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Erschienen in: Irish Journal of Medical Science (1971 -) 2/2015

01.06.2015 | Original Article

The role of maternal screening in diagnosing congenital cytomegalovirus infections in highly immune populations

verfasst von: F. Şahiner, M. Honca, Y. Çekmez, A. Kubar, T. Honca, M. K. Fidanci, T. Purtuloğlu, M. Yapar

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2015

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Abstract

Background

Congenital cytomegalovirus (CMV) infection is the most important infectious cause of central nervous system disease and hearing loss in children.

Aims

In this study, we aimed to investigate the role of maternal screening in early diagnosis of congenital infection in highly immune populations.

Methods

A total of 163 women were included in the study; 103 of the subjects were pregnant and were at full term. The other 60 women were not pregnant, and all were healthy.

Results

CMV IgG seropositivity among the pregnant and control groups was found to be 98.1 % (101/103) and 98.3 % (59/60), respectively, and high IgG avidity was found in all women who had IgG positivity. We did not find any primary CMV infection in the two groups. The recurrent infection rate was found to be 5.82 % in the pregnant group and 3.33 % in the control group. There were no significant differences between the pregnant and control women in terms of CMV excretion in urine samples (4.85 vs. 3.33 %, respectively; P = 1.000) or CMV-DNA presence in serum samples (1.94 vs. 0.0 %, respectively; P = 0.532). The presence of symptomatic infection was not observed in any of the 104 babies born from the 103 pregnancies.

Conclusions

According to our results, a maternal screening-based approach would be useful for only a very small group that is at risk of primary infection. Considering the cost of the scan, a routine maternal-based screening program is unadvisable in developing societies, but it is necessary for studies of different cohort groups and infectious diseases.
Literatur
1.
Zurück zum Zitat Mocarski ES, Pass RF (2008) Human cytomegalovirus: general features. In: Mahy BWJ, Van Regenmortel MHV (eds) Encyclopedia of virology, 3rd edn. Academic Press, Oxford, pp 474–485CrossRef Mocarski ES, Pass RF (2008) Human cytomegalovirus: general features. In: Mahy BWJ, Van Regenmortel MHV (eds) Encyclopedia of virology, 3rd edn. Academic Press, Oxford, pp 474–485CrossRef
2.
Zurück zum Zitat Preston CM (2008) Herpesviruses: latency. In: Mahy BWJ, Van Regenmortel MHV (eds) Encyclopedia of virology, 3rd edn. Academic Press, Oxford, pp 436–442CrossRef Preston CM (2008) Herpesviruses: latency. In: Mahy BWJ, Van Regenmortel MHV (eds) Encyclopedia of virology, 3rd edn. Academic Press, Oxford, pp 436–442CrossRef
3.
Zurück zum Zitat Kenneson A, Cannon MJ (2007) Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 17(4):253–276CrossRefPubMed Kenneson A, Cannon MJ (2007) Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 17(4):253–276CrossRefPubMed
4.
Zurück zum Zitat Cannon MJ, Hyde TB, Schmid DS (2011) Review of cytomegalovirus shedding in bodily fluids and relevance to congenital cytomegalovirus infection. Rev Med Virol 21(4):240–255CrossRefPubMed Cannon MJ, Hyde TB, Schmid DS (2011) Review of cytomegalovirus shedding in bodily fluids and relevance to congenital cytomegalovirus infection. Rev Med Virol 21(4):240–255CrossRefPubMed
5.
Zurück zum Zitat Boppana SB (2006) Cytomegalovirus. In: Hutto C (ed) Congenital and perinatal infections. Humana Press Inc., Totowa, pp 73–86CrossRef Boppana SB (2006) Cytomegalovirus. In: Hutto C (ed) Congenital and perinatal infections. Humana Press Inc., Totowa, pp 73–86CrossRef
6.
Zurück zum Zitat de Graan-Hentzen YC, Gratama JW, Mudde GC et al (1989) Prevention of primary cytomegalovirus infection in patients with hematologic malignancies by intensive white cell depletion of blood products. Transfusion 29:757–760CrossRefPubMed de Graan-Hentzen YC, Gratama JW, Mudde GC et al (1989) Prevention of primary cytomegalovirus infection in patients with hematologic malignancies by intensive white cell depletion of blood products. Transfusion 29:757–760CrossRefPubMed
7.
Zurück zum Zitat Schoenfisch AL, Dollard SC, Amin M et al (2011) Cytomegalovirus (CMV) shedding is highly correlated with markers of immunosuppression in CMV-seropositive women. J Med Microbiol 60(Pt 6):768–774CrossRefPubMed Schoenfisch AL, Dollard SC, Amin M et al (2011) Cytomegalovirus (CMV) shedding is highly correlated with markers of immunosuppression in CMV-seropositive women. J Med Microbiol 60(Pt 6):768–774CrossRefPubMed
8.
Zurück zum Zitat Pereira L, Maidji E, McDonagh S, Tabata T (2005) Insights into viral transmission at the uterine-placental interface. Trends Microbiol 13(4):164–174CrossRefPubMed Pereira L, Maidji E, McDonagh S, Tabata T (2005) Insights into viral transmission at the uterine-placental interface. Trends Microbiol 13(4):164–174CrossRefPubMed
9.
Zurück zum Zitat Stagno S, Pass RF, Cloud G et al (1986) Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus, and clinical outcome. JAMA 256(14):1904–1908CrossRefPubMed Stagno S, Pass RF, Cloud G et al (1986) Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus, and clinical outcome. JAMA 256(14):1904–1908CrossRefPubMed
10.
Zurück zum Zitat Ahlfors K, Ivarsson SA, Harris S et al (1984) Congenital cytomegalovirus infection and disease in Sweden and the relative importance of primary and secondary maternal infections. Scand J Infect Dis 16(2):129–137CrossRefPubMed Ahlfors K, Ivarsson SA, Harris S et al (1984) Congenital cytomegalovirus infection and disease in Sweden and the relative importance of primary and secondary maternal infections. Scand J Infect Dis 16(2):129–137CrossRefPubMed
11.
Zurück zum Zitat Stagno S, Reynolds DW, Huang ES, Thames SC, Smith RJ, Alford CA (1977) Congenital cytomegalovirus infection: occurrence in an immune population. N Engl J Med 296(22):1254–1258CrossRefPubMed Stagno S, Reynolds DW, Huang ES, Thames SC, Smith RJ, Alford CA (1977) Congenital cytomegalovirus infection: occurrence in an immune population. N Engl J Med 296(22):1254–1258CrossRefPubMed
12.
Zurück zum Zitat Morris DJ, Sims D, Chiswick M, Das VK, Newton VE (1994) Symptomatic congenital cytomegalovirus infection after maternal recurrent infection. Pediatr Infect Dis J 13(1):61–64CrossRefPubMed Morris DJ, Sims D, Chiswick M, Das VK, Newton VE (1994) Symptomatic congenital cytomegalovirus infection after maternal recurrent infection. Pediatr Infect Dis J 13(1):61–64CrossRefPubMed
13.
Zurück zum Zitat Picone O, Vauloup-Fellous C, Cordier AG et al (2013) A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome. Prenat Diagn 33(8):751–758CrossRefPubMed Picone O, Vauloup-Fellous C, Cordier AG et al (2013) A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome. Prenat Diagn 33(8):751–758CrossRefPubMed
14.
Zurück zum Zitat Lazzarotto T, Varani S, Guerra B, Nicolosi A, Lanari M, Landini MP (2000) Prenatal indicators of congenital cytomegalovirus infection. J Pediatr 137(1):90–95CrossRefPubMed Lazzarotto T, Varani S, Guerra B, Nicolosi A, Lanari M, Landini MP (2000) Prenatal indicators of congenital cytomegalovirus infection. J Pediatr 137(1):90–95CrossRefPubMed
15.
Zurück zum Zitat Sambrook J, Fritsch EF, Maniatis T (1989) Isolation of DNA from mammalian cells. In: Sambrook J, Fritsch EF, Maniatis T (eds) Molecular cloning: a laboratory manual (Vol 1), 2nd edn. Cold Spring Harbor Laboratory Press, New York, pp 9.16–9.19 Sambrook J, Fritsch EF, Maniatis T (1989) Isolation of DNA from mammalian cells. In: Sambrook J, Fritsch EF, Maniatis T (eds) Molecular cloning: a laboratory manual (Vol 1), 2nd edn. Cold Spring Harbor Laboratory Press, New York, pp 9.16–9.19
16.
Zurück zum Zitat Kubar A, Saygun I, Yapar M, Ozdemir A, Slots J (2004) Real-time PCR quantification of cytomegalovirus in aggressive periodontitis lesions using TaqMan technology. J Periodontal Res 39(2):81–86CrossRefPubMed Kubar A, Saygun I, Yapar M, Ozdemir A, Slots J (2004) Real-time PCR quantification of cytomegalovirus in aggressive periodontitis lesions using TaqMan technology. J Periodontal Res 39(2):81–86CrossRefPubMed
17.
Zurück zum Zitat Kubar A, Saygun I, Özdemir A, Yapar M, Slots J (2005) Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein-Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions. J Periodont Res 40:97–104CrossRefPubMed Kubar A, Saygun I, Özdemir A, Yapar M, Slots J (2005) Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein-Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions. J Periodont Res 40:97–104CrossRefPubMed
18.
Zurück zum Zitat Yapar M, Aydogan H, Pahsa A et al (2005) Rapid and quantitative detection of Crimean-Congo haemorrhagic fever virus by one-step real-time reverse transcriptase-PCR. Jpn J Infect Dis 58:358–362PubMed Yapar M, Aydogan H, Pahsa A et al (2005) Rapid and quantitative detection of Crimean-Congo haemorrhagic fever virus by one-step real-time reverse transcriptase-PCR. Jpn J Infect Dis 58:358–362PubMed
19.
Zurück zum Zitat Sahiner F, Gumral R, Sener K et al (2012) Investigation of HPV-DNA in cervical smear samples by two different methods: MY09/11 consensus PCR and type-specific real-time PCR. Mikrobiyol Bul 46(4):624–636PubMed Sahiner F, Gumral R, Sener K et al (2012) Investigation of HPV-DNA in cervical smear samples by two different methods: MY09/11 consensus PCR and type-specific real-time PCR. Mikrobiyol Bul 46(4):624–636PubMed
20.
Zurück zum Zitat Ludwig A, Hengel H (2009) Epidemiological impact and disease burden of congenital cytomegalovirus infection in Europe. Euro Surveill 14(9):26–32PubMed Ludwig A, Hengel H (2009) Epidemiological impact and disease burden of congenital cytomegalovirus infection in Europe. Euro Surveill 14(9):26–32PubMed
21.
Zurück zum Zitat Naessens A, Casteels A, Decatte L, Foulon W (2005) A serologic strategy for detecting neonates at risk for congenital cytomegalovirus infection. J Pediatr 146(2):194–197CrossRefPubMed Naessens A, Casteels A, Decatte L, Foulon W (2005) A serologic strategy for detecting neonates at risk for congenital cytomegalovirus infection. J Pediatr 146(2):194–197CrossRefPubMed
22.
Zurück zum Zitat Grangeot-Keros L, Simon B, Audibert F, Vial M (1998) Should we routinely screen for cytomegalovirus antibody during pregnancy? Intervirology 41(4–5):158–162CrossRefPubMed Grangeot-Keros L, Simon B, Audibert F, Vial M (1998) Should we routinely screen for cytomegalovirus antibody during pregnancy? Intervirology 41(4–5):158–162CrossRefPubMed
23.
Zurück zum Zitat Lazzarotto T, Varani S, Spezzacatena P et al (1998) Delayed acquisition of high-avidity anticytomegalovirus antibody is correlated with prolonged antigenemia in solid organ transplant recipients. J Infect Dis 178(4):1145–1149CrossRefPubMed Lazzarotto T, Varani S, Spezzacatena P et al (1998) Delayed acquisition of high-avidity anticytomegalovirus antibody is correlated with prolonged antigenemia in solid organ transplant recipients. J Infect Dis 178(4):1145–1149CrossRefPubMed
24.
Zurück zum Zitat Lazzarotto T, Spezzacatena P, Varani S et al (1999) Anticytomegalovirus (anti-CMV) immunoglobulin G avidity in identification of pregnant women at risk of transmitting congenital CMV infection. Clin Diagn Lab Immunol 6(1):127–129PubMedCentralPubMed Lazzarotto T, Spezzacatena P, Varani S et al (1999) Anticytomegalovirus (anti-CMV) immunoglobulin G avidity in identification of pregnant women at risk of transmitting congenital CMV infection. Clin Diagn Lab Immunol 6(1):127–129PubMedCentralPubMed
25.
Zurück zum Zitat Ataman S, Colak D, Gunseren F et al (2007) Investigation of cytomegalovirus seroepidemiology in Antalya with a population-based cross-sectional study and review of related data in Turkey. Mikrobiyol Bul 41(4):545–555PubMed Ataman S, Colak D, Gunseren F et al (2007) Investigation of cytomegalovirus seroepidemiology in Antalya with a population-based cross-sectional study and review of related data in Turkey. Mikrobiyol Bul 41(4):545–555PubMed
26.
Zurück zum Zitat Satılmış A, Güra A, Ongun H, Mendilcioğlu I, Çolak D, Oygür N (2007) CMV seroconversion in pregnants and the incidence of congenital CMV infection. Turk J Pediatr 49(1):30–36PubMed Satılmış A, Güra A, Ongun H, Mendilcioğlu I, Çolak D, Oygür N (2007) CMV seroconversion in pregnants and the incidence of congenital CMV infection. Turk J Pediatr 49(1):30–36PubMed
27.
Zurück zum Zitat Ocak S, Zeteroglu S, Ozer C, Dolapcioglu K, Gungoren A (2007) Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in southern Turkey. Scand J Infect Dis 39(3):231–234CrossRefPubMed Ocak S, Zeteroglu S, Ozer C, Dolapcioglu K, Gungoren A (2007) Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in southern Turkey. Scand J Infect Dis 39(3):231–234CrossRefPubMed
28.
Zurück zum Zitat Griffiths PD, Baboonian C, Rutter D, Peckham C (1991) Congenital and maternal cytomegalovirus infections in a London population. Br J Obstet Gynaecol 98(2):135–140CrossRefPubMed Griffiths PD, Baboonian C, Rutter D, Peckham C (1991) Congenital and maternal cytomegalovirus infections in a London population. Br J Obstet Gynaecol 98(2):135–140CrossRefPubMed
29.
Zurück zum Zitat Yow MD, Williamson DW, Leeds LJ et al (1988) Epidemiologic characteristics of cytomegalovirus infection in mothers and their infants. Am J Obstet Gynecol 158(5):1189–1195CrossRefPubMed Yow MD, Williamson DW, Leeds LJ et al (1988) Epidemiologic characteristics of cytomegalovirus infection in mothers and their infants. Am J Obstet Gynecol 158(5):1189–1195CrossRefPubMed
30.
Zurück zum Zitat Shen CY, Chang SF, Yen MS, Ng HT, Huang ES, Wu CW (1993) Cytomegalovirus excretion in pregnant and nonpregnant women. J Clin Microbiol 31(6):1635–1636PubMedCentralPubMed Shen CY, Chang SF, Yen MS, Ng HT, Huang ES, Wu CW (1993) Cytomegalovirus excretion in pregnant and nonpregnant women. J Clin Microbiol 31(6):1635–1636PubMedCentralPubMed
31.
Zurück zum Zitat Stagno S, Reynolds D, Tsiantos A et al (1975) Cervical cytomegalovirus excretion in pregnant and nonpregnant women: suppression in early gestation. J Infect Dis 131(5):522–527CrossRefPubMed Stagno S, Reynolds D, Tsiantos A et al (1975) Cervical cytomegalovirus excretion in pregnant and nonpregnant women: suppression in early gestation. J Infect Dis 131(5):522–527CrossRefPubMed
32.
Zurück zum Zitat Collier AC, Handsfield HH, Ashley R et al (1995) Cervical but not urinary excretion of cytomegalovirus is related to sexual activity and contraceptive practices in sexually active women. J Infect Dis 171(1):33–38CrossRefPubMed Collier AC, Handsfield HH, Ashley R et al (1995) Cervical but not urinary excretion of cytomegalovirus is related to sexual activity and contraceptive practices in sexually active women. J Infect Dis 171(1):33–38CrossRefPubMed
33.
Zurück zum Zitat Pass RF, Stagno S, Dworsky ME, Smith RJ, Alford CA (1982) Excretion of cytomegalovirus in mothers: observation after delivery of congenitally infected and normal infants. J Infect Dis 146(1):1–6CrossRefPubMed Pass RF, Stagno S, Dworsky ME, Smith RJ, Alford CA (1982) Excretion of cytomegalovirus in mothers: observation after delivery of congenitally infected and normal infants. J Infect Dis 146(1):1–6CrossRefPubMed
34.
Zurück zum Zitat Dollard SC, Grosse SD, Ross DS (2007) New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol 17(5):355–363CrossRefPubMed Dollard SC, Grosse SD, Ross DS (2007) New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol 17(5):355–363CrossRefPubMed
35.
Zurück zum Zitat Stagno S, Pass RF, Dworsky ME, Alford CA (1983) Congenital and perinatal cytomegalovirus infections. Semin Perinatol 7(1):31–42PubMed Stagno S, Pass RF, Dworsky ME, Alford CA (1983) Congenital and perinatal cytomegalovirus infections. Semin Perinatol 7(1):31–42PubMed
36.
Zurück zum Zitat Fowler KB, Stagno S, Pass RF (2003) Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA 289(8):1008–1011CrossRefPubMed Fowler KB, Stagno S, Pass RF (2003) Maternal immunity and prevention of congenital cytomegalovirus infection. JAMA 289(8):1008–1011CrossRefPubMed
Metadaten
Titel
The role of maternal screening in diagnosing congenital cytomegalovirus infections in highly immune populations
verfasst von
F. Şahiner
M. Honca
Y. Çekmez
A. Kubar
T. Honca
M. K. Fidanci
T. Purtuloğlu
M. Yapar
Publikationsdatum
01.06.2015
Verlag
Springer London
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2015
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-014-1149-5

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