Cytomegalovirus (CMV)-encoded UL144 (truncated tumor necrosis factor receptor) and outcome of congenital CMV infection.
BACKGROUND
Cytomegalovirus (CMV) is the most common congenital infection in humans. The effect of viral strains on the outcome of congenital CMV is debated. We evaluated whether UL144 polymorphisms in amniotic fluid from CMV-infected Italian women were associated with terminations of pregnancy, subsequent disease in their offspring, or viral load.


METHODS
The study was nested within a prenatal CMV program. We sequenced the UL144 gene from 66 amniotic-fluid samples, without knowledge of pregnancy outcome. We performed data analyses on 56 samples for which all information was available.


RESULTS
Genotype C was associated with termination of pregnancy (P=.03). Genotype B was associated with fewer terminations of pregnancy (P=.003). A possible association was found between genotype C and symptomatic disease in newborns (odds ratio, 8.81 [95% confidence interval, 0.48-164.02]; P=.05). There was no association between specific genotype and the viral load in amniotic fluid. Symptomatic newborns who had the most common UL144 genotype (B) were more likely to have higher viral loads than were asymptomatic infants (P=.003).


CONCLUSIONS
UL144 polymorphisms may be associated with the outcome of congenital CMV infection. Larger studies should be conducted to confirm this association, before genotype analysis can be used, along with other factors, in considering terminations of pregnancy.
Arav-Boger
Ravit
R
Department of Pediatrics, Division of Infectious Disease, Johns Hopkins Hospital, Baltimore, MD 21287, USA. boger@jhmi.edu
Battaglia
Catherine A
CA
Lazzarotto
Tiziana
T
Gabrielli
Liliana
L
Zong
Jian C
JC
Hayward
Gary S
GS
Diener-West
Marie
M
Landini
Maria P
MP
D000653:Amniotic Fluid / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics* / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000635:transmission / Q000821:virology*; D005260:Female; D005333:Fetus / Q000821:virology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007558:Italy; D008562:Membrane Glycoproteins / Q000235:genetics; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011256:Pregnancy Outcome; D018124:Receptors, Tumor Necrosis Factor / Q000235:genetics; D011991:Receptors, Virus / Q000235:genetics; D014764:Viral Proteins / Q000235:genetics
D008562:Membrane Glycoproteins; D018124:Receptors, Tumor Necrosis Factor; D011991:Receptors, Virus; C119624:UL144 ORF protein, Human herpesvirus 5; D014764:Viral Proteins