Abstract
Cytomegalovirus (CMV) is a ubiquitous virus, and CMV-associated diseases range from mild illness in immunologically normal hosts to life-threatening diseases in newborns and immunocompromised children. This study investigated the association between childhood CMV infection and subsequent epilepsy or neurodevelopmental disorders, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). A retrospective analysis was performed on data for 69 children with confirmed CMV infections (CMV infection group) and 292 patients with other infections (control group) between 1 January 2006 to 31 December 2012. The results indicated that the CMV infection group had a higher risk of epilepsy in comparison to the control (odds ratio (OR), 16.4; 95% CI (confidence interval), 3.32–80.7; p = 0.001). Epilepsy risk increased in younger children (age 0–2) with CMV infection when compared to the control group (OR, 32.6; 95% CI, 3.84–276; p = 0.001). The ASD risk was also determined to be higher in the CMV infection group (OR, 17.9; 95% CI, 1.96–162; p = 0.01). The ADHD risk between the groups was not significant. This study suggests that CMV infection in infancy may increase the risk of subsequent epilepsy and ASD, especially in infants younger than 2 years, but is not associated with ADHD.
Highlights
Cytomegalovirus (CMV) infection is an inconspicuous and mostly symptomless disease commonly infecting people of all ages throughout the world
The final analysis excluded individuals who had had more than one CMV infection episode, who had died during follow-up, who had been diagnosed with neoplasms, who had undergone organ transplantation, or who had suffered from any serious disease affecting the immune system before or after CMV infection
Our study demonstrated a similar trend, namely that patients with non-congenital CMV in infancy, regardless of infection type, exhibited less severe neurological sequelae, we suggested an association between early CMV infection and the development of epilepsy and autism spectrum disorder (ASD) by analyzing our patients and by referring to research publications [8,23,24,25,26]
Summary
Cytomegalovirus (CMV) infection is an inconspicuous and mostly symptomless disease commonly infecting people of all ages throughout the world. Most children are infected by 3 years of age; by contrast, in developed countries, infection can often occur throughout childhood and adolescence, where as much as 60% to 80% of some countries’ populations are infected with CMV by adulthood [1]. Approximately 10% of acquired CMV infections produce symptoms. These include mononucleosis-like syndrome, fever, fatigue, pharyngitis, adenopathy (especially cervical adenopathy), hepatitis, and hepatosplenomegaly (HSM) [2]. Congenital CMV infection often results in nonhereditary sensorineural hearing loss or other long-term neurodevelopmental disorders (NDDs). Young children who survive a CMV infection congenitally might have a higher risk of developing neurodevelopmental sequelae, including intellectual disability, cerebral palsy, hearing loss, and seizures [4]
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