The problem of congenital cytomegalovirus infection
Abstract
This paper comprises a review of up-to-date literature devoted to the problem of congenital cytomegalovirus infection, its epidemiology and pathogenesis. The paper includes one report on features and variants of clinical presentation of congenital cytomegalovirus infection and its sequelae, including late-onset complications. We pay attention to the problems related to timely diagnostics of congenital infections during pregnancy and suggest measures that can improve the quality of the survey. The basic aspects of laboratorial verification of cytomegalovirus infection in fetus and newborn are reviewed in the light of peculiarities of the features of the newborns’ immune system. In addition, significant points of etiotropic therapy are emphasized. Principal groups of antiviral drugs are delineated in this review, with proposal for their administration according to the clinical course and sequlae development. Furthermore, in this review we pay attention to the importance of preventive measures for reducing prevalence of cytomegalovirus in pregnant women. In view of its high prevalence among adult population and likelihood of recurrent clinical course in pregnant women, we specifically focus on necessity of further professional development of pediatricians and neonatogists. This necessity is determined by the prevalence of latent course of congenital cytomegalovirus infection, as its diagnostics is frequently retarded and, consequently, provokes development of severe complications. In this paper the indispensability of universal neonatal cytomegalovirus screening embedding is proven. Therefore, this review presents contemporary data about the problem of congenital cytomegalovirus infection and highlights general problems related to timely diagnostics and treatment of intrauterine infections.
About the Authors
R. A. Ivanova
Science Research Institutе of Children’s Infections
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
V. V. Vasiliev
Science Research Institute of Children’s Infections;
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
S. M. Vikhnina
First Saint-Petersburg State Medical University named after I.P. Pavlov
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
M. Yu. Boboshko
First Saint-Petersburg State Medical University named after I.P. Pavlov
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
G. M. Ushakova
Science Research Institutе of Children’s Infections
Russian Federation
Saint-Petersburg
Russian Federation
Saint-Petersburg
References
1. Cinzerling V.A. Vnutriurobnye infekcii: sovremennyj vzgljad na problemu / V.A. Cinzerling // Zhurnal infectologii. – 2014. – T.6,№ – S. 5-10.
2. Tuktarova A.Ju. Vrozhdennaja citomegalovirusnaja infekcicija (klinicheskij sluchaj) / A.Ju. Tuktarova, V.V. Vasil’ev, I.A. Ivashhenko, G.M. Ushakova // Zhurnal infectologii. 2014. – Т.6,№4. – S. 93-7.
3. Mardanly S.G. Citomegalovirusnaja infekcija. Jetiologija, jepedemiologija, patogenez, klinika, laboratornaja diagnostika, lechenie, profilaktika / Mardanly S.G., Kirpichnikova G.I., Neverov V.A., // Jelektrogorsk: ZAO «Jekolab», 2011. – 32 s.
4. Smirnova A.I. Rol’ citomegalovirusov v akusherskoj patologii i neonatologii. / A.I. Smirnova, E.V. Rossihina, N.S. Djupin // Vjatskij medicinskij vestnik. – 2010. – № 4. – S. 41-47.
5. Ross DS, Fowler КВ. Cytomegalovirus: A major cause of hearing loss in children. The ASHA leader. 2008;13(6):14-7.
6. Buonsenso D, Serranti D, Gargiullo L, et al. Congenital cytomegalovirus infection: current strategies and future perspectives. European Review for Medical and Pharmacological Sciences. 2012;16(7):919-35.
7. Germanenko I.P. Citomegalovirusnaja infekcija u detej / I.P. Germanenko, P. Kudin // Minsk: BGMU, 2009. – 34 s.
8. Nyholm JL, Schleiss MR. Prevention of maternal cytomegalovirus infection: current status and future prospects. International Journal of Women’s Health. 2010;2:23–35.
9. Medzhidova M.G. Vyjavlenie markerov citomegalovirusa u novorozhdennyh i detej rannego vozrasta. Razvitie apoptoza pri citomegalovirusnoj infekcii: avtoref. dis. kandidata biologicheskih nauk / M.G. Medzhidova – М.: GU NII virusologii im. D.I. Ivanovskogo, 2005. – 28 s.
10. Vasil’ev V.V. Klinicheskie rekomendacii po diagnostike i lecheniju vrozhdennyh infekcij central’noj nervnoj sistemy / V.V. Vasil’ev, N.V. Skritenko, V.I. Guzeva // Detskaja nevrologija, vyp. 3: klinicheskie rekomendacii. – М.: ООО «MK», 2015. – gl. 14. – S. 240-263s.
11. Vossen A, de Vries J, van der Zeijst B. The 2008 congenital cytomegalovirus conference; 5-7 november, centers for disease control and prevention, Atlanta: Eurosurveillance; c2009. p. 1-2
12. Artemchik Т.А. Vrozhdennaja citomegalovirusnaja infekciaja – kak problema nejrosensornoj tugouhosti u detej / Т.А. Artemchik, А.М. Levaja-Smoljak, N.V. Beljaeva, S.U. Reut // Medicinskaja panorama, 2011. – № 2. – S. 1-4.
13. Nystad M, Fagerheim T, Brox V, et al. Human cytomegalovirus (HCMV) and hearing impairment: infection of fibroblast cells with HCMV induces chromosome breaks at 1q23.3, between loci DFNA7 and DFNA49 – both involved in dominantly inherited, sensoneural hearing impairment. Mutat Res. 2008;637(1-2):56-65.’
14. Siew VK, Duh ChY, Wang ShK. Human cytomegalovirus UL76 induces chromosome aberrations. J Biomed Sci. 2009;25(16):107.
15. Swanson EC. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North AM. 2013;60(2):335-49.
16. Artemchik Т.А. Vrozhdannaja citomegalovirusnaja infekciaja. Skrytaja ugroza / Т.А. Artemchik. // Minsk: BGMU, 2012. – 12 s.
17. Boppana SB, Fowler KB, Pass RF, et al. Congenital cytomegalovirus infection: association between virus burden and hearing loss. J Pediatr. 2005;146(6):817-23.
18. Morton CC, Walter NE. Newborn Hearing Screening – A silent revolution. New Eng J Med. 2006;354:2151-64.
19. Barbi M, Binda S, Caroppo S, et al. Multicity Italian Study of Congenital Cytomegalovirus Infection. Pediatr Infect Dis J. 2006;25:156-9.
20. Frize K. Infekcionnie zabolevanija beremennyh i novorozhdennyh / К. Frize, V. Kahel’– М.: Мedicina, 2003. – 422 s.
21. Obryadina А.P. Avidnost’ antitel v diagnostike infekcionnyh zabolevanij / A.P. Obrjadina, E.О. Kopnina // Medlajn Jekspress. – 2006. – № 1. – S. 64-8.
22. Barkai G, Barzilai A, Mendelson E, et al. Newborn screening of cytomegalovirus using real-time polymerase chain reaction in umbilical cord blood. Isr Med Assoc J. 2013;15(6):279-83.
23. Folkins AK, Chisholm KM, Guo FP, et al. Diagnosis of congenital CMV using PCR performed on formalin-fixed, paraffin-embedded placenatal tissue. Am J Surg Pathol. 2013;37. (9):1413-20.
24. Kondratenko I.V. Vnutrivennye immunoglobuliny: chto i kogda? / I.V. Kondratenko, A.L. Zaplatnikov, А.А. Bologov // Detskaja bol’nica. – 2010. – № 4. – S. 56-60.
25. Lipitz S, Hoffman C, Feldman B, et al. Value of prenatal ultrasound and magnetic resonance imaging in assessment of congenital primary cytomegalovirus infection. Ultrasound in Obstetrics & Gynecology. 2010;36(6):709-17.
Review
For citations:
Ivanova R.A., Vasiliev V.V., Vikhnina S.M., Boboshko M.Yu., Ushakova G.M. The problem of congenital cytomegalovirus infection. Journal Infectology. 2016;8(2):26-31. (In Russ.)
Views:
813
.png)
.png)
Email this article 