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Erschienen in: Archives of Gynecology and Obstetrics 2/2017

17.06.2017 | Maternal-Fetal Medicine

Congenital cytomegalovirus infection in Central Germany: an underestimated risk

verfasst von: Hannah Rütten, Anke Rissmann, Birgit Brett, Serban-Dan Costa, Birgit Doßow, Jacqueline Färber, Stefan Fest, Christiane Fritzsch, Anke Lux, Ilona Päge, Claudia Spillner, Anke Redlich

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2017

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Abstract

Purpose

This is the first study to determine the cytomegalovirus (CMV) seronegativity rate for women of childbearing age in Saxony-Anhalt and to determine the prevalence of clinically relevant congenital CMV (cCMV) infection in Central Germany, because there are no valid data available.

Methods

The retrospective study was undertaken between January 2005 and December 2015. For the first time in Germany, the following seven data sources were used to analyze the prevalence of clinically relevant cCMV infection and the rate of CMV seronegative women of childbearing age: CMV Screening in maternity unit, University Women’s Hospital, Social Paediatrics Centre (SPC), Malformation Monitoring Centre (MMC), Newborn Hearing Screening (NHS), Neonatal Intensive Care Unit (NICU), and In-house Doctor Department. Key parameters were anti-CMV IgG and IgM, CMV PCR of urine, and clinically relevant symptoms caused by CMV.

Results

Between 46 and 52% of women of childbearing age were CMV seronegative. The prevalence of clinically relevant cCMV infection was between 0.008 and 0.04%.

Conclusions

The CMV seronegativity rate of women of childbearing age was confirmed to be in the middle range of estimated data from other sources in Germany. Data from the NICU, SPC, NHS, and MMC show the prevalence of clinically relevant cCMV infection. The risk of all cCMV infections is underestimated. Thus, the true prevalence of clinically relevant and subclinical cCMV infections is >0.04%.
Literatur
1.
Zurück zum Zitat Numazaki KCS (1997) Current aspects of diagnosis and treatment of cytomegalovirus infections in infants. Clin Diagn Virol 8:169–181CrossRefPubMed Numazaki KCS (1997) Current aspects of diagnosis and treatment of cytomegalovirus infections in infants. Clin Diagn Virol 8:169–181CrossRefPubMed
7.
Zurück zum Zitat Knabl J (2011) CMV-Infektion und -Screening in der Schwangerschaft. Z Geburtshilfe Neonatol 35:719–721 Knabl J (2011) CMV-Infektion und -Screening in der Schwangerschaft. Z Geburtshilfe Neonatol 35:719–721
8.
Zurück zum Zitat Nyholm JLS (2010) Prevention of maternal cytomegalovirus infection: current status and future prospects. Int J Women’s Health 2:23–35 Nyholm JLS (2010) Prevention of maternal cytomegalovirus infection: current status and future prospects. Int J Women’s Health 2:23–35
9.
Zurück zum Zitat Meyer-Wittkopf M, Buxmann H, Gonser M et al (2009) Neues zu prä- und perinatalen Cytomegalovirus-Infektion. Frauenarzt 6:525–527 Meyer-Wittkopf M, Buxmann H, Gonser M et al (2009) Neues zu prä- und perinatalen Cytomegalovirus-Infektion. Frauenarzt 6:525–527
12.
Zurück zum Zitat Hamprecht K, Jahn G (2007) Human cytomegalovirus and congenital virus infection (Humanes Cytomegalovirus und kongenitale Infektion). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(11):1379–1392. doi:10.1007/s00103-007-0194-x CrossRefPubMed Hamprecht K, Jahn G (2007) Human cytomegalovirus and congenital virus infection (Humanes Cytomegalovirus und kongenitale Infektion). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50(11):1379–1392. doi:10.​1007/​s00103-007-0194-x CrossRefPubMed
19.
Zurück zum Zitat Revello MG, Fabbri E, Furione M et al (2011) Role of prenatal diagnosis and counseling in the management of 735 pregnancies complicated by primary human cytomegalovirus infection: a 20-year experience. J Clin Virol 50(4):303–307. doi:10.1016/j.jcv.2010.12.012 CrossRefPubMed Revello MG, Fabbri E, Furione M et al (2011) Role of prenatal diagnosis and counseling in the management of 735 pregnancies complicated by primary human cytomegalovirus infection: a 20-year experience. J Clin Virol 50(4):303–307. doi:10.​1016/​j.​jcv.​2010.​12.​012 CrossRefPubMed
20.
Zurück zum Zitat Fowler Karen B, Sergio Stagno, Pass Robert F, Britt William J, Boll Thomas J, Alford Charles A (1992) The outcome of congenital cytomegalovirus infection in relation to maternal antibody status. N Engl J Med 10:663–667CrossRef Fowler Karen B, Sergio Stagno, Pass Robert F, Britt William J, Boll Thomas J, Alford Charles A (1992) The outcome of congenital cytomegalovirus infection in relation to maternal antibody status. N Engl J Med 10:663–667CrossRef
21.
Zurück zum Zitat Naing ZW, Scott GM, Shand A et al (2016) Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention. Aust N Z J Obstet Gynaecol 56(1):9–18. doi:10.1111/ajo.12408 CrossRefPubMed Naing ZW, Scott GM, Shand A et al (2016) Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention. Aust N Z J Obstet Gynaecol 56(1):9–18. doi:10.​1111/​ajo.​12408 CrossRefPubMed
23.
Zurück zum Zitat Kharfan-Dabaja MA, Boeckh M, Wilck MB et al (2012) A novel therapeutic cytomegalovirus DNA vaccine in allogeneic haemopoietic stem-cell transplantation: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis 12(4):290–299. doi:10.1016/S1473-3099(11)70344-9 CrossRefPubMed Kharfan-Dabaja MA, Boeckh M, Wilck MB et al (2012) A novel therapeutic cytomegalovirus DNA vaccine in allogeneic haemopoietic stem-cell transplantation: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis 12(4):290–299. doi:10.​1016/​S1473-3099(11)70344-9 CrossRefPubMed
24.
Zurück zum Zitat Leruez-Ville MVY (2016) Optimum treatment of congenital cytomegalovirus infection. Expert Rev Anti Infect Ther 14:479–488CrossRefPubMed Leruez-Ville MVY (2016) Optimum treatment of congenital cytomegalovirus infection. Expert Rev Anti Infect Ther 14:479–488CrossRefPubMed
25.
Zurück zum Zitat Vauloup-Fellous C, Picone O, Cordier A et al (2009) Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital. J Clin Virol 46(Suppl 4):S49–S53. doi:10.1016/j.jcv.2009.09.003 CrossRefPubMed Vauloup-Fellous C, Picone O, Cordier A et al (2009) Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital. J Clin Virol 46(Suppl 4):S49–S53. doi:10.​1016/​j.​jcv.​2009.​09.​003 CrossRefPubMed
30.
Zurück zum Zitat Schampera MS, Schweinzer K, Abele H et al (2017) Comparison of cytomegalovirus (CMV)-specific neutralization capacity of hyperimmunoglobulin (HIG) versus standard intravenous immunoglobulin (IVIG) preparations: impact of CMV IgG normalization. J Clin Virol 90:40–45. doi:10.1016/j.jcv.2017.03.005 CrossRefPubMed Schampera MS, Schweinzer K, Abele H et al (2017) Comparison of cytomegalovirus (CMV)-specific neutralization capacity of hyperimmunoglobulin (HIG) versus standard intravenous immunoglobulin (IVIG) preparations: impact of CMV IgG normalization. J Clin Virol 90:40–45. doi:10.​1016/​j.​jcv.​2017.​03.​005 CrossRefPubMed
31.
Zurück zum Zitat Leruez-Ville M, Ghout I, Bussieres L et al (2016) In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicenter, open-label, phase II study. Am J Obstet Gynecol 215(4):462.e1. doi:10.1016/j.ajog.2016.04.003 CrossRef Leruez-Ville M, Ghout I, Bussieres L et al (2016) In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicenter, open-label, phase II study. Am J Obstet Gynecol 215(4):462.e1. doi:10.​1016/​j.​ajog.​2016.​04.​003 CrossRef
32.
Zurück zum Zitat Mareri A, Lasorella S, Iapadre G, Maresca M, Tambucci R, Nigro G (2016) Anti-viral therapy for congenital cytomgealovirus infection: pharmacokinetics, efficacy and side effect. J Matern Fetal Neonatal Med 29:1657–1664CrossRefPubMed Mareri A, Lasorella S, Iapadre G, Maresca M, Tambucci R, Nigro G (2016) Anti-viral therapy for congenital cytomgealovirus infection: pharmacokinetics, efficacy and side effect. J Matern Fetal Neonatal Med 29:1657–1664CrossRefPubMed
33.
34.
Zurück zum Zitat Karacan M, Batukan M, Cebi Z et al (2014) Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet 290(6):1115–1120. doi:10.1007/s00404-014-3340-3 CrossRefPubMed Karacan M, Batukan M, Cebi Z et al (2014) Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet 290(6):1115–1120. doi:10.​1007/​s00404-014-3340-3 CrossRefPubMed
35.
Zurück zum Zitat Rahav G (2007) Congenital Cytomegalovirus Infection-a Question of Screening. Isr Med Assoc J 9:392–394PubMed Rahav G (2007) Congenital Cytomegalovirus Infection-a Question of Screening. Isr Med Assoc J 9:392–394PubMed
42.
Zurück zum Zitat de Vries JJ, van Zwet EW, Dekker FW et al (2013) The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population-based prediction model. Rev Med Virol 23(4):241–249. doi:10.1002/rmv.1744 CrossRefPubMed de Vries JJ, van Zwet EW, Dekker FW et al (2013) The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population-based prediction model. Rev Med Virol 23(4):241–249. doi:10.​1002/​rmv.​1744 CrossRefPubMed
44.
Zurück zum Zitat Yamamoto AY, Mussi-Pinhata MM, Boppana SB et al (2010) Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population. Am J Obstet Gynecol 202(3):297.e1–8. doi:10.1016/j.ajog.2009.11.018 CrossRefPubMed Yamamoto AY, Mussi-Pinhata MM, Boppana SB et al (2010) Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population. Am J Obstet Gynecol 202(3):297.e1–8. doi:10.​1016/​j.​ajog.​2009.​11.​018 CrossRefPubMed
51.
Zurück zum Zitat Vochem M (2003) CMV infections of the neonate: prevalence, diagnosis, therapy (CMV-Infektionen bei Neugeborenen: pravalenz, Diagnostik und Therapie). Z Geburtshilfe Neonatol 207(3):114–118. doi:10.1055/s-2003-40978 CrossRefPubMed Vochem M (2003) CMV infections of the neonate: prevalence, diagnosis, therapy (CMV-Infektionen bei Neugeborenen: pravalenz, Diagnostik und Therapie). Z Geburtshilfe Neonatol 207(3):114–118. doi:10.​1055/​s-2003-40978 CrossRefPubMed
52.
Zurück zum Zitat McMullen BJ, Palasanthiran P, Jones CA, Hall BV, Robertson PW, Howard J, Rawlinson WD (2011) Congenital cytomegalovirus- time to diagnosis, management and clinical sequelae in Australia: opportunities for earlier identification. Med J Aust 12:625–629 McMullen BJ, Palasanthiran P, Jones CA, Hall BV, Robertson PW, Howard J, Rawlinson WD (2011) Congenital cytomegalovirus- time to diagnosis, management and clinical sequelae in Australia: opportunities for earlier identification. Med J Aust 12:625–629
54.
Zurück zum Zitat De Vries J, Vossen A, Kroes A, Van der Zeijst B (2011) Implementing neonatal screening for congenital cytomegalovirus: addressing the deafness of policy makers. Rev Med Virol 21:54–61CrossRefPubMed De Vries J, Vossen A, Kroes A, Van der Zeijst B (2011) Implementing neonatal screening for congenital cytomegalovirus: addressing the deafness of policy makers. Rev Med Virol 21:54–61CrossRefPubMed
Metadaten
Titel
Congenital cytomegalovirus infection in Central Germany: an underestimated risk
verfasst von
Hannah Rütten
Anke Rissmann
Birgit Brett
Serban-Dan Costa
Birgit Doßow
Jacqueline Färber
Stefan Fest
Christiane Fritzsch
Anke Lux
Ilona Päge
Claudia Spillner
Anke Redlich
Publikationsdatum
17.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-017-4435-4

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