Illnesses during the first two years of life and their association with perinatal cytomegalovirus infection

Antiviral therapy for herpesvirus central nervous system infections: neonatal herpes simplex virus infection, herpes simplex encephalitis, and congenital cytomegalovirus infection

Herpesvirus infections of the central nervous system (CNS) are a significant cause of morbidity and mortality, including long-term neurologic sequelae. Among the family of herpesviruses, the most significant CNS infections are due to herpes simplex virus (HSV) and cytomegalovirus (CMV). The onset of HSV CNS infection can occur in neonates as well as older children and adults. CNS infection associated with CMV occurs predominantly in the perinatal period, but may also be seen rarely in children and adults, especially in immunocompromised individuals. Although advances in antiviral agents have led to improved outcomes, there is still a need for more effective treatments.

[Perinatal infection due to cytomegaloviruses in a public hospital of the municipality of São Paulo: a prospective study]

In order to demonstrate the occurrence of CMV perinatal infection in a middle socioeconomic class population, the authors conducted a 8-month prospective study in 37 children, not infected congenitally, born in a public hospital of São Paulo city, Prevalence of CMV-IgG antibodies in mothers, detected by immunoenzymatic assay (ELISA), was 92.7%. Survival analysis showed that the risk of acquiring CMV perinatal infection diagnosed by virus isolation in human fibroblasts was 30.9%. When the diagnostic method was detection of IgM class antibodies by indirect immunofluorescence the risk was 8.1% (p < 0.05). Milk samples inoculated in human fibroblasts failed to demonstrate the presence of virus. The infected children did not present any signal of disease in a 4-month follow-up.

Intellectual ability of children after perinatal cytomegalovirus infection

The intellectual ability of 16 children who had not had congenital cytomegalovirus (CMV) infection, but acquired it before the age of six months, was compared with that of two other groups: one comprising 32 children who had had CMV-excreting mothers but who were not infected themselves: the other comprising 18 healthy controls. Serial audiological, ophthalmological and psychometric examinations were performed. The only statistically significant difference found was that the children with acquired CMV infection had lower mean arithmetic scores. The results suggest that healthy term infants who acquire early CMV infection are not at increased risk of intellectual impairment.