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Published on: July 6, 2013
Human cytomegalovirus infection in infants with prolonged neonatal jaundice
D Goedhals1, J Kriel, M L Hertzog
1Department of Medical Microbiology and Virology, Faculty of Health Sciences, University of the Free State, PO Box 339 (G23), Bloemfontein 9300, South Africa. gnvrdg.md@ufs.ac.za
Background:
Although human cytomegalovirus (HCMV) infection in infants has been associated with liver disease, the role of HCMV in infants presenting with prolonged neonatal jaundice is unclear as this clinical picture can be caused by a broad spectrum of underlying conditions.
Objectives:
This study aimed to determine a possible role for HCMV infection in infants with prolonged cholestatic neonatal jaundice that could facilitate the appropriate use of diagnostic assays and specific treatment in this condition.
Study Design:
HCMV immunohistochemical staining was performed on liver biopsy specimens received for histopathological examination from 85 infants (mean age 3 months) with a clinical history of prolonged neonatal jaundice. HCMV serology was also performed.
Results:
One infant with a histological diagnosis of HCMV hepatitis was also positive by immunohistochemical staining, while all other tissue specimens were negative for HCMV. HCMV IgG was positive in 92.3% and HCMV IgM in 39.7% of the infants (n=78).
Conclusions:
The serological results confirm the ubiquitous nature of HCMV with many primary infections occurring within the first year of life. Despite this, HCMV hepatitis was uncommon in this cohort.
Insights
Human cytomegalovirus (HCMV) hepatitis is uncommon in infants with prolonged neonatal jaundice. While widespread HCMV infection occurs in infants, it rarely causes liver disease in this context.
Area of Science:
- Pediatrics
- Virology
- Hepatology
Background:
- Prolonged neonatal jaundice can stem from diverse causes.
- Human cytomegalovirus (HCMV) infection is a potential, though unclear, contributor to infant liver disease.
Purpose of the Study:
- To investigate the role of HCMV in infants experiencing prolonged cholestatic neonatal jaundice.
- To inform diagnostic and therapeutic strategies for HCMV-related neonatal conditions.
Main Methods:
- Liver biopsy specimens from 85 infants with prolonged jaundice were analyzed using HCMV immunohistochemical staining.
- HCMV serology (IgG and IgM) was conducted on a subset of infants.
Main Results:
- Only one infant showed histological evidence of HCMV hepatitis confirmed by immunohistochemistry.
- HCMV IgG antibodies were prevalent (92.3%), and IgM antibodies were detected in 39.7% of infants.
Conclusions:
- HCMV infection is widespread in infants, with many primary infections occurring in the first year of life.
- HCMV-induced hepatitis appears to be an infrequent cause of prolonged neonatal jaundice in this cohort.
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