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Saliva pools for screening of human cytomegalovirus using real-time PCR
Cláudia Fernandes1, Augusta Marques1, Maria de Jesus Chasqueira1
1Centro de Estudos de Doenças Crónicas, CEDOC, Faculdade de Ciências Médicas|NOVA Medical School, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.
Insights
Newborn screening for human cytomegalovirus (HCMV) infection is feasible using pooled saliva samples. This cost-effective method allows for timely detection and confirmation of congenital HCMV in large populations.
Area of Science:
- Virology
- Public Health
- Neonatal Screening
Background:
- Human cytomegalovirus (HCMV) is a significant global congenital infection.
- Late sequelae affect 10-15% of asymptomatic newborns with congenital HCMV.
- Effective screening strategies are crucial for early intervention.
Purpose of the Study:
- To evaluate the feasibility of using pooled saliva samples for congenital HCMV screening.
- To assess the cost-effectiveness of saliva pooling in a large-scale screening program.
- To determine the prevalence of congenital HCMV in two Portuguese hospitals.
Main Methods:
- Screening involved pooling 10 newborn saliva samples for real-time PCR detection of HCMV DNA.
- Positive pools were followed by individual sample testing.
- Confirmation of positive cases was performed using urine samples collected within the first two weeks of life.
Main Results:
- 1492 newborns were included in the study.
- 150 saliva pools were screened, with 14 initially testing positive.
- 10 confirmed cases of congenital HCMV infection were identified, yielding a prevalence of 0.67%.
Conclusions:
- Pooled saliva screening is an effective strategy for detecting congenital HCMV infection.
- This approach enables timely screening and confirmation in large populations.
- Saliva pooling offers significant cost reductions for newborn screening programs.
Abstract:
Human cytomegalovirus (HCMV) is the leading congenital infection agent in the world. The importance of screening this infection has been debated, as 10-15% of the asymptomatic newborns with HCMV at birth will present late sequelae. The aim of this study was to test the feasibility of using saliva pools from newborns in a screening program for congenital HCMV infection, in two Portuguese hospitals. The screening was based on the use of pools of 10 saliva samples for detection of viral DNA by real-time PCR. Whenever there was a positive pool, the samples were tested individually, and for each positive sample the result was confirmed with a urine sample collected in the first 2 weeks of life. The study involved 1492 newborns. One hundred and fifty pools were screened, with 14 positive results in saliva, but only 10 were confirmed in urine samples, giving a prevalence of congenital HCMV infection in both hospitals of 0.67% (CI95% 0.36 to 1.23%).Conclusion: The overall prevalence of congenital HCMV infection in both hospitals was 0.67%. The use of saliva pools proved to be effective for the screening of this congenital infection, allowing timely screening and confirmation in a large population, with associated cost reduction. What is Known: • Newborn screening for HCMV is desirable. • Saliva is a good and practical sample. What is New: • The feasibility of using saliva pools for a large-scale screening. • The cost reduction of this strategy.
