Immunization to prevent congenital cytomegalovirus infection

Abstract

Introduction: A primary maternal cytomegalovirus (CMV) during pregnancy causes newborn disease that includes hearing deficit and/or mental retardation.

Sources of data: Relevant published literature.

Areas of agreement: There are no biologic obstacles to immunization against fetal/placental infection with CMV.

Areas of uncertainty: CMV vaccine trials may be difficult due to a lack of public awareness of CMV. Vaccine trials that use fetal infection as an endpoint will be prolonged, since vaccination will need to occur preconception.

Areas timely for developing research: Vaccines in preclinical development include antigens of the CMV gB glycoprotein and the gH/gL UL128, 130 and 131 pentameric complex. These antigens induce antibodies that block viral entry into fibroblasts and endothelial/epithelial cells. Vaccines immunogenic in animals include an inactivated virus with a wild-type UL131 gene, a DNA vaccine using a wild-type UL130 gene and peptide vaccines using peptides from UL130 and 131.

Conclusions: In spite of these potential obstacles, successful evaluation of CMV vaccines is possible.

Keywords: cytomegalovirus; pregnancy; vaccines.