Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Nov 1;44(11):1044-1050.
doi: 10.1097/INF.0000000000004905. Epub 2025 Jul 4.

Severe Neutropenia in Infants With Congenital Cytomegalovirus on Antiviral Therapy

Vassiliki Papaevangelou  1 , Roberto Pedrero-Tomé  2 , Garyfallia Syridou  1 , Fernando Baquero-Artigao  3 , Paula Rodríguez-Molino  3 , Teresa Del Rosal  3 , Antoni Noguera-Julián  4   5   6 , María Ríos-Barnés  4 , Claudia Fortuny  4   5   6 , Serena Villaverde  2 , María Antoinnette Frick  6 , Beatriz Álvarez Vallejo  7   8   9 , Pere Soler-Palacín  7   8   9 , Jesús Saavedra  10   11   12 , Elena Rincón  10   11   12 , Sofia Karagiannidou  1 , Itziar Sota Busselo  13 , Oihana Muga Zuriarrain  13 , Elisenda Moliner Calderón  14 , Alfredo Tagarro  15 , María Malumbres  16 , Elena Colino  17 , Elisa Garrote Llanos  18 , Ana Menasalvas Ruiz  19 , Miguel Sánchez Mateos  20 , Xavier Bringué Espuny  21 , Almudena Alonso-Ojembarrena  22   23 , Laura Ferreras-Antolin  24 , Irene Cuadrado Pérez  25 , Ana Filgueira Posse  26 , Hermione Lyall  27 , Daniel Blázquez-Gamero  2 ; cCMVnet Registry Study Group
Affiliations
Multicenter Study

Severe Neutropenia in Infants With Congenital Cytomegalovirus on Antiviral Therapy

Vassiliki Papaevangelou et al. Pediatr Infect Dis J. .

Abstract

Aim: To describe European real-life experience of severe neutropenia (SN) during ganciclovir (GCV) and/or valganciclovir (VGCV) treatment in infants with congenital cytomegalovirus (cCMV) infection and identify risk factors associated with the development of SN.

Methods: A multicenter retrospective cohort study from the European cCMVnet registry included infants with confirmed cCMV infection treated since 2011 with GCV and/or VGCV. Details of treatment, including age at initiation, route of administration and duration, are described. Prevalence and risk factors associated with the development of SN, defined as neutrophil count of <500 cells/mm 3 , were analyzed.

Results: Overall, 566 children with confirmed cCMV treated with antivirals were included; 165 (29.7%) were born prematurely (gestational age <37 weeks). Administration of intravenous GCV, alone or in combination with oral VGCV, was associated with prematurity and date of birth before 2017. SN occurred in 102 infants (18%). Multivariate logistic regression analysis identified 2 independent risk factors for the development of SN: prematurity almost doubled the risk of developing SN [odds ratio (OR) = 1.961; 95% confidence interval (CI): 1.163-3.300], while the risk of developing SN increased by 11% for every 1000 neutrophils decrease in the absolute neutrophil count at baseline (OR = 1.104; 95% CI: 1.031-1.192). When term newborns were analyzed alone, baseline absolute neutrophil count remained an important risk factor for developing SN.

Conclusions: In children with cCMV treated with GCV/VGCV prematurity and low pretreatment neutrophil counts are associated with an increased risk of developing SN. This is important for patient management, and when informing parents about treatment side effects.

Keywords: antiviral treatment; congenital cytomegalovirus; neutropenia; prematurity.

PubMed Disclaimer

Conflict of interest statement

D.B.-G. was supported by the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III and Fondos FEDER by “Contratos para la intensificación de la actividad investigadora en el Sistema Nacional de Salud, 2020 (INT20/00086) and 2023 (INT23/00039). P.R.-M. is funded by Instituto de Salud Carlos III- Spanish Ministry of Health and Fondos Feder of the EU [CM21/00174]. M.R.-B. was supported by a predoctoral contract for training in health research (PFIS) by Instituto de Salud Carlos III, ref. FI20/00237. The other authors have no conflicts of interest to disclose.

References

    1. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol. 2007;17:253–276.
    1. Ssentego P, Hehnly C, Birungi P, et al. Congenital cytomegalovirus infection burden and epidemiologic risk factors in countries with universal screening: a systematic review and meta-analysis. JAMA Netw Open. 2021;4:e2120736.
    1. Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007;17:355–363.
    1. Kabani N, Ross SA. Congenital cytomegalovirus infection. J Infect Dis. 2020;221(Suppl 1):S9–S14.
    1. Chiopris G, Veronse P, Cusenza F, et al. Congenital cytomegalovirus infection: update on diagnosis and treatment. Microorganisms. 2020;8:1516.

Publication types

MeSH terms