Key result
High birth CMV DNAemia predicts ~50% risk of neonatal clinical disease and hearing deficits.
Why the study?
The relationship between viral load in blood at birth and the development of late-onset sequelae in asymptomatic congenital CMV infection was unclear.
Does high CMV DNAemia at birth predict late-onset sequelae in asymptomatic congenitally infected newborns?
Cohort (n=33)
Does high CMV DNAemia at birth predict late-onset sequelae in asymptomatic congenitally infected newborns?
High CMV DNAemia at birth (≥ 12,000-17,000 copies/mL) strongly predicts the development of late-onset sequelae, including hearing deficits, in initially asymptomatic congenitally infected newborns.
Answers are grounded in this paper and cite their sources.
High CMV DNAemia at birth may flag risk for late sequelae in asymptomatic congenital CMV; leaves open whether thresholds warrant targeted monitoring or trials.
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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Forner et al. (2014) conducted a cohort in Asymptomatic congenital CMV infection (n=33). High CMV DNAemia at birth vs. Lower CMV DNAemia at birth was evaluated on Neonatal clinical disease (p=.0002). CMV DNAemia at birth of ≥ 12,000 copies/mL predicted a >50% risk of neonatal clinical disease, and ≥ 17,000 copies/mL predicted a >50% risk of hearing deficit.
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