Congenital Cytomegalovirus: A European Expert Consensus Statement on Diagnosis and Management

C cytomegalovirus (cCMV) is the most common congenital infection in the developed world. Reported prevalence varies between cohorts but is approximately 7 per 1000 births. About half of cytomegalovirus (CMV)-infected babies with clinically detectable disease at birth are destined to have significant impairments in their development, and cCMV infection is implicated in approximately 25% of all children with sensorineural hearing loss (SNHL). Meta-analysis shows that although long-term sequelae, especially SNHL, are more common in those with clinically detectable disease at birth, they are also found in 13% of those without clinical features attributable to CMV on initial examination.

[1]  A. Keir,et al.  Cost‐effectiveness of universal and targeted newborn screening for congenital cytomegalovirus infection , 2018, Acta paediatrica.

[2]  P. Soler-Palacín,et al.  Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up , 2017, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  P. Griffiths,et al.  Compartmentalized dynamics of cytomegalovirus replication in treated congenital infection. , 2016, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[4]  R. Tambucci,et al.  Anti-viral therapy for congenital cytomegalovirus infection: pharmacokinetics, efficacy and side effects , 2016, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[5]  J. Pardo,et al.  Hearing outcome of infants with congenital cytomegalovirus and hearing impairment , 2016, Archives of Disease in Childhood.

[6]  P. Griffiths,et al.  First estimates of the potential cost and cost saving of protecting childhood hearing from damage caused by congenital CMV infection , 2015, Archives of Disease in Childhood: Fetal and Neonatal Edition.

[7]  Jihong Qian,et al.  Dried blood spots PCR assays to screen congenital cytomegalovirus infection: a meta-analysis , 2015, Virology Journal.

[8]  R. DeBiasi,et al.  Valganciclovir for symptomatic congenital cytomegalovirus disease. , 2015, The New England journal of medicine.

[9]  I. Dhooge,et al.  Hearing Loss and Congenital CMV Infection: A Systematic Review , 2014, Pediatrics.

[10]  D. Bernstein,et al.  Detection of congenital cytomegalovirus infection by real-time polymerase chain reaction analysis of saliva or urine specimens. , 2014, The Journal of infectious diseases.

[11]  J. Pardo,et al.  Treatment of Late-Onset Hearing Loss in Infants With Congenital Cytomegalovirus Infection , 2014, Clinical pediatrics.

[12]  C. Shannon-Weickert BIOMARKERS , 2014, Schizophrenia Research.

[13]  W. Britt,et al.  Spectrum of disease and outcome in children with symptomatic congenital cytomegalovirus infection. , 2014, The Journal of pediatrics.

[14]  T. Lazzarotto,et al.  Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection , 2014, Brain and Development.

[15]  W. Carlo,et al.  Incidence and Impact of CMV Infection in Very Low Birth Weight Infants , 2014, Pediatrics.

[16]  S. Berrettini,et al.  Neonatal screening for congenital cytomegalovirus infection in preterm and small for gestational age infants , 2014, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[17]  T. Lazzarotto,et al.  Human fetal inner ear involvement in congenital cytomegalovirus infection , 2013, Acta neuropathologica communications.

[18]  A. García-Alix,et al.  Clinical, biochemical, and neuroimaging findings predict long-term neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. , 2013, The Journal of pediatrics.

[19]  F. Dekker,et al.  The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population‐based prediction model , 2013, Reviews in medical virology.

[20]  Y. Ville,et al.  Management of Pregnancies with Confirmed Cytomegalovirus Fetal Infection , 2013, Fetal Diagnosis and Therapy.

[21]  F. Baquero-Artigao,et al.  Treatment of symptomatic congenital cytomegalovirus infection beyond the neonatal period. , 2012, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[22]  N. Inoue,et al.  Newborn screening of congenital cytomegalovirus infection using saliva can be influenced by breast feeding , 2012, Archives of Disease in Childhood: Fetal and Neonatal Edition.

[23]  E. Claas,et al.  Real-time PCR versus viral culture on urine as a gold standard in the diagnosis of congenital cytomegalovirus infection. , 2012, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[24]  J. Pardo,et al.  Is lenticulostriated vasculopathy a sign of central nervous system insult in infants with congenital CMV infection? , 2011, Archives of Disease in Childhood.

[25]  D. Bernstein,et al.  Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns. , 2011, The New England journal of medicine.

[26]  R. Manara,et al.  Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection , 2011, Pediatric Radiology.

[27]  E. Lopriore,et al.  Is routine TORCH screening and urine CMV culture warranted in small for gestational age neonates? , 2011, Early human development.

[28]  M. Cannon,et al.  Attribution of congenital cytomegalovirus infection to primary versus non-primary maternal infection. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  S. Soong,et al.  Neurodevelopmental outcomes following ganciclovir therapy in symptomatic congenital cytomegalovirus infections involving the central nervous system. , 2009, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[30]  F. Walther,et al.  Is Routine TORCH Screening Warranted in Neonates with Lenticulostriate Vasculopathy? , 2009, Neonatology.

[31]  W. Britt,et al.  Cytomegalovirus Blood Viral Load and Hearing Loss in Young Children With Congenital Infection , 2009, The Pediatric infectious disease journal.

[32]  D. Kimberlin,et al.  Treatment of congenital cytomegalovirus infection: implications for future therapeutic strategies. , 2009, The Journal of antimicrobial chemotherapy.

[33]  M. Sharland,et al.  Postnatal cytomegalovirus: innocent bystander or hidden problem? , 2008, Archives of Disease in Childhood Fetal and Neonatal Edition.

[34]  G. Guyatt,et al.  GRADE: an emerging consensus on rating quality of evidence and strength of recommendations , 2008, BMJ : British Medical Journal.

[35]  P. Sánchez,et al.  Pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease. , 2008, The Journal of infectious diseases.

[36]  S. Grosse,et al.  New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection , 2007, Reviews in medical virology.

[37]  T. Lazzarotto,et al.  Cranial ultrasound scanning and prediction of outcome in newborns with congenital cytomegalovirus infection. , 2007, The Journal of pediatrics.

[38]  P. Griffiths,et al.  Advances in the antiviral therapy of herpes virus infection in children , 2006, Expert review of anti-infective therapy.

[39]  L. J. Marin,et al.  Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection? , 2006, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[40]  C. Morton,et al.  Newborn hearing screening--a silent revolution. , 2006, The New England journal of medicine.

[41]  Valentina Venturi,et al.  Neonatal Cytomegalovirus Blood Load and Risk of Sequelae in Symptomatic and Asymptomatic Congenitally Infected Newborns , 2006, Pediatrics.

[42]  W. Britt,et al.  Detection of cytomegalovirus (CMV) DNA by polymerase chain reaction is associated with hearing loss in newborns with symptomatic congenital CMV infection involving the central nervous system. , 2005, The Journal of infectious diseases.

[43]  L. D. de Vries,et al.  The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. , 2004, Neuropediatrics.

[44]  M. H. Ensom,et al.  Ganciclovir in Solid Organ Transplant Recipients: Is There a Role for Clinical Pharmacokinetic Monitoring? , 2004, Therapeutic drug monitoring.

[45]  S. Soong,et al.  Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. , 2003, The Journal of pediatrics.

[46]  W. Britt,et al.  Predictors of hearing loss in children with symptomatic congenital cytomegalovirus infection. , 2002, Pediatrics.

[47]  M. Tomicic,et al.  Comparative analysis of DNA breakage, chromosomal aberrations and apoptosis induced by the anti-herpes purine nucleoside analogues aciclovir, ganciclovir and penciclovir. , 2002, Mutation research.

[48]  Y. Schlesinger,et al.  Congenital Cytomegalovirus Infection , 2001, Journal of Perinatology.

[49]  J. Bale,et al.  Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. , 2001, The Journal of pediatrics.

[50]  W. Britt,et al.  Longitudinal investigation of hearing disorders in children with congenital cytomegalovirus. , 2000, Journal of the American Academy of Audiology.

[51]  D. Coats,et al.  Ophthalmologic findings in children with congenital cytomegalovirus infection. , 2000, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[52]  W. Britt,et al.  Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. , 1992, The Pediatric infectious disease journal.

[53]  A. Daley,et al.  Ganciclovir for the treatment of congenital cytomegalovirus: what are the side effects? , 2014, The Pediatric infectious disease journal.

[54]  L. Papile Saliva Polymerase-Chain-Reaction Assay for Cytomegalovirus Screening in Newborns , 2011 .

[55]  J. Preiksaitis,et al.  Congenital cytomegalovirus infection in high-risk Canadian infants: Report of a pilot screening study. , 2010, The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale.

[56]  S. Kazzi,et al.  YIELD AND COSTS OF SCREENING GROWTH-RETARDED INFANTS FOR TORCH INFECTIONS , 2000, American journal of perinatology.

[57]  S. Boppana,et al.  Newborn hearing screening: will children with hearing loss caused by congenital cytomegalovirus infection be missed? , 1999, The Journal of pediatrics.

[58]  M Forshaw,et al.  A critical review of the role of neonatal hearing screening in the detection of congenital hearing impairment. , 1997, Health technology assessment.