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Viruses
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Congenital Cytomegalovirus Infection: Volume II
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Congenital Cytomegalovirus Infection: Volume II

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 4426

Special Issue Editor

Prof. Dr. Giovanni Nigro

E-Mail Website
Guest Editor
Department of Clinical Pathology, San Salvatore Hospital, 67100 L’Aquila, Italy
Interests: primary cytomegalovirus infection; pregnancy; CMV screening; hyperimmune globulin; antiviral strategies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The relevance of congenital cytomegalovirus (CMV) infection has been well known for more than 50 years. However, this virus remains a major cause of severe and permanent disabilities in children, mostly after primary maternal infection, and is associated with severe neurological and hearing sequelae, which may be evidenced during pregnancy, at birth, or years after birth. Hygienic measures can prevent CMV transmission, which mainly occurs following contact with children under 3 years of age when attending a nursery or daycare. Many studies have been conducted considering animal and human pregnancies with the aim of preventing congenital CMV infection and disease using CMV-specific hyperimmune globulin (HIG). A recent study has shown that high-dosage valaciclovir appears to be capable of decreasing the rates of congenital infection and disease. The implementation of CMV screening would enable primary prevention via hygiene counseling, an improvement in the understanding and awareness of congenital CMV infection, and an increase in our knowledge on the potential efficacy of preventive or therapeutic HIG or valaciclovir administration.

The aim of this second Special Issue of Viruses is to compile the newest contributions on the prevention of congenital CMV infection and disease.

Prof. Dr. Giovanni Nigro
Guest Editor

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Keywords

  • primary cytomegalovirus infection
  • pregnancy
  • CMV screening
  • hyperimmune globulin
  • valaciclovir

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Published Papers (3 papers)

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Research

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12 pages, 449 KiB  
Article
Useful Clinical Criteria for Identifying Neonates with Congenital Cytomegalovirus Infection at Birth in the Context of an Expanded Targeted Screening Program
by Valeria Poletti de Chaurand, Gaia Scandella, Marianna Zicoia, Francesca Arienti, Federica Fernicola, Laura Lanteri, Diletta Guglielmi, Anna Carli, Maria Viola Vasarri, Lucia Iozzi, Annalisa Cavallero, Sergio Maria Ivano Malandrin, Anna Locatelli, Maria Luisa Ventura, Mariateresa Sinelli and Sara Ornaghi
Viruses 2024, 16(7), 1138; https://doi.org/10.3390/v16071138 - 16 Jul 2024
Viewed by 631
Abstract
Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). Targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; [...] Read more.
Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). Targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; also, congenital CMV (cCMV) may manifest with subtle signs other than SNHL. Therefore, the inclusion of additional criteria for cCMV screening appears clinically valuable. Starting January 2021, we have implemented expanded targeted cCMV screening at our center, with testing in case of maternal CMV infection during pregnancy, inadequate antenatal care, maternal HIV infection or immunosuppression, birthweight and/or head circumference < 10th centile, failed hearing screen, and prematurity. During the first three years of use of this program (2021–2023), 940 (12.3%) of 7651 live-born infants were tested. The most common indication was birthweight < 10th centile (n = 633, 67.3%). Eleven neonates were diagnosed as congenitally infected, for a prevalence of 1.17% (95%CI 0.48–1.86) on tested neonates and of 0.14% (95%CI 0.06–0.23) on live-born infants. None of the cCMV-infected newborns had a failed hearing screen as a testing indication. Implementation of an expanded cCMV screening program appears feasible and of clinical value. Full article
(This article belongs to the Special Issue Congenital Cytomegalovirus Infection: Volume II)
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10 pages, 241 KiB  
Article
Evaluation of Congenital Cytomegalovirus Infection in Pregnant Women Admitted to a University Hospital in Istanbul
by Evrim Ozdemir, Tugba Sarac Sivrikoz, Kutay Sarsar, Dilruba Tureli, Mustafa Onel, Mehmet Demirci, Gizem Yapar, Eray Yurtseven, Recep Has, Ali Agacfidan and Hayriye Kirkoyun Uysal
Viruses 2024, 16(3), 414; https://doi.org/10.3390/v16030414 - 8 Mar 2024
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Abstract
Cytomegalovirus (CMV) can cause serious complications in immunocompromised individuals and fetuses with congenital infections. These can include neurodevelopmental impairments and congenital abnormalities in newborns. This paper emphasizes the importance of concurrently evaluating ultrasonography findings and laboratory parameters in diagnosing congenital CMV infection. To [...] Read more.
Cytomegalovirus (CMV) can cause serious complications in immunocompromised individuals and fetuses with congenital infections. These can include neurodevelopmental impairments and congenital abnormalities in newborns. This paper emphasizes the importance of concurrently evaluating ultrasonography findings and laboratory parameters in diagnosing congenital CMV infection. To examine the prenatal characteristics of CMV DNA-positive patients, we assessed serum and amniotic fluid from 141 pregnant women aged 19–45 years, each with fetal anomalies. ELISA and PCR tests, conducted in response to these amniocentesis findings, were performed at an average gestational age of 25 weeks. Serological tests revealed that all 141 women were CMV IgG-positive, and 2 (1.41%) had low-avidity CMV IgG, suggesting a recent infection. CMV DNA was detected in 17 (12.05%) amniotic fluid samples using quantitative PCR. Of these, 82% exhibited central nervous system abnormalities. Given that most infections in pregnant women are undetectable and indicators non-specific, diagnosing primary CMV in pregnant women using clinical findings alone is challenging. We contend that serological tests should not be the sole means of diagnosing congenital CMV infection during pregnancy. Full article
(This article belongs to the Special Issue Congenital Cytomegalovirus Infection: Volume II)

Review

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20 pages, 1642 KiB  
Review
Cytomegalovirus Infection in Pregnancy Prevention and Treatment Options: A Systematic Review and Meta-Analysis
by Magda Rybak-Krzyszkowska, Joanna Górecka, Hubert Huras, Magdalena Massalska-Wolska, Magdalena Staśkiewicz, Agnieszka Gach, Adrianna Kondracka, Jakub Staniczek, Wojciech Górczewski, Dariusz Borowski, Renata Jaczyńska, Mariusz Grzesiak and Waldemar Krzeszowski
Viruses 2023, 15(11), 2142; https://doi.org/10.3390/v15112142 - 24 Oct 2023
Cited by 4 | Viewed by 1901
Abstract
Objectives: Cytomegalovirus (CMV) infection is a significant health concern affecting numerous expectant mothers across the globe. CMV is the leading cause of health problems and developmental delays among infected infants. Notably, this study examines CMV infection in pregnancy, its management, prevention mechanisms, and [...] Read more.
Objectives: Cytomegalovirus (CMV) infection is a significant health concern affecting numerous expectant mothers across the globe. CMV is the leading cause of health problems and developmental delays among infected infants. Notably, this study examines CMV infection in pregnancy, its management, prevention mechanisms, and treatment options. Methods: Specifically, information from the Cochrane Library, PUBMED, Wiley Online, Science Direct, and Taylor Francis databases were reviewed along with additional records identified through the register, the Google Scholar search engine. Based on the search, 21 articles were identified for systematic review. Results: A total of six randomized controlled trials (RCTs) were utilized for a meta-analytic review. As heterogeneity was substantial, the random effects model was used for meta-analysis. Utilizing the random-effects model, the restricted maximum likelihood (REML) approach, the estimate of effect size (d = −0.479, 95% CI = −0.977 to 0.019, p = 0.060) suggests the results are not statistically significant, so it cannot be inferred that the prevention methods used were effective, despite an inverse relationship between treatment and number of infected cases. The findings indicated that several techniques are used to prevent, diagnose, and manage CMV infection during pregnancy, including proper hygiene, ultrasound examination (US), magnetic resonance imaging (MRI), amniocentesis, viremia, hyperimmunoglobulin (HIG), and valacyclovir (VACV). Conclusions: The current review has significant implications for addressing CMV infection in pregnancy. Specifically, it provides valuable findings on contemporary management interventions to prevent and treat CMV infection among expectant mothers. Therefore, it allows relevant stakeholders to address these critical health concerns and understand the effectiveness of the proposed prevention and treatment options. Full article
(This article belongs to the Special Issue Congenital Cytomegalovirus Infection: Volume II)
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