High Cytomegalovirus (CMV) DNAemia Predicts CMV Sequelae in Asymptomatic Congenitally Infected Newborns Born to Women With Primary Infection During Pregnancy.
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.
Department of Molecular Medicine, University of Padua.
Gabriella
G
Forner
Department of Molecular Medicine, University of Padua.
Davide
D
Abate
Department of Molecular Medicine, University of Padua.
Carlo
C
Mengoli
Department of Molecular Medicine, University of Padua.
Giorgio
G
Palù
Maternal fetal Infectious Disease Unit, University Hospital of Padua, Italy.
Nadia
N
Gussetti
D058070:Asymptomatic Diseases; D001769:Blood / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000821:virology; D004279:DNA, Viral / Q000097:blood* / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D014556:Urine / Q000821:virology; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis*
D004279:DNA, Viral
CMV kinetics of clearance; DNAemia at birth; congenital CMV infection; late-onset sequelae