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Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
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Blood Viral Load in Symptomatic Congenital Cytomegalovirus Infection
Concetta Marsico1, Immaculada Aban2, Huichien Kuo2
1Neonatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Italy.
The Journal of Infectious Diseases
|December 12, 2018
Summary
Viral loads (VLs) in infants with symptomatic congenital cytomegalovirus disease do not reliably predict long-term outcomes. Monitoring VLs before antiviral therapy offers limited clinical value for predicting disease progression or hearing loss.
Area of Science:
- Virology
- Pediatrics
- Infectious Diseases
Background:
- Symptomatic congenital cytomegalovirus (CMV) disease management often involves viral load (VL) monitoring.
- The predictive value of these viral loads for long-term outcomes remains unclear.
Purpose of the Study:
- To evaluate the predictive value of viral loads (VLs) in infants with symptomatic congenital cytomegalovirus (CMV) disease.
- To determine if baseline or during-treatment VLs correlate with clinical outcomes, particularly hearing, following antiviral therapy.
Main Methods:
- A post hoc analysis of two antiviral treatment studies was conducted.
- Seventy-three subjects received 6 weeks of treatment, and 47 received 6 months of treatment.
- Whole blood viral loads were quantified using real-time polymerase chain reaction before and during therapy.
Main Results:
- Higher baseline viral loads were associated with central nervous system involvement, thrombocytopenia, and transaminitis, but with significant overlap between groups.
- Lower baseline VL correlated with better hearing outcomes at 12 months in the 6-month treatment group, but no predictive breakpoints were identified.
- Sustained viral suppression during 6 months of therapy correlated with improved hearing outcomes at 6, 12, and 24 months, though many without suppression also showed hearing improvement.
Conclusions:
- Higher whole blood viral loads before antiviral therapy initiation in infants with symptomatic congenital CMV disease lack clinically meaningful predictive value for long-term outcomes.
- While viral suppression correlates with better hearing, baseline VL is not a reliable predictor of long-term hearing loss.
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