[A review on the prevention and treatment of congenital cytomegalovirus infection in mothers and infants]
- PMID: 30369367
- PMCID: PMC7389047
- DOI: 10.7499/j.issn.1008-8830.2018.10.018
[A review on the prevention and treatment of congenital cytomegalovirus infection in mothers and infants]
Abstract
Human cytomegalovirus (HCMV) has a high infection rate worldwide, and 85%-90% of congenital cytomegalovirus (CMV) infections are asymptomatic at birth, with the clinical manifestations of hearing loss, psychomotor retardation, and learning disabilities, while 10%-15% are symptomatic infections. Some preterm infants develop CMV infection after birth, which can cause sepsis-like syndrome, thrombocytopenia, neutropenia, liver injury, and lung injury. However at present, women of childbearing age have a lack of awareness of CMV. CMV education and hygiene precautions for pregnant women can prevent CMV infections in themselves and congenital CMV infections in their infants. No definite results have been obtained from the studies on the effect of CMV vaccine and high-titer immunoglobulin in preventing congenital CMV infection in fetuses. Recent studies have confirmed that the specificity and sensitivity of urinary or salivary CMV-DNA detection have reached more than 98%, which contributes to the early diagnosis of congenital CMV infection. In addition to short-term treatment with ganciclovir, long-term treatment with oral valganciclovir is safe for symptomatic congenital CMV infection and appears to have a better clinical effect than the short-term treatment. In the future, it is necessary to strengthen the health education for pregnant women, enhance the mother-to-child management of CMV infection, conduct the research on CMV vaccine, and further standardize treatment regimens.
人巨细胞病毒(HCMV)在世界范围内均有较高的感染率,先天性巨细胞病毒(CMV)感染者出生时85%~90%为无症状性感染,表现为听力损失、精神运动迟缓、学习障碍等;10%~15%为症状性感染,部分早产儿生后CMV感染,可造成败血症样综合征、血小板减少症、中性粒细胞减少症、肝损伤、肺损伤等。目前育龄妇女对CMV认识度极低,为孕妇提供CMV教育和卫生预防措施,可以预防怀孕妇女和新生儿先天性CMV感染。CMV疫苗及高价免疫球蛋白预防胎儿先天性CMV感染的研究尚无明确结果。近年来的研究证实尿液或唾液CMV-DNA检测的特异性和敏感性达98%以上,有助于先天性CMV感染的早期诊断。除了更昔洛韦的短期治疗,对有症状的先天性CMV感染患儿予口服缬更昔洛韦长期治疗更安全,而且似乎比短期治疗效果更好。未来还需加强对孕妇的宣传教育,加强对CMV感染的母婴管理,开展CMV疫苗的研究,以及进一步规范治疗方案等。
Similar articles
-
Prevention and treatment of fetal cytomegalovirus infection with cytomegalovirus hyperimmune globulin: a multicenter study in Madrid.J Matern Fetal Neonatal Med. 2019 Feb;32(4):617-625. doi: 10.1080/14767058.2017.1387890. Epub 2017 Oct 26. J Matern Fetal Neonatal Med. 2019. PMID: 28978246
-
Treatment of symptomatic congenital cytomegalovirus infection with intravenous ganciclovir followed by long-term oral valganciclovir.Eur J Pediatr. 2010 Sep;169(9):1061-7. doi: 10.1007/s00431-010-1176-9. Epub 2010 Mar 16. Eur J Pediatr. 2010. PMID: 20232081
-
Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention.Aust N Z J Obstet Gynaecol. 2016 Feb;56(1):9-18. doi: 10.1111/ajo.12408. Epub 2015 Sep 22. Aust N Z J Obstet Gynaecol. 2016. PMID: 26391432 Review.
-
Use of cytomegalovirus hyperimmunoglobulin for prevention of congenital cytomegalovirus disease: a retrospective analysis.J Perinat Med. 2012 Mar 27;40(4):439-46. doi: 10.1515/jpm-2011-0257. J Perinat Med. 2012. PMID: 22752777
-
[Review and guidelines on the prevention, diagnosis and treatment of post-natal cytomegalovirus infection].An Pediatr (Barc). 2011 Jan;74(1):52.e1-52.e13. doi: 10.1016/j.anpedi.2010.05.024. Epub 2010 Jul 14. An Pediatr (Barc). 2011. PMID: 20630814 Review. Spanish.
Cited by
-
Functional Profile of Human Cytomegalovirus Genes and Their Associated Diseases: A Review.Front Microbiol. 2020 Sep 4;11:2104. doi: 10.3389/fmicb.2020.02104. eCollection 2020. Front Microbiol. 2020. PMID: 33013768 Free PMC article. Review.
-
Congenital Human Cytomegalovirus Infection Inducing Sensorineural Hearing Loss.Front Microbiol. 2021 Apr 14;12:649690. doi: 10.3389/fmicb.2021.649690. eCollection 2021. Front Microbiol. 2021. PMID: 33936007 Free PMC article. Review.
-
Lights and Shadows of TORCH Infection Proteomics.Genes (Basel). 2020 Aug 5;11(8):894. doi: 10.3390/genes11080894. Genes (Basel). 2020. PMID: 32764347 Free PMC article. Review.
-
A Review of Sensorineural Hearing Loss in Congenital Cytomegalovirus Infection.Cureus. 2022 Oct 26;14(10):e30703. doi: 10.7759/cureus.30703. eCollection 2022 Oct. Cureus. 2022. PMID: 36439580 Free PMC article. Review.
-
Genetic Counseling of Fetal Microcephaly.J Med Ultrasound. 2024 Mar 21;32(1):1-7. doi: 10.4103/jmu.jmu_18_23. eCollection 2024 Jan-Mar. J Med Ultrasound. 2024. PMID: 38665355 Free PMC article. Review.