Cytomegalovirus IgM Antibodies Research Articles

Seroprevalence and susceptibility to primary cytomegalovirus infection among childbearing women

Background: Amaternal primary cytomegalovirus (CMV) infection during pregnancy is more likely to transmit CMV frommother to fetus with more severe sequelae of congenital infection compared with a maternal non-primary CMV infection (reinfection or reactivation). The aim of this study is the evaluation of CMV seroprevalence and susceptibility to primary CMV infection among Greek and immigrant pregnant and non-pregnantwomenof reproductive age. Methods & Materials: From January 2011 to September 2013, a total of 3,121 pregnant and non-pregnant women of childbearing age, were tested for CMV-IgG and IgM antibodies. Out of 3,121 women the 1,683 were Greeks and 1,438 were immigrants from developingcountries.Of the1,683Greeksand1,438 immigrants the 755 and 815 respectivelywere pregnant. Detection of CMV-specific IgG and IgM antibodies was carried out by EIA and electrochemiluminescence immunoassay (ABBOTT, AxSYM CMV IgG and IgM Microparticle Enzyme Immunoassay and Roche CMV IgG and IgM electrochemiluminescence immunoassay on cobas e 411 analyzer) according to the manufacturer’s instructions. Results: CMV-IgG and IgM antibodies were detected in 617 (66.49%) and 7 (0.75%) non-pregnant and 537 (71.12%) and 2 (0.26%) pregnant Greek women respectively, whereas CMV IgG and IgM antibodies were detected in 581 (93.26%) and 7 (1.12%) non-pregnant and 789 (96.81%) and 1 (0.12%) pregnant immigrant women respectively. The susceptibility to primary CMV infection of non-pregnant and pregnant Greek women was found to be 33.51% (311/928) and 28.88% (218/755) respectively, whereas the susceptibility to primary CMV infection of no-pregnant and pregnant immigrant women was 6.74% (42/623) and 3.19% (26/815) respectively. Statistical analysis by x2 test showed significantly higher susceptibility to primary CMV infection in non-pregnant and pregnant Greek women than in immigrant women. Conclusion: (a) The prevalence of specific antibodies to CMV in pregnant and non-pregnant Greek women of childbearing age is high. (b) The CMV seroprevalence in pregnant and non-pregnant immigrant women is significantly higher than in Greek women. (c) The susceptibility to primary CMV infection is significantly higher in pregnant and non-pregnant Greek women than in immigrants. (d) A remarkable number of Greek women of reproductive age remain at risk of primary CMV infection during pregnancy.

Association Between Cytomegalovirus Infection and Bad Obstetric Outcomes in Women from Kirkuk

<p>The human cytomegalovirus (CMV) is one of the common viral infections worldwide that represent a major causes of congenital infections. To determine the seroprevalence of CMV in women with bad obstetric history and sociodemographic characteristics that may influence the seropositivity, a case<strong> </strong>control descriptive prospective study was conducted in Kirkuk, Iraq. A 838 women with age range from 14 to 48 were included in the study. Of the total, 547 women were with bad obstetric history(BOH) and 291 women with normal previous pregnancy as control group. All the serum samples collected from the study and control groups were tested for CMV IgM and IgG antibodies by ELISA kits. CMV IgM seroprevalence was higher in women with BOH.<strong> </strong>CMV IgG seroprevalence was with no significant difference between BOH and control. CMV IgG seroprevalence significantly influenced by age, education, smoking, and family size. However, CMV IgM seroprevalence significantly associated with pregnancy, residence, and animal exposure. Odd ratio confirmed the association between CMV IgG and age, crowding index, residence, smoking, and number of abortion in women with BOH. In addition, current CMV infection significantly associated with residence in women with BOH.</p>

Association Between Cytomegalovirus Infection and Bad Obstetric Outcomes in Women from Kirkuk

<p>The human cytomegalovirus (CMV) is one of the common viral infections worldwide that represent a major causes of congenital infections. To determine the seroprevalence of CMV in women with bad obstetric history and sociodemographic characteristics that may influence the seropositivity, a case<strong> </strong>control descriptive prospective study was conducted in Kirkuk, Iraq. A 838 women with age range from 14 to 48 were included in the study. Of the total, 547 women were with bad obstetric history(BOH) and 291 women with normal previous pregnancy as control group. All the serum samples collected from the study and control groups were tested for CMV IgM and IgG antibodies by ELISA kits. CMV IgM seroprevalence was higher in women with BOH.<strong> </strong>CMV IgG seroprevalence was with no significant difference between BOH and control. CMV IgG seroprevalence significantly influenced by age, education, smoking, and family size. However, CMV IgM seroprevalence significantly associated with pregnancy, residence, and animal exposure. Odd ratio confirmed the association between CMV IgG and age, crowding index, residence, smoking, and number of abortion in women with BOH. In addition, current CMV infection significantly associated with residence in women with BOH.</p>

CMV Infection and Pregnancy

Cytomegalovirus (CMV) occurs in 0.2 % to 2.2 % of all live births and is the most common cause of intrauterine infection and the leading infectious cause of sensorineural hearing loss and mental retardation. This article reviews literature that relate to the pathogenesis, diagnosis, and treatment of this disease for pregnant women and their fetus. Primary maternal CMV infection during pregnancy has a much higher rate of mother-to-fetus transmission and causes symptoms at birth and long-term disability than nonprimary infection. In addition, some research has shown that children with congenital CMV infection following first-trimester maternal infection are more likely to have severe sequelae. The prenatal diagnosis of fetal CMV infection includes serological testing (IgM detection and IgG avidity assay), amniocentesis, and ultrasound examination. The combination of the presence of CMV IgM antibodies and low CMV IgG avidity, along with maternal or fetal symptoms is used for the diagnosis of a primary maternal infection. Amniocentesis should be complemented until approximately 20-21 weeks of gestation to increase the sensitivity. Because ultrasound abnormalities are only found in less than 25 % of infected fetuses, ultrasound is as a relatively poor predictor of symptomatic congenital infection. CMV hyperimmunoglobulin also may be considered when the pregnant women are confirmed as primary CMV infection with low IgG avidity and amniotic fluid is found to contain CMV or CMV DNA. There is no consensus on the benefit of prenatal administration of ganciclovir into the umbilical vein.

Transfusion associated CMV infection: Transfusion strategies for high risk patients

The role of blood and blood products in acquisition of cytomegalovirus (CMV) infections following transfusion was reviewed in this study. CMV IgG prevalence was particularly high in Bangladesh. Thus 97% of the study groups were found to be CMV IgG positive. The present study showed that CMV IgM antibody prevalence was significantly higher in multiple transfused groups (24%) than control group (2%) indicating CMV primary infection and reactivation or reinfection occur frequently in multitransfused patients. Most CMV infections acquired after transfusion are either asymptomatic or characterized by a self-limited infectious mononucleosis syndrome but it may be serious or fatal in those who are immunocompromised. Particularly at risk are low-birth weight infants, bone marrow and organ transplant patients. If a patient is at high risk of getting CMV diseases, blood from seronegative donors is appropriate and likely to prevent post transfusion CMV infection. Alternatively, blood that has been filtered to decrease the number of white blood cells - the cells that carry CMV - will protect patients from getting a CMV infection from transfusion.DOI: http://dx.doi.org/10.3329/bjmm.v4i2.10828

Relationship of cytomegalovirus, Chlamydia pneumoniae and herpes simplex virus type 2 infections with preeclampsia

To explore the potential relationship of cytomegalovirus (CMV), Chlamydia pneumoniae (CP) and herpes simplex virus type 2 (HSV-2) in inflammation and preeclampsia. Fifty-two pregnant women with preeclampsia and 34 with uncomplicated pregnancy in the third trimester were recruited. The exclusions included uterine contractions, multiple pregnancies, rupture of membranes, symptomatic infectious diseases, medical diseases and antibiotics or hormones users. Samples of maternal blood were harvested from two groups. Serum levels of CMV, CP, and HSV-2 IgM and IgG antibodies as well as high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA) in preeclampsia and normal pregnancy controls. (1) Recent infections of CMV, CP and HSV-2 were not more common in patients with preeclampsia versus normal pregnancy. The prevalence rates of long-dated CMV, CP and HSV-2 infection were 94.2% (49/52), 53.9% (28/52) and 3.9% (2/52) in preeclampsia group versus 100.0% (34/34), 55.9% (19/34) and 5.9% (2/34) in control group. No significant difference existed between two groups (P > 0.05). (2) Maternal serum concentrations of IL-6 and hs-CRP in patients with preeclampsia were significantly higher than that in normal pregnancy women ((7.2 ± 2.1) ng/L and (6.8 ± 5.6) mg/L vs (6.2 ± 1.8) ng/L and (4.6 ± 3.0) mg/L, both P < 0.05). Excessive inflammatory reactions are present in women with preeclampsia. But previous infections, as measured by IgM and IgG antibody seropositivity to CMV, CP and HSV-2, are not correlated with preeclampsia in the third trimester.

Evaluation of the IMMULITE® 2000 CMV IgM assay

BackgroundDiagnosis of cytomegalovirus (CMV) infection is challenging because of the high rate of asymptomatic infection and the low specificity of associated symptoms and signs. As a result, laboratory testing is an essential aid in making an accurate diagnosis. The presence of CMV IgM is indicative of primary CMV infection. In pregnancy, diagnosis of primary infection is important because primary maternal infection increases fetal infection risk substantially. Fetal infection can result in serious sequelae ranging from neurological deficits to death. Diagnosis among the immunocompromised is also critical for the timely initiation of therapy that can reduce morbidity and mortality risk.MethodsThe IMMULITE® 2000 CMV IgM assay qualitatively detects CMV IgM antibodies in human serum or plasma to aid in the diagnosis of current or recent CMV infection. To determine expected values in apparently healthy subjects, 136 samples were tested. Reproducibility, normal range, and method comparison studies were also performed to evaluate the assay's performance. The assay's reproducibility was evaluated across three sites. Seven hundred and eighteen (n = 718) individual patient serum samples, which included samples from CMV IgM-positive (n = 109, determined by the Abbott IMx CMV or the Diamedix CMV IgM assays), pregnant (n = 210), HIV-positive (n = 30), immunosuppressed (n = 102), and transplant patients (n = 17) and from patients with potentially cross-reacting conditions (n = 136) were evaluated in the method comparison study. The positive, negative, and overall agreement between the IMMULITE 2000 CMV IgM assay and the VIDAS CMV IgM assay (predicate assay) were determined.ResultsThe assay demonstrated excellent reproducibility with a total CV of less than 10%. The positive, negative, and overall agreement between the IMMULITE 2000 assay and the VIDAS assay were > 95% for the method comparison samples. Among potentially cross-reactive samples, the overall agreement between the two assays was 96%. Similarly, among the immunocompromised and pregnant subjects, the overall agreement was ~96% and ~97%, respectively.ConclusionsThe IMMULITE 2000 CMV IgM assay demonstrated excellent reproducibility, minimal cross-reactivity, and performance comparable to that of the VIDAS CMV IgM assay. It can aid in the diagnosis of acute CMV or recent CMV infection by qualitatively detecting the CMV IgM antibodies in human serum or plasma.

Detection of Toxoplasma gondii IgM and Cytomegalovirus IgM antibodies among blood donors in Mosul

Background: Toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii. This parasite can be transmitted via blood transfusion. Cytomegalovirus (CMV) is a herpes virus that can cause many complications and mostly transfer via blood transfusion. The aim of this study was to evaluate the percentage of risk of infections that could occur due to blood transfusion. Subjects and methods: Ninety blood donor samples were randomly obtained from central blood bank of Mosul city and investigated for IgM of toxoplasmosis and CMV by the serological method ELISA, IgM. Results: ELISA test for Toxoplasma gondii IgM test showed 3% seropositive and for CMV showed 10% seropositive. Conclusion: The results indicate a risk of infection with toxoplasmosis and CMV via blood transfusion.

National Prevalence Estimates for Cytomegalovirus IgM and IgG Avidity and Association between High IgM Antibody Titer and Low IgG Avidity

Primary cytomegalovirus (CMV) infection of the mother during pregnancy presents risk of CMV infection of the fetus with resulting permanent disability. CMV IgM antibody is generated following primary CMV infection but also can appear during nonprimary CMV infection and is thus of limited diagnostic use by itself. In contrast, the presence of low CMV IgG avidity has been shown to be a unique and reliable serologic indicator of primary CMV infection. We measured CMV IgG and IgM antibody levels and IgG avidity in sera from a population sample of 6,067 U.S. women aged 12 to 49 years from NHANES (National Health and Nutrition Examination Survey). The CMV IgG prevalence was 58% overall and increased strongly with age. The CMV IgM prevalence was 3.0% overall and remained relatively flat across age groups. The prevalence of low IgG avidity was 2.0% overall, decreased sharply with age, and was seen mainly among IgM-positive sera. Fourteen to 18% of the CMV IgM-positive sera were low IgG avidity, presumably representing primary CMV infection. High CMV IgM antibody titer was a strong predictor of low IgG avidity. The ability to reliably identify primary CMV infection during pregnancy is important for management of the pregnancy, including possible treatment options for the fetus. Both IgM and IgG avidity measurements provide useful clinical information for evaluating primary CMV infection, although commercial tests for CMV IgG avidity are not yet widely available in the United States.

An association between cytomegalovirus infection and pre‐eclampsia: a case–control study and data synthesis

Pre-eclampsia shares several similarities with atherosclerotic heart disease. We explored whether, like atherosclerosis, there is a potential link between cytomegalovirus (CMV) infection and pre-eclampsia. CMV IgG, IgM and IgA antibodies were determined by enzyme-linked immunosorbent assays in serums from pre-eclampsia (n = 78), normotensive intrauterine growth restriction (nIUGR) (n = 30) and normal pregnancy controls (n = 109). Data were analyzed by chi-squared, Kruskal-Wallis ANOVA and Mann-Whitney U-tests. Further, we conducted a comprehensive review of published studies on the relation between CMV infection and pre-eclampsia. Risk ratios (RRs) and 95% confidence interval (CI), according to CMV infection status, were calculated using Review Manager. Women with pre-eclampsia had increased CMV IgG seropositivity compared with nIUGR (p < 0.01) and normal pregnancy controls (p < 0.01). In addition, CMV IgG antibody level was higher in pre-eclampsia than normal pregnancy controls (p < 0.001). No difference was observed in CMV IgM or IgA among study groups. Data synthesis revealed that women with CMV infection were at higher risk in the development of pre-eclampsia, compared with women without CMV infection. Combined results for six studies yielded a RR of 1.5 (95% CI 1.2-1.9). CMV infection seems to affect the occurrence of pre-eclampsia. Evaluation of the relation between CMV infection and pre-eclampsia may provide mechanistic insights into pre-eclampsia-related inflammation.

Seroprevalence of cytomegalovirus antibodies in blood donors in southern, Brazil

Cytomegalovirus (CMV) infection is a matter of concern for blood bank professionals and blood transfusion recipients, especially in cases of transfusions to neonates and immunocompromised patients. Thus, the present study aimed to determine the seroprevalence of CMV IgG and IgM antibodies among blood donors in the city of Lages, in the mountain region of Santa Catarina, southern Brazil, and to investigate possible associations between the socioeconomic characteristics of donors and CMV serological status. A seroepidemiological cross-sectional study was conducted on 1,045 blood samples from donors that were used in serological screening over a one-year investigation. All the analyses were conducted using the microparticle enzyme immunoassay with Biokit(R) reagents (Barcelona, Spain), in accordance with the manufacturer's instructions. Anti-CMV IgG seroprevalence in the sample studied was 96.4% (95% CI: 95.23 - 97.50) and that of anti-CMV IgM was 2.3% (95% CI: 1.39 - 3.20). There were no statistically significant associations between the presence of antibodies and the socioeconomic characteristics of donors. The blood donors in the study region had high seroprevalence of anti-CMV IgG. Thus, blood component screening strategies and careful indication for blood transfusions require special attention among healthcare professionals as part of the actions for prevention and reduction of primary infections caused by CMV.

Seroprevalence of cytomegalovirus among some voluntary blood donors at the 37 military Hospital, Accra, Ghana

Cytomegalovirus (CMV) is one of the most significant pathogens infecting immunosuppressed individuals. CMV is transmissible through transfusion of blood components. The goal of this study was to determine the seroprevalence of antibodies to CMV among blood donors seen at the 37 Military Hospital Blood Transfusion Unit, (MHBTU) Accra, Ghana. The seroprevalence of antibodies specific for CMV was tested using CMV IgG/IgM particle agglutination test kit and ELISA. Of the 264 blood donors, 18 were negative and 246 were positive for CMV IgG antibodies, giving an overall CMV prevalence rate of 93.2%. None of the 264 blood donors was positive for CMV IgM antibodies. About 96% of the donors aged between 30 to 39 years were seropositive for CMV, as against 91.9% in those aged 20-29 years, 88.6% in 40 to 49 years, 75.0% (3 out of 4) in 50 to 59 years, and 100% (1 out 1) in 60-69 years. There was no statistically significant difference (P>0.05) in the CMV IgG status in different age groups. The blood donors comprised largely of male donors (236 out of 264), making sex comparisons statistically undesirable. However, all the female (n=28) donors were positive for CMV IgG. Since about 93% of blood donors at the MHBTU are seropositive for CMV, it would be very useful to screen blood donors in Ghana for CMV to identify the very few CMV-seronegative blood donors, and maintain an inventory of them for use as donors.

The natural course of primary cytomegalovirus infection in blood donors

As cytomegalovirus (CMV) DNA is frequently detectable in the plasma of recently infected sero-positive blood donors, information concerning primary CMV infection is important for the identification of possibly infectious donors. Monitoring of 17 982 donors for CMV antibodies and DNA in plasma identified 14 subjects with ongoing primary CMV infection. Thirteen donors were interrogated for possible sources of infection and CMV-related symptoms, and monitored for CMV antigens, CMV DNA in plasma, leucocytes and urine, course of IgG and IgM antibodies as well as markers of systemic infection and parameters of organ function. CMV antigens and DNA were detectable in peripheral blood for up to 54 and 269 days respectively. Clearance of CMV DNA from blood correlated with clearance of IgM antibodies, development of IgG antibodies against the membrane glycoprotein gB and development of high avidity IgG antibodies. Eighty-five percent of subjects with primary CMV infection, but even 69% of matched controls reported possibly CMV-related symptoms. Sixty-two and 23%, respectively, had contact with possible sources of infection. One donor developed a febrile illness accompanied by increased levels of CMV DNA in peripheral blood 2 to 3 weeks after seroconversion. In other donors, neither markers of systemic infection nor parameters of organ function correlated with the course of CMV DNA and antigens. Potentially infectious donors can be identified by measuring CMV DNA, IgM antibodies or avidity of IgG antibodies. Alternatively, blood products donated during the first year after seroconversion should not be used for immunocompromised patients.

Ross syndrome associated with cytomegalovirus infection

We report a 40-year-old woman who developed Ross syndrome (impairment of sweating and thermoregulation, tonic pupils, and hyporeflexia) associated with cytomegalovirus (CMV) infection. Her serum CMV IgM and IgG antibody titer levels were elevated. Along with clinical improvement, a gradual decrease of her elevated CMV IgM antibody titer level was seen with a continued increase in her CMV IgG antibody titer level. The CMV IgM antibody titer was also positive in the cerebrospinal fluid.

Herpes virus antibodies seroprevalence in children with autoimmune thyroid disease

Elevated titers of antibodies against different herpes virus antigens have been reported in some immunodeficient and systemic autoimmune disorders. To examine if Herpes Simplex Virus (HSV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) IgG and IgM antibodies are detected more frequently in children with autoimmune thyroid disease (AITD) compared to controls. Thirty-four children with AITD, aged 9.62 +/- 2.35 years, and 31 matched controls, aged 9.24 +/- 2.98 years, were studied. The percentage of EBV IgG+ children with AITD was statistically higher than the percentage of EBV IgG+ controls (82.35% versus 51.61%, P = 0.008). The percentage of EBV IgG+ children with AITD and hypothyroidism was statistically higher than the percentage of EBV IgG+ children with AITD, without hypothyroidism (100% versus 70%, P = 0.024). No other statistically significant differences were observed in HSV-1+2, and CMV IgG or IgM antibodies between the subgroups of children studied. EBV seroprevalence is higher in children with AITD compared to controls and the underlying pathology remains to be elucidated.

Cytomegalovirus Colitis in a Critically Ill Patient following Elective Repair of an Abdominal Aortic Aneurysm

We describe a case of cytomegalovirus colitis in a critically ill but otherwise immunocompetent 61-year-old male. Infection was demonstrated by histology and confirmed by plasma polymerase chain reaction and detection of cytomegalovirus IgM antibody. The patient was treated with ganciclovir with resolution of the cytomegalovirus viraemia. Cytomegalovirus colitis may be an under-recognised problem in immunocompetent patients who are critically ill. Quantification of plasma cytomegalovirus DNA by polymerase chain reaction is a non-invasive method of supporting the diagnosis and can be used to monitor the treatment of cytomegalovirus infection in the immunocompetent.

Adverse reproductive outcomes in urban women with adeno-associated virus-2 infections in early pregnancy

We demonstrated recently that adeno-associated virus-2 (AAV-2) DNA was detected significantly more frequently in placental trophoblast cells from cases of severe pre-eclampsia than from normal term deliveries. Here, we sought to determine if maternal AAV-2 infection early in pregnancy preceded adverse outcomes resulting from placental dysfunction. We collected first trimester maternal serum samples and compared anti-AAV-2 IgM antibody levels (indicating primary infection or reactivation of latent AAV-2) between controls delivered at term (n = 106) and three groups of cases: spontaneous abortions (n = 34), spontaneous preterm deliveries (n = 24) and women with at least one outcome usually attributed to placental dysfunction, including pre-eclampsia, intrauterine growth restriction (IUGR) or stillbirth (n = 20). The seroprevalence of immunoglobulin G (IgG) antibodies against AAV-2 and IgM antibodies against viruses that promote AAV-2 replication [adenovirus and cytomegalovirus (CMV)] were also determined. First trimester maternal IgM seropositivity was 5.6 times more prevalent among pre-eclampsia/IUGR/stillbirth cases (P = 0.0004) and 7.6 times more prevalent among preterm deliveries (P < 0.0001) than among controls. CMV and adenovirus IgM antibodies and chronic AAV-2 infections (IgG seropositivity) were not associated with adverse pregnancy outcomes. Primary or reactivated AAV-2 infection (maternal IgM seropositivity) early in pregnancy was associated with adverse reproductive outcomes associated with placental dysfunction, including pre-eclampsia, stillbirth and spontaneous preterm delivery.

High perinatal seroprevalence of cytomegalovirus in northern Taiwan

The living style, health-care system and socio-economic environments have changed substantially in Taiwan over past 20 years. This study was aimed to estimate the current perinatal cytomegalovirus (CMV) seroprevalence in northern Taiwan. In a Taiwan Birth Panel Study, 483 pairs of mothers and neonates were prospectively recruited from one tertiary medical center, one local hospital, and two obstetric clinics located in northern Taiwan from April 2004 through January 2005. Sera of their paired maternal and cord blood were tested by an enzyme-linked immunosorbent assay method for CMV IgG and IgM antibodies. Additional data were collected for health measures and epidemiological characteristics through trained interviewers utilising structured questionnaires. Among 483 mothers studied, 93% were Taiwanese, 6.4% were immigrants from the south-eastern Asia and Mainland China, and 0.6% was aborigines. The seropositive rate of CMV IgG and IgM among the mothers was 91.1% and 3.5%, respectively. The immigrant mothers and the mothers younger than 20 years of age had a higher IgM seroprevalence (P < 0.05). Furthermore, 90.8% of the offspring had CMV IgG seropositivity and yet none of the neonates were CMV IgM positive. The seroprevalence of CMV among childbearing women is high in northern Taiwan. The immigrant mothers and the teenage mothers appear to have higher seropositivity of CMV IgM.

Active cytomegalovirus replication in patients with coronary disease

Objectives. To study the prevalence of active cytomegalovirus (CMV) infection in patients with stable and unstable conditions of coronary artery disease (CAD). Design. Forty patients with acute coronary syndrome (ACS), 50 patients with stable angina and angiographically verified CAD (SA) and 50 clinically healthy controls were included. Monocytes were isolated from peripheral blood and CMV-RNA expression was determined by a nested RT-PCR assay. CMV IgM and IgG antibodies, interleukin-(IL)-6, IL-10 and CRP were measured in serum. Results. The prevalence of active CMV infection was significantly higher in patients with ACS (15%) and in patients with SA (10%) compared with controls (2%) (p<0.001). The presence of an active CMV infection was associated with increased serum concentrations of IL-6. Conclusions. Active CMV infection was found to a larger extent in CAD patients than in healthy controls. The data indicate that CAD patients are more susceptible to reactivation of CMV and put new focus on the role of CMV in atherosclerosis.

Umbilical cord blood screening for cytomegalovirus DNA by quantitative PCR

Background Cytomegalovirus (CMV) infection, which is the most common congenitally transmitted infection, affects approximately 1% of neonates worldwide. Despite its prevalence, no convenient screening test for neonatal CMV infection has been implemented. Objective The purpose of this pilot study was to evaluate the feasibility and yield of screening umbilical cord blood for CMV DNA emiaby quantitative PCR. Study design Umbilical cord blood was tested for CMV DNAemia using a commercial quantitative PCR assay. Maternal CMV serostatus at the time of delivery was assessed by testing for CMV IgG and IgM antibodies in serum. Conclusions Screening for congenital CMV infection with PCR is easily incorporated into routine labor and delivery care using discarded cord blood specimens to identify neonates whose infection is otherwise undiagnosed. Among 433 infants tested, two (0.5%) had DNAemia detected in cord blood, one of whom was symptomatic, and both of whose mothers were CMV IgG positive and IgM negative. Viremic neonates identified by screening with PCR may be at high risk of developing long-term neurological complications of CMV infection and cannot reliably be identified using clinical presentation or maternal serology. Because of its convenience, cord blood CMV screening with PCR should be further investigated for incorporation into neonatal screening protocols.