title: Congenital cytomegalovirus infection: current strategies and future perspectives.
abstract: BACKGROUND
  Cytomegalovirus is the most common cause of congenital infections in humans and it produces considerable morbidity in newborns.
  
  
  OBJECTIVE
  The present study reviews current concepts on epidemiology, clinical manifestations, diagnosis, treatment, future strategies and prognosis of children with congenital cytomegalovirus infection.
  
  
  RESULTS
  Congenital cytomegalovirus infection can be symptomatic or not at birth, but about 10-20% of them all will exhibit neurological damage when followed up. Sensorineural hearing loss is the most frequent long-term consequence and is not manifest invariably at birth or in the neonatal period but in many cases becomes clinically apparent in later childhood. There are growing evidences that newborns with symptomatic congenital cytomegalovirus infection would benefit from treatment with either ganciclovir or valganciclovir, the most widely studied drugs in this setting. It is not yet clear if children with asymptomatic or pauci-symptomatic infection at birth would benefit from treatment.
  
  
  CONCLUSIONS
  Studies evaluating treatment and long-term follow-up of infants with both symptomatic and asymptomatic infection are necessary, in order to definitely evaluate the short and long-term effectiveness and safety of both ganciclovir and valganciclovir and to identify risk factors associated to the development of long-term sequelae. In this way it will be possible to select those children that might benefit for treatment.
authors.affiliation: Department of Pediatrics, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Buonsenso
authors.forename: D
authors.initials: D
authors.lastname: Serranti
authors.forename: L
authors.initials: L
authors.lastname: Gargiullo
authors.forename: M
authors.initials: M
authors.lastname: Ceccarelli
authors.forename: O
authors.initials: O
authors.lastname: Ranno
authors.forename: P
authors.initials: P
authors.lastname: Valentini
mesh_terms: D000367:Age Factors; D000998:Antiviral Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D058070:Asymptomatic Diseases; D003587:Cytomegalovirus / Q000187:drug effects* / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015774:Ganciclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000821:virology; D006801:Humans; D007231:Infant, Newborn; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir