Prevalence Of Cytomegalovirus Research Articles

Epstein-Barr Virus and Human Cytomegalovirus Infection in Intestinal Mucosa of Chinese Patients With Inflammatory Bowel Disease.

ObjectiveThis study aimed to determine the frequency of Epstein–Barr virus (EBV), cytomegalovirus (CMV) in mucosa and blood of inflammatory bowel disease (IBD) patients in China and evaluate their correlation with the clinical disease activities.MethodsPeripheral blood and endoscopic fresh colonic mucosal samples were collected from a cohort of 287 IBD patients and 50 controls. Viral DNA load was analyzed through quantitative real-time PCR. The clinical disease activity of ulcerative colitis (UC) and Crohn’s disease (CD) was assessed by the Mayo Clinic Score and Crohn’s disease activity index, respectively.ResultsAmong 287 IBD patients, 228 (79.4%) were positive for EBV and 99 (34.5%) were positive for CMV. EBV and CMV infection rates are significantly higher than those in the control group (28.0%, p < 0.05; 4.0%, p < 0.05). In addition, EBV/CMV prevalence increases as clinical activities progress [For EBV infection, the prevalence was 53.93% (48/89) in the mild group, 87.00% (87/100) in the moderate group, and 94.90% (93/98) in the severe group; and for CMV infection, the prevalence was 3.37% (3/89) in the mild group, 27.00% (27/100) in the moderate group, and 70.41% (69/98) in the severe group]. EBV and CMV loads are related to clinical disease activities (p < 0.05). In addition, viral load in the intestinal mucosa of patients with acute exacerbation of IBD is higher than that of patients in remission.ConclusionHigh prevalence of EBV and CMV is found in patients with IBD, and their prevalence is related to clinical disease activities. In addition, the viral load in the intestinal mucosa is associated with the status of mucosa in the same patients (active phase versus remission phase). Detection of viral load on mucosal specimens with quantitative real-time PCR is a feasible method to monitor EBV and CMV infection in IBD patients.

Prevalence of Cytomegalovirus Infection among Suspected Infants in Baghdad

Background: Cytomegalovirus (CMV) virus is a recognized important cause of congenital CMV infection which carries a significant risk for symptomatic disease and developmental defects in newborns. Its prevalence varies from place to other and time to time. This study is conducted to estimate its prevalence in Baghdad among infants suspected of having a congenital infection and to study the associated findings. Subjects and Methods: The study was carried out in Al-Alwyia pediatrics teaching hospital. Data were collected, and blood samples were taken for infants suspected to have intrauterine infections over a period of one year, from 1 October 2019 to 1 October 2020. Immunoglobulin M (IgM) tests for CMV were conducted for all collected samples. CMV- immunoglobulin G (IgG) was a further analysis if negative results were obtained for CMV-IgM testing. Samples were tested by Eliza method. Results: The overall positivity for CMV-specific antibodies among suspected infants was 16.7% for IgM and 66 % for IgG. Males constitute 55% of CMV-IgM positive results. These results are statistically significant concerning age groups. 1-3-month age group was the largest (40 % of IgM positive infants) with a p-value of 0.000. This indicates delayed presentation of CMV-affected infants. With the same p-value, 74% of infants less than one month of age were IgG positive reflecting the maternal prevalence of CMV- IgG in an equivalent percentage. Convulsion followed by delayed milestones was the most common presenting symptoms in congenital CMV infection with statistically significant associations. Conclusions: The study indicates that infection with CMV constitutes a significant portion of suspected infants. The study recommends special attention to take steps concerning early management.

Docosahexaenoic acid supplementation represses the early immune response against murine cytomegalovirus but enhances NK cell effector function

BackgroundDocosahexaenoic acid (DHA) supplementation is beneficial for several chronic diseases; however, its effect on immune regulation is still debated. Given the prevalence of cytomegalovirus (CMV) infection and because natural killer (NK) cells are a component of innate immunity critical for controlling CMV infection, the current study explored the effect of a DHA-enriched diet on susceptibility to murine (M) CMV infection and the NK cell effector response to MCMV infection.ResultsMale C57BL/6 mice fed a control or DHA-enriched diet for 3 weeks were infected with MCMV and sacrificed at the indicated time points postinfection. Compared with control mice, DHA-fed mice had higher liver and spleen viral loads at day 7 postinfection, but final MCMV clearance was not affected. The total numbers of NK cells and their terminal mature cell subset (KLRG1+ and Ly49H+ NK cells) were reduced compared with those in control mice at day 7 postinfection but not day 21. DHA feeding resulted in higher IFN-γ and granzyme B expression in splenic NK cells at day 7 postinfection. A mechanistic analysis showed that the splenic NK cells of DHA-fed mice had enhanced glucose uptake, increased CD71 and CD98 expression, and higher mitochondrial mass than control mice. In addition, DHA-fed mice showed reductions in the total numbers and activation levels of CD4+ and CD8+ T cells.ConclusionsThese results suggest that DHA supplementation represses the early response to CMV infection but preserves NK cell effector functions by improving mitochondrial activity, which may play critical roles in subsequent MCMV clearance.

Cytomegalovirus viremia and risk of disease progression and death in HIV-positive patients starting antiretroviral therapy.

The aim of this study was to assess the prevalence of cytomegalovirus (CMV) viremia in HIV-positive patients starting antiretroviral therapy (ART) and to evaluate its impact on clinical outcomes. A retrospective analysis of four clinical trials (INSIGHT FIRST, SMART, START, and ANRS REFLATE TB). Stored plasma samples from participants were used to measure CMV viremia at baseline prior to initiating ART and at visits through 1 year of follow-up after ART initiation. CMV viremia was measured centrally using a quantitative PCR assay. Within FIRST, associations of CMV viremia at baseline and through 8 months of ART were examined with a composite clinical outcome of AIDS, serious non-AIDS events, or death using Cox proportional hazards regression. Samples from a total of 3176 participants, 1169 from FIRST, 137 from ANRS REFLATE TB, 54 from SMART, and 1816 from START were available with baseline CMV viremia prevalence of 17, 26, 0, and 1%, respectively. Pooled across trials, baseline CMV viremia was associated with low CD4 + T-cell counts and high HIV RNA levels. In FIRST, CMV viremia was detected in only 5% of participants between baseline and month 8. After adjustment for CD4 + T-cell count and HIV RNA levels, hazard ratios for risk of clinical outcomes was 1.15 (0.86-1.54) and 2.58 (1.68-3.98) in FIRST participants with baseline and follow-up CMV viremia, respectively. Baseline CMV viremia in HIV-positive patients starting ART is associated with advanced infection and only persistent CMV viremia after ART initiation is associated with a higher risk of morbidity and mortality.

Evaluation of the periodontal viruses in cardiovascular patients associated with periodontitis.

The current study aimed in evaluating the prevalence of Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV) in periodontitis and/or coronary artery disease (CAD) patients to compare with their healthy controls and insist their significance in the same. Two hundred and forty patients were divided into 4 groups. Non-periodontitis+non-cardiac (NP+NC)=60 patients, periodontitis+non-cardiac patients (P+NC)=60 patients, non-periodontitis+cardiac patients (NP+C)=60 patients, and periodontitis+cardiac (P+C)=60 patients. Demographic variables, cardiac and periodontal parameters were recorded. EBV, CMV, and HSV were evaluated in the subgingival plaque samples using RT-PCR (real-time polymerase chain reaction) and compared between the groups. The results were statistically analyzed using Student's t-test, Pearson's chi-square, Turkey post hoc analysis, and multiple logistic regression analysis. The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, diastolic blood pressure, low-density lipoprotein, and random blood sugar were significantly higher in NP+C and P+C (p≤0.05). The plaque index, probing pocket depth, and clinical attachment loss (p≤0.05) were significantly higher in P+NC and P+C. EBV and CMV were significantly higher in the two periodontitis groups P+NC and P+C (p-value=0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p≤0.05). Multiple logistic regression analysis revealed a significant association between EBV and CAL (p≤0.05). The study concluded that higher prevalence of EBV and CMV was found in groups with periodontitis patients. This indicates the significant role of the viruses in periodontitis as confirmed by association between EBV and CAL. The viruses were said to be highest in periodontitis patients with CAD. This could pave a new link in the risk of CAD in periodontitis patients.

Prognostic factors and impact of CMV reactivation on acute myeloid leukemia patients after HLA-matched myeloablative allogeneic stem cell transplantation in a high CMV prevalence country

IntroductionRelapse of acute myeloid leukemia (AML) after allogeneic stem cell transplantation (allo-SCT) leads to dismal outcomes. This study aimed to identify high-risk patients and explore the effects of cytomegalovirus (CMV) reactivation in a high CMV-seropositive population. MethodsThe study involved a single-center retrospective cohort in Thailand, analyzing clinical risk factors and CMV-mediated immune responses, correlated with transplant outcomes in AML patients. ResultsEighty-five patients with AML in complete remission (CR) undergoing HLA-matched myeloablative allo-SCT between 2011 and February 2021 were enrolled. The relapse rate was 27.1% with the median time of 7 months after transplantation. The 3-year relapse-free-survival (RFS) and overall-survival (OS) were 72.2% and 80.8%, respectively. The disease status (>CR1) and absence of chronic graft-versus-host disease (cGVHD) were independently significant adverse prognostic factors of RFS and OS. Ninety-two percent of recipient-donor pairs were both CMV seropositive. The CMV reactivation occurred in 54.1% of the patients. The clinically significant CMV infection rate was 49.4%. No CMV syndrome/disease or CMV-related mortality occurred. One-year cumulative incidence of relapse among CMV-reactivation and non-reactivation groups were 14.3% and 25.6%, respectively, without a statistically significant difference. Transplantation-related mortality was 11.1%. ConclusionsThe transplantation beyond CR1 and absence of cGVHD are powerful prognostic factors associated with inferior RFS and OS. In a high CMV prevalence country, there appears to be no impact of CMV reactivation on relapse in AML patients undergoing an allo-SCT.

Cytomegalovirus infections in infants in Uganda: Newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus

ObjectivesTo estimate the prevalence of cytomegalovirus (CMV) infections among newborn-mother pairs, neonates with sepsis, and infants with hydrocephalus in Uganda. Design and MethodsThree populations—newborn-mother pairs, neonates with sepsis, and infants (≤3 months) with nonpostinfectious (NPIH) or postinfectious (PIH) hydrocephalus—were evaluated for CMV infection at 3 medical centers in Uganda. Quantitative PCR (qPCR) was used to characterize the prevalence of CMV. ResultsThe overall CMV prevalence in 2498 samples across all groups was 9%. In newborn-mother pairs, there was a 3% prevalence of cord blood CMV positivity and 33% prevalence of maternal vaginal shedding. In neonates with clinical sepsis, there was a 2% CMV prevalence. Maternal HIV seropositivity (adjusted odds ratio [aOR] 25.20; 95% confidence interval [CI] 4.43–134.26; p = 0.0001), residence in eastern Uganda (aOR 11.06; 95% CI 2.30–76.18; p = 0.003), maternal age <25 years (aOR 4.54; 95% CI 1.40–19.29; p = 0.02), and increasing neonatal age (aOR 1.08 for each day older; 95% CI 1.00–1.16; p = 0.05), were associated risk factors for CMV in neonates with clinical sepsis. We found a 2-fold higher maternal vaginal shedding in eastern (45%) vs western (22%) Uganda during parturition (n = 22/49 vs 11/50, the Fisher exact test; p = 0.02). In infants with PIH, the prevalence in blood was 24% and in infants with NPIH, it was 20%. CMV was present in the cerebrospinal fluid (CSF) of 13% of infants with PIH compared with 0.5% of infants with NPIH (n = 26/205 vs 1/194, p < 0.0001). ConclusionsOur findings highlight that congenital and postnatal CMV prevalence is substantial in this African setting, and the long-term consequences are uncharacterized.

The Prevalence of Cytomegalovirus (CMV) Infection among Infants and Correlation between CMV PCR with Clinical Outcomes in a Tertiary Teaching Hospital in Malaysia

Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of congenital hearing loss and neurodevelopmental disability. This study aimed to describe the prevalence and clinical manifestations of infants age 12 months and below with CMV infection in Hospital Universiti Sains Malaysia (Hospital USM) and to determine the correlation between CMV PCR with clinical outcomes. A total of 648 hospitalized infants with clinically suspected cases of cytomegalovirus infection admitted to Hospital USM from January 2018 to December 2018 were tested for anti-CMV IgM and IgG by electrochemiluminescence immunoassay method. The results suggestive of CMV infection were requested for the second serum sample at 2-4 weeks’ interval together with plasma samples for CMV DNA viral load quantification by real-time PCR and maternal sample for serological analysis. Correlation of CMV viral load with clinical outcomes was analyzed using the point- biserial correlation. The results showed that the prevalence of acute CMV infection was 6.48 % (42/648) and cCMV infection was 0.3% (n=2/648). The findings were as follows: acute CMV infection (n = 42), passive immunity (n = 113) and inconclusive (n =41).) CMV hepatitis (p-value= 0.018), rash (p-value= 0.043), presumed sepsis (p-value=0.044) and abnormal hearing (p-value 0.031) were significantly associated with CMV status. Significant moderate correlation between CMV viral load and abnormal hearing assessment was observed. As a conclusion, CMV hepatitis, presumed sepsis, rash, and abnormal hearing were associated with the infant's CMV status. A significant correlation was found between CMV viral load and abnormal hearing.

Genotyping clinical cytomegalovirus isolates in solid-organs-transplant recipients

Cytomegalovirus infection remains one of the leading problems in contemporary healthcare. It belongs to socially and economically significant infections with a high incidence both in children and adults, characterized by polymorphic clinical manifestations and a variety of routes and factors for infection transmission. CMV infection of blood and organ recipients is a serious problem. It should be noted that, despite the great medical and social significance, in the Russian Federation there is no system of CMV epidemiological surveillance and control as it was traditionally developed for other topical infections. The aim of this study is to search for optimal method of cytomegalovirus (CMV) genotyping and estimate genotypic diversity of CMV isolates in Russia for patients underwent solid organ transplantation. The research presents the data after examining blood samples, leukocytes, saliva, urine and lacrimal discharge collected from 160 patients at the Transplantation Department of the Privolzhsky District Medical Center of the FMBA, aged 22 to 64 years, after liver and kidney transplantation. Molecular biological and serological methods were used for testing. Genotyping was carried out by the NGS sequencing of CMV DNA fragments. A high prevalence of CMV was found in patients undergoing solid organ transplantation. For 41.8±3.8% patients, cytomegalovirus DNA was detected in saliva and urine samples, and for 18.1±3.04% of them — in blood samples. In 98.8±3.2% of patients, the diagnosis of Cytomegalovirus infection (CMVI) was confirmed serologically. Based on a summary of reported data, estimation of various methodological approaches for genotyping of clinical CMV isolates was carried out. As a result, a typing option based on genotype determining for two variable genes UL55 (gB) and UL73 (gN) was selected. The spectra and proportional distribution of gB and gN CMV genotypes circulating among adults were determined. It was found that genotype prevalence in the group of patients who underwent solid organ transplantation was as follows: gB2, gN4c, gN4a, gN1. In some cases, a mixed infection was found due to the association of two and three CMV genotypes. The performed phylogenetic analysis of UL55 and UL73 gene nucleotide sequences indicates the genetic heterogeneity found for Russia-wide CMV isolates from in adult patients in the risk group.

Role of Cytomegalovirus in the Development of Posttransplant Lymphoproliferative Disorders With or Without Epstein-Barr Virus Infection.

Many studies have revealed the role of Epstein-Barr virus infection, in combination with chronic immunosuppression, as the main factor in the development of posttransplant lymphoproliferative disorder malignancy. Although many studies have been published on other confounding factors involved in posttransplant lymphoproliferative disorders, the role of coinfection with both cytomegalovirus and Epstein-Barr virus has not been investigated. We evaluated the role of cytomegalovirus infection as a risk factor in transplant recipients who were simultaneously infected with Epstein-Barr virus. In the current retrospective study, 143 recipients of various solid-organ transplants at Namazi Hospital from April 2018 to March 2019 were assessed for coinfection with cytomegalovirus and Epstein-Barr virus with the TaqMan real-time polymerase chain reaction assay. We collected clinical and pathology details from their medical records. Of the 143 patients, 81 (57%) were male. Children under 5 years old were the largest group with 32% prevalence, and the most common organ transplant in this study was liver transplant. The prevalence of cytomegalovirus and Epstein-Barr virus coinfection was 12.6% (18/143 patients), of whom 50% experienced posttransplant lymphoproliferative disorder (9/18 patients) during 18 months after transplant. The incidence of posttransplant lymphoproliferative disorder was significantly higher among patients coinfected with cytomegalovirus and Epstein-Barr virus than among patients without coinfection. We observed a significant correlation between cytomegalovirus viral loads, as well as Epstein-Barr virus genome load, in posttransplant lymphoproliferative disorder development. Coinfection with cytomegalovirus and Epstein-Barr virus, as well as the genome load of each virus, can serve as a strong predictive factor of posttransplant lymphoproliferative disorder in solidorgan transplant recipients.

Maternal Facial Nerve Palsy and a Perinatal Infection.

Maternal Facial Nerve Palsy and a Perinatal Infection.

Cytomegalovirus infection after renal transplantation.

Renal transplant patients show a high prevalence of cytomegalovirus (CMV) infection after the procedure. This study was conducted to assess the prevalence and factors associated with the incidence of CMV infection among renal transplant patients. A total of 100 patients were recruited in this study. The CMV load in the blood of each patient was assessed using the technique of polymerase chain reaction (PCR). The serostatus of all recipients and donors was examined preoperatively and those of the recipients again postoperatively. The association of CMV load was assessed with the following factors: age, gender, alanine aminotransferase (ALT) and serum creatinine levels, types of immunosuppressive and induction regimens, preoperative diabetes status, and serological virologic response (SVR) at 12 weeks postoperatively. Our findings showed that CMV incidence was significantly higher in middle-aged patients (62 of 66 patients, 93.9%; p=0.0001). Furthermore, about 88.2% of patients induced by anti-thymocyte globulin (ATG) showed a high viral load, significantly higher than the proportion of CMV-positive patients induced by basiliximab (p=0.001). In addition, a higher proportion of CMV-negative recipients who received the graft from CMV-positive donors and vice-versa were CMV-positive postoperatively. Administration of Valcyte 450 showed 100% efficiency in decreasing the CMV load in the patients. Among all the assessed factors, only the age of the recipients, type of induction therapy used, and the preoperative serostatus of both donors and recipients were significantly associated with the postoperative CMV incidence among the patients.

Prevalence of Cytomegalovirus, Rubella and Toxoplasma gondii among Internally Displaced Women of District North Waziristan, Pakistan with Home Obstetric History

The present study was conducted to estimate the prevalence rate and to identify risk factors of Cytomegalovirus, Rubella and Toxoplasma gondii among internally displaced women of District North Waziristan, Pakistan with home obstetric history. A total of 387 blood samples were collected from internally displaced infected women with the help of a comprehensive filled data form. To determine levels of Cytomegalovirus, Rubella and Toxoplasma gondii Infection, all blood samples were qualitative and quantitative analyzed using Immune chromatographic and Chemiluminescence Microparticle Immunoassay (CMIA) technique. Among 387 blood samples, the total numbers of reactive samples observed were 341 (88.11%) and non-reactive samples were 46 (11.88%). Of 341 (88.11%) reactive samples, the highest ratio 168 (49.26%) was reported for the co-infection of Cytomegalovirus and Rubella, followed by 76 (22.28%) for Cytomegalovirus, Rubella and Toxoplasma gondii combined. In reactive samples, the highest ratio of IgG was noted in order of CMV 22 (64.70%), Rubella 21 (67.74%) and Toxoplasma gondii 16 (72.72%), followed by IgG+IgM and IgM only. Regarding age-wise distribution, the highest ratio 144 (90.56%) of total reactive samples of Cytomegalovirus, Rubella and Toxoplasma gondii was reported in the 25-32 years old group of individuals. Similarly, the highest ratio 53 (48.18%) and 60 (41.66%) of co-infection among reactive samples for Cytomegalovirus, and Rubella was observed in 18-24 and 25-32 years old group. Further, the highest ratio of 100 (40.32%) of risk factors was observed in infected patients who were exposed to a poor hygienic environment and 57 (44.18%) of infected patients had complications of Severe UTI followed by others. Hence, it was revealed that Cytomegalovirus, Rubella and Toxoplasma gondii infection was most prevalent in internally displaced women of District North Waziristan, Pakistan. Therefore, an urgent base prophylactic approaches should need to be addressed to reduce the risk of the spread of disease in this locality.

High Rate of Cytomegalovirus Detection in Cholestatic Preterm Infants.

Objectives: To evaluate the prevalence of cytomegalovirus (CMV) infection in preterm infants with cholestasis.Study design: Preterm infants (<37 weeks gestational age) with cholestasis were tested for CMV DNA using Taqman PCR in blood cells from sedimented whole blood, plasma, and urine. Infants were regarded as positive for CMV if any sample was tested positive. Their mothers were tested for CMV serostatus simultaneously. A control group of non-cholestatic preterm infants, and their mothers, were tested at a similar age.Results: A total of 69 preterm infants with a median gestational age of 26 weeks and 5 days were included, 45 cholestatic and 24 non-cholestatic. Of the cholestatic infants, 31/45 (69%) were CMV positive vs. 3/24 (13%) of the non-cholestatic infants (p < 0.001). Cholestatic infants were equally preterm as the non-cholestatic ones, but were more severely ill. After adjusting for the risk factors necrotizing enterocolitis, prolonged parenteral nutrition, and gestational age, being CMV positive remained significantly associated with cholestasis in a multivariable logistic regression model. Characteristics of CMV-positive and -negative cholestatic infants showed differences only for necrotizing enterocolitis, occurring in 55% (17/31) of CMV positive vs. 21% (3/14) of CMV negative (p = 0.054), and mortality. Eight cholestatic CMV-positive infants died (26%) vs. none of the CMV-negative infants (p = 0.044).Conclusions: CMV DNA was detected in two out of three cholestatic preterm infants, by far more often than in the non-cholestatic control group. Cholestasis with simultaneous detection of CMV DNA may be associated with increased mortality.

Cytomegalovirus Infection in Adolescents of Russian Federation: Results of Cross-Sectional Population Analysis of Seroprevalence

Background. Cytomegalovirus infection (CMVI) is the reason of high mortality in perinatal period, disability in children from risk groups with further development of congenital malformations and chronic diseases. Clear understanding of epidemiology and determination of focus population groups is crucial for development of measures and algorithms of congenital CMVI prevention.Objective. The aim of the study is to study CMVI seroprevalence among immunocompetent adolescents in Russian Federation with reference to the gender, regional, social and economic, and age factors.Methods. We have used for our study data from the survey of senior schoolchildren from 7 municipalities representing various regions of Russian Federation: group 1 (10–12 years old) and group 2 (14–16 years old). The study of CMVI seroprevalence and immune response was performed via the analysis of the level of IgG antibodies to cytomegalovirus (CMV) in blood serum. The social and economic well-being of the region was determined by "RIA Rating" experts.Results. Serological prevalence of CMVI in the study group of adolescents (n = 1403) was 70.6% (n = 990). There were no statistically significant gender differences in the distribution of seropositive children in regions (p = 0.525). Infection in boys (72.6%; n = 455; median age — 12.9 (11.0; 14.9)) did not prevail over the infection in girls (68.8%; n = 535; median age — 13.1 (11.0; 14,9)); p = 0,117. The overall prevalence of CMVI increased statistically significant with age — from 68% (n = 486) in group 1 to 73% (n = 504) in group 2 (p = 0.036). The prevalence of CMVI varied statistically significant by region (p = 0.003). There was no correlation between the regional seropositive level and the social and economic situation in the region (r = 0.034, p = 0.192). Immune response intensity did not differ by age, gender, and region with the antibody median of 88.9 CU/ml.Conclusion. More than half of adolescents (by the age of 10) in Russian Federation are infected, and infection increases with approaching to childbearing age, however, age is not the only aspect associated with serological status. Factors affecting immune response intensity require further study. Understanding of the CMV prevalence among children is crucial for determining future prevention approaches in target groups.

Cytomegalovirus Infection in Adolescents of Russian Federation: Results of Cross-Sectional Population Analysis of Seroprevalence

Background. Cytomegalovirus infection (CMVI) is the reason of high mortality in perinatal period, disability in children from risk groups with further development of congenital malformations and chronic diseases. Clear understanding of epidemiology and determination of focus population groups is crucial for development of measures and algorithms of congenital CMVI prevention.Objective. The aim of the study is to study CMVI seroprevalence among immunocompetent adolescents in Russian Federation with reference to the gender, regional, social and economic, and age factors.Methods. We have used for our study data from the survey of senior schoolchildren from 7 municipalities representing various regions of Russian Federation: group 1 (10–12 years old) and group 2 (14–16 years old). The study of CMVI seroprevalence and immune response was performed via the analysis of the level of IgG antibodies to cytomegalovirus (CMV) in blood serum. The social and economic well-being of the region was determined by "RIA Rating" experts.Results. Serological prevalence of CMVI in the study group of adolescents (n = 1403) was 70.6% (n = 990). There were no statistically significant gender differences in the distribution of seropositive children in regions (p = 0.525). Infection in boys (72.6%; n = 455; median age — 12.9 (11.0; 14.9)) did not prevail over the infection in girls (68.8%; n = 535; median age — 13.1 (11.0; 14,9)); p = 0,117. The overall prevalence of CMVI increased statistically significant with age — from 68% (n = 486) in group 1 to 73% (n = 504) in group 2 (p = 0.036). The prevalence of CMVI varied statistically significant by region (p = 0.003). There was no correlation between the regional seropositive level and the social and economic situation in the region (r = 0.034, p = 0.192). Immune response intensity did not differ by age, gender, and region with the antibody median of 88.9 CU/ml.Conclusion. More than half of adolescents (by the age of 10) in Russian Federation are infected, and infection increases with approaching to childbearing age, however, age is not the only aspect associated with serological status. Factors affecting immune response intensity require further study. Understanding of the CMV prevalence among children is crucial for determining future prevention approaches in target groups.

Prevalence of viral co-infection among COVID-19 cases in association disease severity and oral hygiene

Background: In December 2019, an episode of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV2) was reported in Wuhan, China and has spread around the world, increasing the number of contagions. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are common herpesviruses that can cause persistent latent infections and affect the developing immune system.The study was conducted to explore the prevalence and reactivation of CMV and EBV antibodies in COVID-19 patients group in comparison to healthy group and to investigate the association between the presence of these viruses with each of severity of disease and oral hygiene. Materials and Methods: Eighty Five subjects were participated in this case control study (50 patients with COVID-19 and 35 healthy controls), their age range from 18 to 77 years. Oral health status was established by oral hygiene index. Serum obtained from patients and controls was analyzed using ELISA to assess levels of anti- CMV and anti- EBV antibodies. Results: The study revealed that the mean of anti-EBV IgG in patients was significantly elevated (p&lt;0.01) than that in controls. Otherwise, there was no significant difference (p&gt;0.05) in levels of anti- EBV IgM, anti- CMV IgG and IgM between two groups (P&gt;0.05). In addition there were no significant differences between patients and controls (p&gt;0.05) in the number and percentage of anti-EBV and anti-CMV antibodies. Interestingly, there was a significant increase in the level of anti-CMV IgM in severe cases as compared to mild cases, (P&lt;0.01). Furthermore, these results revealed that there were no significant differences (P&gt;0.05) in levels of anti-viral antibodies in patients with good oral hygiene compared to patients with poor oral hygiene. Conclusions: Higher frequency of anti-EBV IgG among patients indicates that latent infection is more common in COVID-19 patients. While an increased percentage of anti-CMV IgM indicated reactivation of latent infection and is related to disease severity suggesting that COVID-19 can cause cellular immune impairment.

Neonatal Hyperbilirubinemia and Cholestasis.

Neonatal Hyperbilirubinemia and Cholestasis.

Cytomegalovirus Infections in Ugandan Infants:Newborns, Neonates with Sepsis and Infants with Hydrocephalus

Background: Congenital and postnatal cytomegalovirus (CMV) infections in Uganda is prevalent and may compromise the health of Ugandan children. The objective of this study is to estimate the prevalence of CMV infections in newborns, neonates with sepsis, and infants with hydrocephalus in Uganda. Methods: Three populations: (1) newborn-mother pairs, (2) neonates with sepsis, and (3) infants (≤ 3 months) with non-postinfectious (NPIH) or postinfectious (PIH) hydrocephalus, were evaluated over four years (2016-2019) for CMV infection at three medical centers – two in the Eastern (Mbale) and one in Western (Mbarara) Uganda. To characterize the prevalence of CMV we used quantitative PCR (qPCR) analysis. In newborn-mother pairs maternal blood (n=99) and a subset of matching cord blood (n=92), placental tissue (n=99), and vaginal specimens (n=99) were tested for CMV. In neonates and infants aged 3 months or less, peripheral blood (751 with sepsis, 399 with hydrocephalus) and cerebrospinal fluid samples (560 with sepsis, 399 with hydrocephalus (205 PIH, 194 NPIH) were also tested for CMV. Findings: The overall CMV prevalence across all groups was 9%. In newborn-mother pairs, a 3% (n=3/92; 95% CI, 1-9%) prevalence of cord blood positivity and 33% (n=33/99; 95% CI, 24-44%) prevalence of maternal vaginal shedding of CMV was estimated. In neonates with clinical sepsis, a 2% (n=17/751; 95% CI, 1-4%) CMV prevalence was estimated. Maternal HIV seropositivity (adjusted odds ratio [aOR], 21.09; 95% CI, 4-109; p= 0.0002), residence in Eastern Uganda (aOR, 11.10; 95% CI, 3-77; p=0 .003), maternal age < 25 years (aOR, 4.91; 95% CI, 2-20; p=0.012), and older neonatal age (9 days vs. 5 days; p= 0.006) were associated with CMV in neonates with clinical sepsis. In infants with PIH, the prevalence in blood was 24% (n=50/205; 95% CI, 19-31%) and in infants with NPIH it was 20% (n=39/194; 95% CI, 15-26%; p=0.34). CMV was present in the CSF of 13% (n=26/205; 95% CI, 8-18%) of infants with PIH compared to 0.5% of infants with NPIH (n=1/194; 95% CI, 0-3%, p<0.0001). Interpretation: Our findings highlight that congenital and postnatal CMV prevalence is high in this African setting and the associated complications may be significant. Universal testing and longitudinal studies are critical to understand the burden infant CMV has in sub-Saharan African countries. Funding Statement: U.S. National Institutes of Health (N.I.H) Director’s Pioneer Award 5DP1HD086071 and NIH Director’s Transformative Award 1R01AI145057. Declaration of Interests: No conflict of interest reported. Ethics Approval Statement: For all participants, mothers had to be at least 18 years of age and able to give informed written consent in either English, Lumasaba, Lugwere, Luganda, Ateso or Runyankole. The study was performed with approval from the CCHU Institutional Review Board, the Mbarara University of Science and Technology Research Ethics Committee, the Pennsylvania State University Institutional Review Board, and with oversight from the Ugandan National Council on Science and Technology. Material Transfer Agreements and a US Centers for Disease Control permit were obtained for the proper transfer and importation of samples to the Pennsylvania State University.

Prevalence of Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV) Subclinical Infection in Patients with Acute Immune Thrombocytopenic Purpura (ITP).

Background: Immune thrombocytopenic purpura (ITP) defined as a bleeding disorder in which the number and production of platelets reduced by the immune system; however, the destruction of peripheral blood platelets also occurs. Although its exact etiology and pathogenesis not already know, several studies have shown that Epstein-Barr virus (EBV) and cytomegalovirus (CMV) known as possible causative agents of ITP. This investigation aims to evaluate the presence of CMV and EBV in two groups of case and control by polymerase chain reaction (PCR). Materials and Methods: we considered the presence of CMV and EBV in 48 acute ITP patients and 48 healthy people. Study participants were recruited from Ahvaz Shafa Hospital between 2017 and 2018 and the presence of two viruses was investigated by (PCR). Results: Out of 48 acute ITP patients, the CMV DNA was detected from the blood of 12 (25%) patients and the EBV DNA from the blood of 2 (4.2%) other patients. In addition, only one patient was (2.1%) co-infected with CMV and EBV. In contrast, in 48 healthy subjects, 3 (6.6%) had CMV and none of the control group was infected with EBV. Conclusion: Due to the presence of both EBV and CMV in the acute ITP patients in Ahvaz, they can be considered as factors in the progression of this disease. Therefore, consideration of the methods of elimination and treatment of these two viruses in these patients may be used as a treatment strategy in ITP patients in the future.