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Cytomegalovirus infection in immunocompromised children in Thailand
S Temcharoen1, P Hirsch, A Theamboonlers
1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and Hospital, Bangkok, Thailand.
Insights
Cytomegalovirus (CMV) is common in Thailand. In immunocompromised children, PCR detection of CMV DNA is the most accurate method for diagnosing active infections, crucial for timely management.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Cytomegalovirus (CMV) is a leading cause of congenital and perinatal viral infections globally.
- Thailand exhibits a high prevalence of CMV, exceeding 90% among blood donors.
Purpose of the Study:
- To determine the prevalence of CMV in immunocompromised children in Thailand.
- To evaluate serology and PCR as diagnostic methods for CMV infection in this population.
Main Methods:
- Serological testing for anti-CMV IgG and IgM antibodies.
- Polymerase chain reaction (PCR) using nested primers for CMV DNA detection in serum.
- Study involved 113 immunocompromised children.
Main Results:
- Anti-CMV IgG (latent infection) showed age-dependent prevalence, independent of the underlying condition.
- Anti-CMV IgM was not a reliable marker due to uniform prevalence across age groups and disease patterns.
- Serum CMV DNA detection by PCR was the most accurate diagnostic parameter, identifying active infection before clinical symptoms.
Conclusions:
- High prevalence of latent CMV infection in the general Thai population necessitates careful consideration in immunocompromised individuals.
- Recommends PCR-based examination of serum CMV DNA for immunocompromised patients in Thailand for clinical management.
- Early detection of active CMV infection via PCR can inform clinical guidelines and improve patient outcomes.
Abstract:
Cytomegalovirus (CMV) constitutes the most widespread cause of congenital and perinatal viral infections on a global scale, exceeding a 90%-prevalence among blood donors in Thailand. The present study was aimed at determining the prevalence of CMV in the sera of 113 immunocompromised children by means of serology, as well as polymerase chain reaction using nested primers. Our results showed anti-CMV IgG, i.e. latent infection, prevalent in an age-dependent manner irrespective of the disorder underlying the children's immunocompromised condition, whereas anti-CMV IgM was equally prevalent throughout all age groups and disease patterns and, therefore, unreliable as a marker. Detection of serum CMV DNA by PCR represented the most exact diagnostic parameter by far, indicating active infection long before clinical symptoms may appear. In conclusion, based on the high prevalence of latent CMV infection among the general population in Thailand, we recommend especially the sera of immunocompromised patients be examined for the presence of viral DNA by means of PCR in order to provide clinical guidelines for their proper management.