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Published on: July 6, 2013
Clinical Characteristics of Infants with Symptomatic Congenital and Postnatal Cytomegalovirus Infection-An 11-Year
Yu-Ning Chen1, Kai-Hsiang Hsu1,2,3, Chung-Guei Huang4,5
1Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan.
Insights
Cytomegalovirus (CMV) infection in infants presents differently based on congenital (cCMV) or postnatal (pCMV) acquisition. Congenital CMV is linked to prematurity, while postnatal CMV shows higher rates of hepatitis and jaundice.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) infection is common in newborns, affecting 0.2%–2.4%.
- Limited data exists on the demographic and clinical features of symptomatic infant CMV infections.
- Distinguishing between congenital CMV (cCMV) and postnatal CMV (pCMV) is crucial for understanding disease presentation.
Purpose of the Study:
- To investigate the demographic characteristics, clinical presentations, and outcomes of infants with CMV infection.
- To compare the features of congenital CMV (cCMV) versus postnatal CMV (pCMV) in infants.
- To identify disparities and differing symptoms between cCMV and pCMV groups.
Main Methods:
- Retrospective cohort study utilizing an 11-year multicenter database (2011–2021).
- Included infants with confirmed CMV infection via urine culture, blood PCR, or IgM.
- Analyzed clinical characteristics at diagnosis, management, and outcomes, differentiating between cCMV and pCMV.
Main Results:
- 272 CMV-infected infants were analyzed; 21 had cCMV and 251 had pCMV.
- Infants with cCMV showed higher rates of prematurity, being small for gestational age, and lower weight Z scores.
- Thrombocytopenia was the primary symptom in cCMV, whereas hepatitis and prolonged jaundice were more common in pCMV.
Conclusions:
- This study highlights distinct demographic and clinical profiles for congenital versus postnatal CMV infections in infants.
- Findings underscore the need for tailored screening, treatment, and follow-up strategies for infants with CMV.
- Further research is recommended to refine screening policies and management protocols for infant CMV.
Abstract:
(1) Background: Cytomegalovirus (CMV) infection is a prevalent viral disease among infants. The prevalence typically ranges from 0.2% to 2.4% among all newborns. There are limited data regarding the demographic characteristics of infants with symptomatic CMV infections. (2) Methods: In this retrospective cohort study using the Chang Gung Memorial Hospital multicenter database, infants with CMV infection determined by a positive urine culture, positive blood polymerase chain reaction assay or positive immunoglobulin M result for CMV from 2011 through 2021 were included. Clinical characteristics at initial diagnosis, management and outcomes were investigated. Congenital CMV (cCMV) infection is diagnosed within three weeks after birth; postnatal CMV (pCMV) is diagnosed when CMV is detected after the first 3 weeks of life. (3) Results: Among the 505 CMV-infected infants identified, 272 were included in the analysis. According to the age at initial presentation, 21 infants had cCMV infection and 251 had pCMV infection. Higher incidences of prematurity and being small for gestational age and a lower Z score for weight at diagnosis were observed in the cCMV group. While thrombocytopenia (61.9%) was the leading presentation in the cCMV group, hepatitis (59.8%) and prolonged jaundice (21.9%) were more common in the pCMV group. (4) Conclusions: Utilizing an 11-year multicenter database, we demonstrated the characteristics of infants with CMV infection in Taiwan and highlighted the demographic disparities and differing symptoms between the cCMV and pCMV groups. These findings emphasize the necessity for future research to refine screening policies, explore treatment options, and establish follow-up protocols for affected infants.
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