Glycoprotein N Associations With Congenital Cytomegalovirus Infection and Neurological Sequelae

Cytomegalovirus (CMV) is a leading cause of congenital infection and long-term clinical complications, such as sensorineural hearing loss and neurological impairment. This study determines the distribution of CMV glycoprotein N (gN) variants and their potential effect on the occurrence of cytomegaly symptoms in infants. A total of 95 neonates with congenital CMV (cCMV) infection and 126 symptomatic infants with postnatal CMV (pCMV) or unproven cCMV infection were recruited for the study. The UL73 genotyping was performed by nested PCR-RFLP and sequencing, while the CMV DNA load was evaluated by quantitative RT-PCR. The gN3a variant was detected more frequently in neonates with cCMV infection than in infants with pCMV or unproven cCMV infection (p < 0.005), while the gN4b genotype was more common in infants than in newborns (p = 0.010). cCMV infection with the gN4c variant increased the risk of neurological dysfunction and sensorineural hearing loss (p = 0.018 and p = 0.010, respectively). At the same time, the gN1 genotype was associated with a decreased risk of anemia (p = 0.007), while gN3b reduced the risk of thrombocytopenia in examined neonates (p = 0.014). No correlation was found between the gN variants and viral load. Our results suggest that the gN4c variant may be associated with the development of neurological dysfunction in newborns with cCMV infection.