Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 212, Issue 1, Pages 67-71Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiu627
Keywords
congenital CMV infection; CMV kinetics of clearance; DNAemia at birth; late-onset sequelae
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Funding
- Padua General Hospital
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Objective. We investigated the kinetics of cytomegalovirus (CMV) clearance in blood and urine and the relationship between the viral load in blood at birth and the development of late-onset sequelae in asymptomatic congenital CMV infection. Methods. Thirty-three newborns with congenital asymptomatic CMV infection born to women with primary CMV infection during pregnancy were enrolled. CMV infection was monitored by polymerase chain reaction analysis of blood and urine. The follow-up examination was concluded at 6 years of age. Results. Ten infants developed postnatal sequelae, whereas twenty-three infants remained asymptomatic. Fifty percent of babies cleared CMV in blood and urine within 3 and 36 months, respectively. Logistic multivariate regression revealed that the risk of neonatal clinical disease crossed the level of 50% with a DNAemia at birth of >= 12 000 copies/mL (P =.0002). The risk of hearing deficit crossed the level of 50% with a DNAemia at birth of >= 17 000 copies/mL (P =.0001). No significant difference was found between the kinetics of CMV clearance in asymptomatic children as compared to babies with late-onset disease. Conclusions. Asymptomatic newborns with a CMV DNAemia at birth of >= 12 000 copies/mL were more likely to experience CMV-related sequelae. The risk of hearing deficit increased with a viral load in blood of >= 17 000 copies/mL.
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