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Observational Study
. 2017 May 15;64(10):1335-1342.
doi: 10.1093/cid/cix105.

Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up

Walter-Alfredo Goycochea-Valdivia  1 , Fernando Baquero-Artigao  1 , Teresa Del Rosal  1 , Marie-Antoinette Frick  2 , Pablo Rojo  3 , María-Juncal Echeverría  4 , Antoni Noguera-Julian  5   6   7 , Xavier Bringué  8 , Jesús Saavedra-Lozano  9 , Isabel Vives-Oñós  2   10 , Elisenda Moliner  11 , María-José Cilleruelo  12 , Irene Cuadrado  13 , Elena Colino  14 , Laura Castells  15 , Alfredo Tagarro  16 , Javier Vilas  17 , Pere Soler-Palacin  2 , Daniel Blázquez-Gamero  3 ; Spanish Registry of Infants with Congenital Cytomegalovirus Infection (REDICCMV) Study Group
Affiliations
Observational Study

Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up

Walter-Alfredo Goycochea-Valdivia et al. Clin Infect Dis. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Clin Infect Dis. 2017 Oct 15;65(8):1431-1433. doi: 10.1093/cid/cix563. Clin Infect Dis. 2017. PMID: 29017252 Free PMC article. No abstract available.

Abstract

Background: DNA detection of human cytomegalovirus (hCMV) in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR) is a marker of central nervous system (CNS) involvement in congenital hCMV infection (cCMV), but its prognostic value is unknown.

Methods: A multicenter, retrospective study was performed using the Spanish Congenital Cytomegalovirus Infection Database (REDICCMV; http://www.cmvcongenito.es). Newborns with cCMV and a lumbar puncture performed were included and classified according to their hCMV-PCR in CSF result (positive/negative). Clinical characteristics, neuroimaging abnormalities, plasma viral load, and audiological and neurological outcomes of both groups were compared.

Results: A total of 136 neonates were included in the study: 21 (15.4%) with positive CSF hCMV-PCR and 115 (84.6%) with negative results. Seventeen patients (81%) in the positive group were symptomatic at birth compared with 52.2% of infants in the negative group (odds ratio [OR], 3.86; 95% confidence interval [CI], 1.28-14.1; P = .01). Only 4 asymptomatic newborns (6.8%) had a positive CSF hCMV-PCR. There were no differences between groups regarding the rate of microcephaly, neuroimaging abnormalities, neurological sequelae at 6 months of age, or plasma viral load. Sensorineural hearing loss (SNHL) at birth was associated with a positive CSF hCMV-PCR result (OR, 3.49; 95% CI, 1.08-11.27; P = .04), although no association was found at 6 months of age.

Conclusions: A positive hCMV-PCR result in CSF is associated with symptomatic cCMV and SNHL at birth. However, no differences in neuroimaging studies, plasma viral load, or outcomes at 6 months were found. These results suggest that hCMV-PCR in CSF may not be a useful prognostic marker in cCMV.

Keywords: cerebrospinal fluid; congenital infection; human cytomegalovirus; pediatrics.; polymerase chain reaction.

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