, 95% CI 1.24 to 3.90). Between 1995 and 2009 the CMV-IgG seroprevalence increased from 63.1% to 71.4% in pregnant women from Sør-Trøndelag County (study groups 2 and 3; p<0.001). The highest CMV-IgG seroprevalence (79.0%) was observed among the youngest pregnant women (<25 years) from Sør-Trøndelag County in 2009 (study group 3). CONCLUSIONS The CMV-IgG seroprevalence of pregnant Norwegian women varies with geographic location and educational level. Additionally, the CMV-IgG seroprevalence appears to have increased over the last years, particularly among young pregnant women.
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Affiliation(s)
- Maria Lisa Odland
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kristin M Strand
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Svein Arne Nordbø
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Siri Forsmo
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Rigmor Austgulen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre of Molecular Inflammation Research, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ann-Charlotte Iversen
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Centre of Molecular Inflammation Research, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection. Epidemiol Infect 2012. [PMID: 23200458 DOI: 10.1017/s0950268812002695] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Congenital cytomegalovirus (CMV) infection rates increase with maternal seroprevalence due to transmission from maternal non-primary infection. CMV seroprevalence estimates of pregnant women are needed for planning strategies against congenital CMV transmission. We aimed to determine the age-specific prevalence of serum antibodies for CMV in a representative age-stratified sample of unselected pregnant women from a Brazilian population. A total of 985 pregnant women, aged 12–46 years (median 24 years), were enrolled. Overall CMV seroprevalence was 97% (95% confidence interval 95.8–98.0), with age-specific (years) prevalence as follows: 12–19 (96.3%), 20–24 (97.7%), 25–29 (97.1%), and 30–46 (96.7%). CMV seroprevalence is almost universal (97%) and is found at similar levels in pregnant women of ages ranging from 12 to 46 years. Because high CMV seroprevalence is found even in women of a younger age in this population, this finding suggests that the majority of primary CMV infections occur early, in infancy or childhood. As a consequence, vaccines currently under development to prevent primary infection may not be a solution for the prevention of congenital CMV infection in this population.
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Visentin S, Manara R, Milanese L, Da Roit A, Forner G, Salviato E, Citton V, Magno FM, Orzan E, Morando C, Cusinato R, Mengoli C, Palu G, Ermani M, Rinaldi R, Cosmi E, Gussetti N. Early Primary Cytomegalovirus Infection in Pregnancy: Maternal Hyperimmunoglobulin Therapy Improves Outcomes Among Infants at 1 Year of Age. Clin Infect Dis 2012; 55:497-503. [DOI: 10.1093/cid/cis423] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Enders G, Daiminger A, Lindemann L, Knotek F, Bäder U, Exler S, Enders M. Cytomegalovirus (CMV) seroprevalence in pregnant women, bone marrow donors and adolescents in Germany, 1996-2010. Med Microbiol Immunol 2012; 201:303-9. [PMID: 22398714 DOI: 10.1007/s00430-012-0232-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 02/12/2012] [Indexed: 11/25/2022]
Abstract
In Germany, studies on the IgG seroprevalence in pregnancy and in women of childbearing age are rare. Therefore, we retrospectively evaluated the CMV IgG seropositive rate in 40,324 pregnant women as well as in 31,093 female and male bone marrow donors over 15 consecutive years (1996-2010). Furthermore, the result of a study conducted in 1999 investigating 1,305 healthy adolescents with known ethnicity was included. The overall CMV IgG seroprevalence in pregnant women (15-50 years) was 42.3%. Age-dependent analysis revealed a significantly higher seropositive rate (55.6%) in young women (15-25 years) than in those aged 26-40 years (37-42%) and in women older than 40 years (48.3%). Over the study period of 15 years, the rate of seroprevalence in pregnant women declined significantly (χ(2) test < 0.01) from 44.3% in the first interval period (1996-2000), to 42.8% (2001-2005) and to 40.9% (2006-2010). The most influencing factor on CMV seropositivity appeared to be the socioeconomic status (SES), which we characterized by type of health insurance: Seroprevalence in women with low, middle and upper SES was 91.8, 46.9 and 33.7%, respectively. Female bone marrow donors of childbearing age (15-45 years) showed a significantly higher seropositive rate of 36.5% than age-matched male donors (28.6%). In adolescents aged 13-16 years, no gender-specific differences were recognized. Concerning ethnicity, youngsters with German descent had a significantly lower seroprevalence (29.9%) than those with non-German descent (67.4%).
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Affiliation(s)
- Gisela Enders
- Labor Enders, Prof. Dr. med. Gisela Enders & Kollegen MVZ, Medizinische Diagnostik, Institut für Virologie, Infektiologie und Epidemiologie e.V., Prof. Gisela Enders, Rosenbergstr. 85, 70193, Stuttgart, Germany.
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Abstract
PURPOSE OF REVIEW With improvements in molecular diagnostics tests, viruses are increasingly being found to be associated with what was previously described as idiopathic anterior uveitis. This review presents the clinical features of viral anterior uveitis. RECENT FINDINGS Herpes simplex virus/varicella zoster virus (HSV/VZV) are important causes of anterior uveitis, but other viruses including cytomegalovirus (CMV) and rubella are also found in a significant number of cases. The various viral anterior uveitides have similar features and should be suspected in eyes with diffuse, fine, stellate keratic precipitates, iris atrophy or ocular hypertension. Acyclovir remains the mainstay of therapy in HSV/VZV infections. CMV responds to ganciclovir, but the relapse rate is high and prolonged therapy may be required. Cataract and glaucoma are the main complications of viral anterior uveitis requiring appropriate management. SUMMARY There is considerable overlap between clinical manifestations of the different viral anterior uveitides as well noninfectious hypertensive anterior uveitis syndromes. Hence, corticosteroids should be used with caution in these eyes if virus diagnostic tests are not available.
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Akinbami AA, Rabiu KA, Adewunmi AA, Wright KO, Dosunmu AO, Adeyemo TA, Adediran A, Osunkalu VO. Seroprevalence of cytomegalovirus antibodies amongst normal pregnant women in Nigeria. Int J Womens Health 2011; 3:423-8. [PMID: 22247628 PMCID: PMC3256943 DOI: 10.2147/ijwh.s24850] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Cytomegalovirus (CMV), a ubiquitous virus belonging to the herpes family, is known to be transmitted frequently to developing fetuses in pregnancy. In an immunocompromised state like pregnancy, primary infection through blood transfusion or reactivation of a latent CMV infection can cause severe illness. The study was carried out to determine the seroprevalence of the immunoglobulin G (IgG) antibody to cytomegalovirus amongst pregnant women in correlation with previous exposure to blood transfusion. METHODS A cross sectional study was carried out amongst 179 HIV negative pregnant women attending the antenatal clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria. Five mL of blood was collected and stored in a plain bottle, centrifuged on the same day and the serum stored at -20°C. All samples were screened for anti-CMV IgG antibodies using the enzyme linked immunosorbent assay (ELISA). Consenting participants were instructed to fill a semi-structured questionnaire to obtain demographic and other related information. Statistical analysis of the results was done using Pearson's chi squared test for analytical assessment. RESULTS A total of 97.2% of the pregnant women recruited for this study were anti-CMV IgG positive. Out of the 179 recruited for the study 174 responded to the question on previous history of blood transfusion, 14.9% of the respondents (26 of 174) had a previous history of blood transfusion and all tested positive to the anti-CMVIgG antibody. However, past history of blood transfusion and educational level were found to be insignificant to the risk of acquiring CMV infection. CONCLUSION The seroprevalence of the CMV antibody amongst pregnant women in this environment is high in relation to findings in other developing countries. There is the need to assess anti-CMV immunoglobulin M antibodies in pregnant women, which is a determinant of active infection.
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Affiliation(s)
| | | | | | - Kikelomo Ololade Wright
- Department of Community Medicine and Primary Health Care, College of Medicine, Lagos State University, Ikeja
| | | | - Titilope Adenike Adeyemo
- Department of Haematology and Blood Transfusion, College of Medicine, Faculty of Clinical Sciences, University of Lagos, Idiaraba, Nigeria
| | - Adewumi Adediran
- Department of Haematology and Blood Transfusion, College of Medicine, Faculty of Clinical Sciences, University of Lagos, Idiaraba, Nigeria
| | - Vincent Oluseye Osunkalu
- Department of Haematology and Blood Transfusion, College of Medicine, Faculty of Clinical Sciences, University of Lagos, Idiaraba, Nigeria
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Cytomegalovirus infection and disease after allogeneic hematopoietic stem cell transplantation: experience in a center with a high seroprevalence of both CMV and hepatitis B virus. Ann Hematol 2011; 91:587-95. [PMID: 21997849 DOI: 10.1007/s00277-011-1351-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 10/04/2011] [Indexed: 01/05/2023]
Abstract
Cytomegalovirus (CMV) infection and disease are important concerns after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The similarity of hepatitis B virus (HBV) and CMV with regards to their chronic viral persistence and potential reactivation at the time of impaired cellular immunity has raised clinicians' interest in the occurrence and association between them among patients receiving allo-HSCT; however, only limited data have been obtained from a high seroprevalence region of both CMV and HBV. We monitored 117 adult allo-HSCT patients with both CMV polymerase chain reaction and pp65 antigenemia assay weekly until day 100. In 91.8% of our cases, donors and recipients were both CMV seropositive, and 13.7% of the patients were positive for HBV surface antigen. The incidences of CMV infection and disease were 45.3% and 6.8%, respectively. Grade II-IV acute graft-versus-host disease and anti-thymocyte globulin-containing conditioning regimen were associated with an increased risk of CMV infection in a multivariate analysis (hazard ratio 3.02, 95% CI 1.68-5.42, p < 0.001 and hazard ratio 5.29, 95% CI 2.57-10.8, p < 0.001). No survival disadvantage was found in patients who developed CMV infection (p = 0.699) and CMV disease (p = 0.093). No clinically significant HBV reactivation was found, and the underlying HBV infection in donors or recipients before allo-HSCT did not increase the risk of CMV infection and CMV disease and did not influence survival after allo-HSCT.
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de Villemeur AB, Gratacap-Cavallier B, Casey R, Baccard-Longère M, Goirand L, Seigneurin JM, Morand P. Occupational risk for cytomegalovirus, but not for parvovirus B19 in child-care personnel in France. J Infect 2011; 63:457-67. [PMID: 21867729 DOI: 10.1016/j.jinf.2011.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 05/09/2011] [Accepted: 06/29/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies assessing the risk of cytomegalovirus (CMV), parvovirus B19 (B19V), rubella and varicella infections in female child-care personnel may help define appropriate preventive strategies during pregnancy. METHODS Serologic testing for all four viruses and a self-administered questionnaire to identify risk factors were conducted on child-care staff aged 20-50 years old and on a reference group of women. RESULTS In 395 exposed and 382 reference women, CMV, B19V, rubella and varicella seroprevalence were 69.4, 79.4, 98.7, 100% for exposed women, and 41.1, 68.0, 98.2, 99.7% for reference women, respectively. For CMV, the adjusted seroprevalence ratio (PR) of exposed versus reference workers, (PR, 1.43 [95% IC, 1.22-1.69]) was observed as of the first year of exposure. The risk attributed to occupation was 30.1%. Identified risk factors included exposure duration, past employment in maternity hospital, and participation in cleaning tasks. The risk attributable to personal factors ranged from 14.5% to 32.4%. The adjusted B19V PR was not significant (PR, 1.05 [95% IC, 0.94-1.16]). CONCLUSIONS French female child-care staff runs an occupational risk for CMV infection, but not for B19V infection. The fraction attributable to this CMV occupational risk was not higher than the risk associated with personal factors.
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Affiliation(s)
- Agathe Billette de Villemeur
- Conseil Général de l'Isère, Service Prospective et Éducation Pour la Santé BP 1096, 38022 Grenoble cedex 1, France.
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Leruez-Ville M, Vauloup-Fellous C, Couderc S, Parat S, Castel C, Avettand-Fenoel V, Guilleminot T, Grangeot-Keros L, Ville Y, Grabar S, Magny JF. Prospective identification of congenital cytomegalovirus infection in newborns using real-time polymerase chain reaction assays in dried blood spots. Clin Infect Dis 2011; 52:575-81. [PMID: 21292661 DOI: 10.1093/cid/ciq241] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is a public health issue, and implementation of neonatal screening has been debated. Detection of CMV DNA by polymerase chain reaction (PCR) of dried blood spots (DBS) routinely collected for metabolic screening from all newborns has been proposed for congenital CMV infection screening. The goal of this study was to prospectively assess the performance of 2 CMV PCR assays of DBS for CMV neonatal screening in a selected population of neonates. METHODS We studied prospective congenital CMV screening in a population of neonates either born with symptoms compatible with congenital CMV or born to mothers with a history of primary infection during pregnancy. For each neonate, 2 CMV PCR assays of DBS were blindly performed in parallel with a gold standard technique (ie, CMV PCR of a urine sample). RESULTS Two hundred seventy-one neonates were studied, and CMV infection, defined by a positive urine sample in the first week of life, was confirmed in 64 (23.6%). Nineteen infected (29.7%) neonates were symptomatic, and 45 (70.3%) were asymptomatic. The ranges of sensitivity, specificity, positive predictive value, and negative predictive value for the 2 CMV PCR assays of DBS were 95.0%-100%; 98.1%-99.0%; 94.1%-96.9%, and 98.5%-100%, respectively. CONCLUSIONS The sensitivity and specificity of both CMV PCR assays of DBS to identify congenital CMV were very high in this population of neonates with a high risk of sequelae. These new data should be considered in the ongoing debate on the appropriateness of the use of DBS as a sample to screen for congenital CMV infection.
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Affiliation(s)
- Marianne Leruez-Ville
- Laboratoire de Virologie, Hôpital Necker-Enfants-Malades, Centre National de Référence du Cytomégalovirus-Laboratoire Associé, Paris, France.
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Dogan Y, Yuksel A, Kalelioglu I, Has R, Tatli B, Yildirim A. Intracranial Ultrasound Abnormalities and Fetal Cytomegalovirus Infection: Report of 8 Cases and Review of the Literature. Fetal Diagn Ther 2011; 30:141-9. [DOI: 10.1159/000330636] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 05/10/2011] [Indexed: 11/19/2022]
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Cordier AG, Vauloup-Fellous C, Picone O. [Is maternal infection with cytomegalovirus prevention possible?]. ACTA ACUST UNITED AC 2010; 38:620-3. [PMID: 20884272 DOI: 10.1016/j.gyobfe.2010.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 07/28/2010] [Indexed: 11/18/2022]
Abstract
Cytomegalovirus (CMV) is the most frequent cause of congenital viral infection in developed countries. Vaccines are currently under development and antiviral treatment or passive immunizations for pregnant women with CMV primary infection are about to be evaluated in randomized trials. However, as it has been shown in few studies, preventing transmission through behavioral changes could be, at the moment, the most effective and inexpensive way to decrease risk of CMV infection during pregnancy. Despite difficulties, such counseling programs deserve to be established.
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Cytomegalovirus seroprevalence in exposed and unexposed populations of hospital employees. Eur J Clin Microbiol Infect Dis 2010; 30:65-70. [PMID: 20842401 DOI: 10.1007/s10096-010-1054-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Accepted: 08/20/2010] [Indexed: 10/19/2022]
Abstract
The objective of this work was to compare the seroprevalence of cytomegalovirus in an unexposed and exposed population, both working in a hospital, and to study the occupational risk factors related to seropositivity, while taking personal risk factors into account. We conducted a cross-sectional study in a French hospital over a period of 12 months. The overall seroprevalence among the 550 subjects was 49.5%. The multivariate analysis showed that seropositivity was significantly associated with age (36-43 years: odds ratio [OR] = 1.7; 95% confidence interval [CI]: [1.1-2.8]) and working as a pediatric nurse's aide (OR = 1.8; 95% CI: [1.1-2.8]). This study confirms the need to improve prevention procedures in the workplace, including screening, information, and hygiene rules.
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De Paschale M, Agrappi C, Manco MT, Clerici P. Positive predictive value of anti-HCMV IgM as an index of primary infection. J Virol Methods 2010; 168:121-5. [DOI: 10.1016/j.jviromet.2010.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 04/29/2010] [Accepted: 05/05/2010] [Indexed: 11/26/2022]
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45
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Grosjean J, Hantz S, Cotin S, Baclet M, Mengelle C, Trapes L, Virey B, Undreiner F, Brosset P, Pasquier C, Denis F, Alain S. Direct genotyping of cytomegalovirus envelope glycoproteins from toddler's saliva samples. J Clin Virol 2009; 46 Suppl 4:S43-8. [DOI: 10.1016/j.jcv.2009.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Revised: 08/06/2009] [Accepted: 08/22/2009] [Indexed: 11/17/2022]
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Vauloup-Fellous C, Picone O, Cordier AG, Parent-du-Châtelet I, Senat MV, Frydman R, Grangeot-Keros L. Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? J Clin Virol 2009; 46 Suppl 4:S49-53. [PMID: 19811947 DOI: 10.1016/j.jcv.2009.09.003] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 08/13/2009] [Indexed: 11/15/2022]
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Matthes-Martin S, Leithner D, Gadner H. Allogene Stammzelltransplantation bei Migranten mit nichtmalignen Krankheiten. Monatsschr Kinderheilkd 2006. [DOI: 10.1007/s00112-006-1424-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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48
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49
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Sheevani, Jindal N, Aggarwal A. A PILOT SEROEPIDEMIOLOGICAL STUDY OF CYTOMEGALOVIRUS INFECTION IN WOMEN OF CHILD BEARING AGE. Indian J Med Microbiol 2005. [DOI: 10.1016/s0255-0857(21)02709-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Canyilmaz D, Aydin F, Tosun I, Kaklikkaya N, Erturk M. Cytomegalovirus excretion in pregnant women in the eastern Black Sea region of Turkey. EUR J CONTRACEP REPR 2004; 9:89-93. [PMID: 15449820 DOI: 10.1080/13625180410001715645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM The study was carried out to determine the viral excretion rate of cytomegalovirus (CMV) in pregnant women in the eastern Black Sea region of Turkey, and to observe how it compared with that in western countries. METHOD Cervical excretion of cytomegalovirus by pregnant women was studied employing a highly sensitive CMV detection assay supported with fluorescent labeled monoclonal antibody directed against an immediate early antigen, known as DEAFF (detection of early antigen by fluorescent foci assay) test. RESULTS CMV excretion rates during the third trimester of pregnancy were similar to the detection rates reported from most developed countries. Our results also showed that the rate of cervical CMV excretion was higher among pregnant women who had a history of more than one spontaneous abortion.
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Affiliation(s)
- D Canyilmaz
- Department of Microbiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
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