Abstract
Cytomegalovirus (CMV) enters latency after primary infection and can reactivate periodically with virus excreted in body fluids which can be called shedding. CMV shedding during the early stage of pregnancy is associated with adverse pregnancy outcome. The shedding pattern in healthy seropositive women who plan to have babies has not been well characterised. Vaginal swabs, urine and blood were collected from 1262 CMV IgG-positive women who intended to have babies and tested for CMV DNA by fluorogenic quantitative PCR method. Serum IgM was also detected. The association between sociodemographic characteristics and CMV shedding prevalence was analysed. Among 1262 seropositive women, 12.8% (161/1262) were detected CMV DNA positive in at least one body fluid. CMV DNA was more frequently detected in vaginal secretion (10.5%) than in urine (3.2%) and blood (0.6%) also with higher viral loads (P < 0.00). CMV shedding was more likely detected in IgM-positive women than IgM-negative women (29.5% (13/44) vs. 12.2% (148/1218); OR 3.03, 95% CI 1.55-5.93; P = 0.001). CMV shedding in vaginal secretion was highly correlated with shedding in urine, the immune state of IgM, the adverse pregnant history and younger age. CMV shedding was more commonly detected in vaginal secretion than in urine or blood with higher viral loads among healthy seropositive women of reproductive age. Further studies are needed to figure out whether the shedding is occasional or continuous and whether it is associated with adverse pregnancy outcomes.
Highlights
Cytomegalovirus (CMV) infection is one of the most common causes of intrauterine infection and congenital infectious disease, which can result in sensorineural hearing loss and intellectual disability [1, 2]
The age span in our study is small, we found that CMV shedding in vaginal secretion was more frequent in women younger than 24, which might be explained by more active sexual act with younger age
For these women, if no intervening measures are taken before gestation, will the intermittent appearance of the virus in the genitourinary tract lead to detrimental results when getting pregnant? Further studies are needed to figure out whether the shedding is occasional or continuous and whether it is associated with adverse pregnancy outcomes
Summary
Cytomegalovirus (CMV) infection is one of the most common causes of intrauterine infection and congenital infectious disease, which can result in sensorineural hearing loss and intellectual disability [1, 2]. In contrast to other congenital infections like rubella and toxoplasmosis, preconception maternal immunity of CMV provides only partial protection to prevent the transmission to the foetus [7, 8]. Plenty of evidence show that congenital CMV infection happens following maternal reactivated infection or reinfection as well as primary infection [9,10,11,12]. In the high seroprevalence country, a large proportion of congenital CMV infection happens following maternal non-primary infection instead of primary infection [9, 10]. The virus becomes latent in the host after primary infection and the host sheds CMV intermittently in body fluids such as urine, saliva and other body secretions as a result of either primary or non-primary infection (including reactivated infection and reinfection) [13]. Understanding the shedding pattern of women who plan to have babies is of great importance
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
