Potential Biomarkers for Predicting Congenital Cytomegalovirus Infection

Abstract

Early diagnosis and treatment of infants with symptomatic congenital cytomegalovirus (CMV) infection may improve neurological outcomes. For this reason, prenatal detection of newborns at high risk for congenital CMV infection is important. A polymerase chain reaction (PCR) assay for CMV DNA in the amniotic fluid is the gold standard for the diagnosis of intrauterine CMV infection; however, amniocentesis is an invasive procedure. Recently, we have found that the presence of CMV DNA in the maternal uterine cervical secretion is predictive of the occurrence of congenital CMV infection in CMV immunoglobulin M (IgM)-positive pregnant women. In contrast, we have suggested that maternal serological screening for primary CMV infection using CMV-specific immunoglobulin G (IgG), the IgG avidity index, or CMV-specific IgM overlooks a number of newborns with congenital CMV infection. We will review current knowledge of the potential biomarkers for predicting congenital CMV infection.

Keywords: biomarker; congenital infection; cytomegalovirus; prediction; screening.

Figure 1

Flow algorithm for the diagnosis, prevention, and treatment of congenital CMV infection. Modalities for prediction or diagnosis of congenital CMV infection are indicated in gray. Interventions for preventing or treating congenital CMV infection are indicated in the dotted boxes. Abbreviations: CMV, cytomegalovirus; Ig, immunoglobulin; US, ultrasound; PCR, polymerase chain reaction; s/o, suspect of; No/asymptomatic, no or asymptomatic; USG, ultrasonography; ABR, auditory brainstem response.