Screening options for prevention of congenital cytomegalovirus infection.

Abstract

Cytomegalovirus (CMV) is a DNA virus and a member of the herpes family of viruses, which includes herpes simplex, Epstein-Barr, and varicella zoster viruses. Like these other viruses, once primary infection has occurred CMV establishes itself in the host in a latent form with periodic episodes of reactivation occurring throughout life. Both primary and recurrent infections are associated with viral shedding in urine, saliva, semen, cervical secretions, breast milk, and other body fluids. In healthy people symptoms of CMV infection are often mild and non-specific, or absent altogether, and rarely cause serious illness. However CMV infection can be life threatening to immunocompromised people—such as those with advanced HIV infection, transplant recipients, or very premature infants, and there is a risk of fetal infection and damage when the infection is acquired during pregnancy. CMV seroprevalence in pregnant women Cytomegalovirus is common in communities all over the world with most people acquiring infection at some time,although the prevalence of past infection in pregnant women varies widely, even between populations within a single country. The age specific seroprevalence found in adults reflects the diVerent patterns of acquisition of CMV in childhood. This is due to several factors associated with the transmission of CMV including breast feeding prevalence and the CMV seroprevalence in breast feeding women, crowding, child rearing arrangements, hygiene standards and practice, the age of onset of sexual activity and the number of sexual partners. Studies carried out in ethnically and socially diverse populations show a high seroprevalence among women of low socioeconomic status compared with those of high socioeconomic status and higher rates of seropositivity among black women and women of Asian and Oriental origin than among white women. In the United Kingdom as a whole, about half of all pregnant women are likely to be seropositive.