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Positive IgM in Congenital CMV Infection
Efraim Bilavsky1,2, Salmas Watad1, Itzhak Levy1,2
11 Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.
Abstract:
Neonatal serum detection of cytomegalovirus (CMV) immunoglobulin M (IgM) has low sensitivity in identifying congenital cytomegalovirus (cCMV). Several reports have endeavored to associate the presence/absence of IgM to disease severity. Data were collected for all infants with cCMV followed in our clinic. Infant outcome after birth was compared between infants who tested positive or negative. Sensitivity of positive IgM in diagnosing cCMV was 40.7%. The rate of symptomatic disease in those who tested positive was statistically higher (67.7%, P < .001). Odds ratio for symptomatic disease in infants with positive IgM born after a maternal primary infection was 3.47 (95% confidence interval = 1.7-7.1). Positive IgM was found in only 48.8% of symptomatic and 22.1% of asymptomatic children. Our results demonstrated a low sensitivity of IgM in diagnosing cCMV. However, while a positive IgM antibody for CMV is associated with a more symptomatic disease, it does not serve as a precise laboratory marker for a severity.
Insights
Neonatal serum detection of cytomegalovirus (CMV) immunoglobulin M (IgM) is not sensitive for diagnosing congenital CMV (cCMV). However, a positive IgM result in infants is linked to more severe symptoms.
Area of Science:
- Virology
- Neonatal Immunology
- Infectious Diseases
Background:
- Congenital cytomegalovirus (cCMV) is a leading cause of non-genetic sensorineural hearing loss.
- Neonatal screening for cCMV often relies on detecting specific antibodies, but their diagnostic utility varies.
- Cytomegalovirus (CMV) immunoglobulin M (IgM) is a marker of recent infection, but its role in cCMV diagnosis and severity assessment is debated.
Purpose of the Study:
- To evaluate the sensitivity of neonatal serum CMV IgM detection for diagnosing cCMV.
- To assess the association between positive CMV IgM and the severity of symptomatic cCMV disease.
- To determine the predictive value of CMV IgM for symptomatic outcomes in infants with cCMV.
Main Methods:
- Retrospective analysis of infants diagnosed with cCMV.
- Comparison of infant outcomes based on CMV IgM test results (positive vs. negative).
- Statistical analysis including calculation of sensitivity, odds ratios, and confidence intervals.
Main Results:
- The sensitivity of neonatal serum CMV IgM for diagnosing cCMV was found to be 40.7%.
- Infants testing positive for CMV IgM showed a statistically significant higher rate of symptomatic disease (67.7%, P < .001).
- Positive CMV IgM was present in 48.8% of symptomatic and 22.1% of asymptomatic infants.
Conclusions:
- Neonatal serum CMV IgM testing demonstrates low sensitivity for diagnosing cCMV.
- While a positive CMV IgM result is associated with more symptomatic cCMV disease, it is not a precise laboratory marker for disease severity.
- Further research into more sensitive diagnostic markers for cCMV is warranted.
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