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. 2025 Feb:176:105756.
doi: 10.1016/j.jcv.2024.105756. Epub 2024 Dec 3.

Cytomegalovirus urinary excretion in children with congenital and postnatally acquired infection

Tatiana M Lanzieri  1 , A Chantal Caviness  2 , Jill J Williams  2 , Gail Demmler-Harrison  3 ; Houston Congenital Cytomegalovirus Longitudinal Study Group
Affiliations

Cytomegalovirus urinary excretion in children with congenital and postnatally acquired infection

Tatiana M Lanzieri et al. J Clin Virol. 2025 Feb.

Abstract

Background: Cytomegalovirus (CMV) infection in children is associated with prolonged viral excretion in urine and saliva. This study characterizes CMV urinary excretion in children with congenital (cCMV) and postnatally acquired CMV infection.

Methods: Children with virologically confirmed cCMV (75 symptomatic and 105 asymptomatic at birth) and 51 children without cCMV were followed through median 11, 18 and 17 years of age, respectively. In children with cCMV, duration of CMV excretion was defined as uninterrupted positive results from initial to last positive culture, and recurrent CMV excretion as ≥1 positive following >1 negative result. CMV urinary excretion in children without cCMV was defined as resulting from postnatally acquired CMV infection.

Results: Mean duration of persistent CMV urinary excretion in children with cCMV was 1.9 (maximum 8.7) years for symptomatic and 2.8 (maximum 9.8) years for asymptomatic children (P = 0.011). Mean duration of CMV excretion was not statistically different for 17 symptomatic children treated with ganciclovir (2.4 years) compared with 58 untreated (1.8 years); P = 0.356. Recurrent excretion occurred in 19 (25 %) symptomatic and 21 (20 %) asymptomatic children, at mean age 4.0 and 6.2 years, respectively (P = 0.084). In 16 (31 %) children with postnatally acquired CMV infection, CMV urinary excretion began at mean age 1.8 (range 0.3-7.3) years.

Conclusions: Both symptomatic and asymptomatic cCMV were associated with persistent long-term CMV excretion in urine, which was significantly longer in asymptomatic cCMV and not influenced by ganciclovir treatment in symptomatic cCMV. CMV urinary excretion was common in young children without cCMV, suggesting rapid CMV acquisition in childhood.

Keywords: Congenital; Culture; Cytomegalovirus; Urinary excretion.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Percentage of CMV-positive urines by age of test stratified by children with symptomatic or asymptomatic cCMV and children with postnatally acquired CMV infection.
Figure 2.
Figure 2.
Percentage of CMV-positive urines by age of test for children with symptomatic cCMV stratified by ganciclovir treatment.
See this image and copyright information in PMC

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