Congenital CMV infection in symptomatic infants in Delhi and surrounding areas (original) (raw)
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Bangladesh Medical Research Council Bulletin
Cytomegalovirus (CMV) is a frequent cause of congenital infection in humans in all regions of the world. In contrast to most congenital viral infections, congenital CMV infection and disease have been consistently demonstrated in populations with a high seroprevalence. Three hundred pregnant women were studied prospectively in their 1st, 2nd and 3rd trimester to determine the seroprevalence and seroconversion of CMV in pregnancy. After birth, babies were also tested for anti CMV IgM to determine the rate of birth prevalence. Anti CMV IgG and IgM tests were performed by chemiluminescence methods. All 300 (100%) pregnant women were anti CMV IgG positive and 180 (60%) were subsequently anti CMV IgM positive during different trimesters of pregnancy. Birth prevalence of CMV IgM antibody was 1.3% among babies of anti CMV IgM positive mothers whereas none in CMV IgM negative mothers (OR 1.01, 95% CI .996-1.027).It may be concluded that CMV IgG seroprevalence is high among Bangladeshi pregn...
Cytomegalovirus (CMV) remains the most common cause of viral intrauterine infection. The objective of this research was to determine the prevalence of at-risk pregnancies for congenital cytomegalovirus transmission in a randomly selected pregnant women and their newborns. Enzyme Link Immunosorbent Assay (ELISA) and real-time polymerase chain reaction (PCR) were utilized to screen the sera of mothers (n = 100) and consecutive umbilical cord blood samples from their newborn (n = 100). Of the 100 mother's sera analyzed, 100 (100%) and 3 (3%) were positive for cytomegalovirus IgG and IgM antibodies, respectively. Of the 100 cord serum specimens analyzed, 99 (99%) and 2 (2%) were positive for cytomegalovirus IgG and IgM antibodies, respectively. Cytomegalovirus DNA was detected in 4 out of 100 (4%) cord blood samples of newborns. From four CMV DNA positive cases, Case 1 had no IgM in cord serum, but had IgM in mother's sera. Cases 2 and 4 were positive for IgM in both mother's sera and cord serum. Case 3 had no detectable CMV IgM in sera and cord serum. As many as 66 and 100% of CMV IgM-positive women in this study also had CMV IgM and CMV DNA in their delivery cord blood samples, respectively suggesting an increased risk of congenital CMV infection in those pregnancies. A paired women sera/cord blood CMV IgM-negative was found to be positive for CMV DNA. The data may also suggest the utility of PCR in place of CMV IgM as a diagnostic method for congenital CMV infection.
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Maternal infections play a crucial role in pregnancy wastage, which are transmitted in utero during pregnancy. The TORCH infections are the most significant of all infections causing morbidity and mortality. Primary infection with Cytomegalovirus (CMV) is one of the most common congenital viral infections. Although, 90% of congenital infections are asymptomatic, 5 to 17% of infants born to mothers with primary CMV infection will be overtly symptomatic and have a mortality rate of 30% and severe neurological morbidity occurs in 90% of survivors. Acute CMV infection can be diagnosed by detection of antibodies by serology and by detection of CMV genomic sequences by RT-PCR. Seroconversion or significant rise in the titre of CMV IgM indicates recent CMV infection and may still be detected upto one year even if the individual presents after the symptoms have subsided. Hence, the present study was carried out. This study aims to screen antenatal women for IgM antibodies to CMV by ELISA and to study the seroprevalence of CMV in antenatal women. Further, the seropositivity was correlated with bad obstetric history cases in antenatal women. MATERIALS AND METHODS An observational cross-sectional study was conducted in a Government Maternity Hospital, Tirupathi, for a period of one year. By using a convenient sampling method, a total of 186 blood samples were collected from antenatal women with bad obstetrics history who attended during the period of July 2011 to Jan 2012. All samples collected were processed and screened for CMV specific IgM antibodies by Enzyme-Linked Immunosorbent Assay (ELISA) using "Anti-CMV IgM ELISA" kit of Euroimmune following the manufacturer's instructions. Chi-square test was applied to check the significance level. Finally, results were displayed in terms of percentages, bar diagrams, pie diagrams and tables. RESULTS A total number of 186 blood samples were collected and processed. Samples were screened for IgM antibodies against CMV using Anti-CMV IgM kit by ELISA as per the manufacturer's instructions. Of the 186 samples tested, 156 were from antenatal women with BOH (test group) and the remaining 30 were from the women with previous normal deliveries (control group). Of the test group, 12 (7.69%) serum samples were found to be positive for IgM antibodies to CMV. Among the control group, no sample was found to be positive for IgM antibodies to CMV. CONCLUSION It is concluded that CMV infections are responsible for some obstetrical losses. There is no vaccine for prevention and there is no way to prevent foetuses from being infected once the mother acquires the infection. It is suggested that women in the reproductive age group should be screened for CMV infections. It is observed that universal screening of pregnant women for CMV infection during an early prenatal visit is not yet recommended worldwide.
BMC infectious diseases, 2017
Cytomegalovirus (CMV) is a common cause of congenital infection worldwide and infants with symptomatic congenital CMV (cCMV) infection are at significantly increased risk of developing adverse long-term outcomes. This study aimed to determine the prevalence of cCMV infections in symptomatic infants under 3 weeks in Tehran, IRAN and to evaluate the usefulness of serologic markers in these neonates. Urine and serum samples of 100 symptomatic infants, under 3 weeks old, with clinical signs referred to Tehran medical centers from June 2013 to December 2014, were collected and tested for CMV-DNA and IgG/IgM antibody titers by PCR and ELISA, respectively. CMV-DNA was detected in urine of 58 cases, whereas only 20 cases had detectable CMV-IgM titers. All CMV-IgM positive cases excreted CMV-DNA through their urine. Of the 100 patients, only 59 had CMV-IgG antibody and CMV-DNA was found in the urine of only 40 of them. We conclude that CMV is an important etiologic agent of congenital infect...
Congenital cytomegalovirus infection: recent advances in the diagnosis of maternal infection
Human Immunology, 2004
In most European countries, pregnant women are tested for cytomegalovirus (CMV) during the first trimester of pregnancy. Within the last 5 years, European laboratories have made significant progress in solving diagnostic problems linked to infection in pregnancy. With advances in CMV serology, the presence of anti-CMV immunoglobulin (Ig)M detected by a screening test such as enzyme immunoassay, can be confirmed by blot, identifying pregnant women undergoing an active or recent infection. Furthermore, primary infections that were proven if a seroconversion was observed or suspected in the presence of IgM, can now be readily diagnosed by disclosing the presence of anti-CMV low avidity in IgM-positive mothers, greatly reducing the number of women who should be considered at risk of transmitting the virus. Virologic maternal tests are not enough to diagnose a recent primary maternal CMV infection and the detection or quantification of CMV in maternal blood does not seem to be associated with a higher risk for fetal infection. A cohort of 1520 pregnant women considered at risk of transmitting the virus were followed in a longitudinal study at the University of Bologna. Women were identified as part of routine CMV screening in several Italian regions and were IgM-positive for CMV. We documented IgG seroconversion in 83 women and 1437 were IgM-positive by commercial kit. Human Immunology 65, 410Ϫ415 (2004).
Iraqi journal of Medical Sciences, 2016
Background Human cytomegalovirus (HCMV) is the major viral etiology of congenital infection and birth defects, during current maternal infection the fetal transmission is high (30-40%) and the symptomatic neonates have diseases involving the neurologic, hematopoietic, respiratory and other organ systems, causing high mortality and long-term sequelae. Objective To measure the frequency of congenital and perinatal HCMV infection among symptomatic neonates and its possible burden of disease among them. Methods A total of one hundred ninety-eight symptomatic neonates with clinical manifestations of overt congenital infection enrolled in this study from September 2014 to March 2015. Serum samples were obtained from each subject targeted in this study. HCMV infection was defined as HCMV-IgM antibody positive by Electrochemiluminescence Immunoassay (ECLIA) techniques. Results The prevalence of HCMV infection among symptomatic neonates with congenital infection was 25 (12.6%). The average age of HCMV detection was 9.96 (SD 6.73) days with a median of 7 days, a minimum of 3 days and a maximum of 28 days. Jaundice was the most predominant clinical finding 14 (56%), followed in order of frequency by hepatomegaly 9 (36%) and pneumonitis 7 (28%). Conclusion The high prevalence of neonatal HCMV infection among neonates with symptomatic congenital infections could indicate a high rate of maternal HCMV primary or current infection among our population.
Journal of clinical microbiology, 2016
Cytomegalovirus (CMV) enzyme-linked immunosorbent spot (ELISPOT) and CMV QuantiFERON assays were examined as potential biomarkers predictive of congenital CMV (cCMV) transmission. Fifty-seven pregnant women with primary CMV infection and 23 with nonprimary CMV infection were recruited in the study. Maternal age, CMV IgG avidity, viremia, and viruria were also included among the potential predictors. Spearman's statistical correlation analysis revealed a positive correlation between the CMV ELISPOT and CMV QuantiFERON assay results (P < 0.001), but only the CMV ELISPOT assay correlated with cCMV (P < 0.001). cCMV was positively correlated with maternal viremia and viruria (P < 0.05) and negatively correlated with CMV IgG avidity (P < 0.01). Maternal age and CMV QuantiFERON assay results were not statistically associated with cCMV. CMV-specific cell-mediated immunity detected by the CMV ELISPOT assay plays a critical role in cCMV.
Prenatal indicators of congenital cytomegalovirus infection
The Journal of Pediatrics, 2000
Objective: To assess the validity of a diagnostic protocol designed to predict the outcome of newborns of mothers suspected to have primary cytomegalovirus (CMV) infection during the first 4 months of pregnancy.