Seronegative Pregnant Women Research Articles

Congenital cytomegalovirus infection: Diagnosis, treatment, and prevention

Congenital cytomegalovirus infection is an infectious disease that results from antenatal transplacental transmission of cytomegalovirus to a fetus. The above virus is the most common cause of congenital infections worldwide. Congenital cytomegalovirus infection may develop both after primary infection of a seronegative pregnant women (primary) and due to reactivation of the virus or reinfection with other virus strains during pregnancy (non-primary). In the neonatal period, 85-90% of children infected in utero are observed to have an asymptomatic or subclinical course of the disease. In other cases, the clinical picture is characterized by lesions of various organs and by frequent CNS involvement. In its severe course, the disease is treated with antiviral drugs that are so far referred to as an “off-label” group. Even in the absence of symptoms in the neonatal period, the babies infected with CMV in utero may develop late sequels, with hearing loss being most common. Preschool hearing control and ophthalmologic and neurologic monitoring are recommended for the timely treatment and rehabilitation of late manifestations of congenital cytomegalovirus infection. The important strategy to reduce the incidence of congenital cytomegalovirus infection is its prevention in pregnant women, by disseminating information about the disease in the publicly accessible sources of information and by teaching simple hygienic practices.

CMV Seroconversion Associated with an high Avidity in a Previously Seronegative Pregnant Woman during her first Trimester of Pregnancy

CMV Seroconversion Associated with an high Avidity in a Previously Seronegative Pregnant Woman during her first Trimester of Pregnancy

Seroprevalence of erythrovirus B19 in Saudi pregnant women.

Background:Erythrovirus B19 infection is associated with clinical symptoms that range from mild to severe. The common clinical presentation of B19 virus (B19V) infection is erythema infectiosum, arthropathy, aplastic crisis, and fetal infection. Infection in seronegative pregnant women can lead to fetal hydrops.Objectives:To determine the seroprevalence of immunoglobulin G (IgG) to erythrovirus B19 in Saudi pregnant women in the cities of Makkah and Jeddah in Saudi Arabia.Materials and Methods:A total of 364 blood (serum) samples were tested for erythrovirus B19-specific-IgG antibody in Saudi pregnant women in the cities of Makkah and Jeddah in Saudi Arabia.Results:Erythrovirus B19-specific-IgG antibodies were detected in 182/364 (50%) of Saudi pregnant women of different age groups.Conclusion:This study indicated that B19V is clearly circulating in the community in a way that is similar to what is found in most nontemperate countries.

Coinfections of Human Immunodeficiency Virus and Sexually Transmitted Infections among HIV Seropositive Pregnant Women at Healthcare Centres in Akure, Southwestern Nigeria

Background: Sexually transmitted infections (STIs) represent significant risk factors for HIV transmission and adverse fetal complications in pregnancy. We tested 240 pregnant women for their HIV serostatus and for the effects of HIV-STI coinfections on CD4+ cell counts and on HIV plasma viral load. The study was conducted at four antenatal clinics in Akure, Ondo State of Nigeria between November 2014 and December 2015. Methods: The HIV-1/2 strip was used for preliminary determination of HIV serostatus and this was followed by a confirmatory Abbott enzyme-linked immunosorbent assay (ELISA) procedure. CD4+ T-cell counts were done by cytometric analysis while viral load was determined by COBAS® AmpliPrep TaqMan HIV-1 procedure. Liver enzymes were determined by an automated chemistry analyzer. Detection of hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus-6 (HPV-6) and herpes simplex virus type-2 (HSV-2) were determined by ELISA. The syphilis VDRL test was done by the rapid plasma reagin procedure, while Trichomonas vaginalis infection was demonstrated by the wet mount procedure. Infections with Chlamydia trachomatis and Neisseria gonorrhoeae were determined respectively by ELISA and by culture on proteose peptone agar supplemented with 5% serum. Results: The results show prevalence of STIs in 33.3% of the 240 study participants; 77.5% for HIV seropositive and 22.5% for seronegative subjects. Trichomonas vaginalis constituted the highest isolate Coinfections in 50% of HIV seropositive subjects and 22.2% for seronegative controls. HIV-HBV coinfection occurred among 7 individuals while HIVHBV-TV coinfection occurred in 4 individuals. The results also showed elevated titers of alanine aminotransferase (ALT), creatinine and total bilirubin liver enzymes in both HIV-HBV coinfection and HBV monoinfection. HIV viral loads were twice as high in HIV-HBV coinfection relative to HBV mono- infection. Conclusion: The prevalence of STIs was significantly high at 54.4% among HIV seropositive pregnant women as compared to 14.3% for HIV seronegative pregnant women. T. vaginalis was the highest isolate at 50% in HIV seropositive subjects and may therefore be a driving factor for HIV transmission and susceptibility as very few T. vaginalis infections were recorded in control subjects.

PROGRAMAS DE CONTROLE DA TOXOPLASMOSE CONGÊNITA: ESTUDO DA SITUAÇÃO ATUAL EM UM MUNICÍPIO BRASILEIRO

As medidas de prevenção da toxoplasmose congênita podem ser implementadas em três níveis. A prevenção primária caracteriza-se por programas de educação e saúde pública, nos quais as gestantes suscetíveis recebem orientações sobre as fontes de infecção e como adotar medidas profiláticas. A secundária consiste no screening sorológico durante o pré-natal e a terciária tem como foco o recém-nascido já infectado buscando prevenir danos clínicos e complicações tardias. Este estudo teve por objetivo descrever a situação do controle da toxoplasmose congênita no município de Niterói-RJ de acordo com a Política Nacional de Promoção da Saúde. Neste município, está implantada a prevenção secundária da toxoplasmose congênita. Não há orientação sobre as medidas preventivas para gestantes soronegativas, como também não há notificação dos casos de toxoplasmose adquirida na gestação e congênita.

Prevention of Maternal–Fetal Transmission of Cytomegalovirus

Reported maternal-to-fetal rates of primary cytomegalovirus (CMV) infection during pregnancy have been between 30% and 50%. The highest rate of symptomatic congenital infection and sequelae occurs in about 25% of infected infants born of mothers with a primary infection during pregnancy. Symptomatic infants demonstrate a constellation of clinical features that reflect placental dysfunction and probable viral infection of the central nervous system of the fetus. In the United States, we estimate that about 8000 affected infants are born each year. Two options may be available to prevent or treat maternal CMV infection during pregnancy, especially for women with exposure to young children in the home. The first is hygienic intervention. Two studies support the simplicity, harmlessness, and effectiveness of hygienic intervention to prevent child-to-mother transmission of CMV among high-risk pregnant women who know they are susceptible. The second is CMV immunoglobulin. A meta-analysis of 2 clinical trials showed an efficacy of 50% if immunoglobulin is given to pregnant women who have acquired a primary CMV infection during pregnancy. These results mean that seronegative pregnant women have options to prevent fetal infection.

An effective and feasible approach to prevention of primary cytomegalovirus infection in pregnancy

In the absence of a cytomegalovirus (CMV) vaccine, other strategies for prevention of primary infection in pregnancy should be considered. Behavioural interventions have been reported to significantly decrease seroconversion rate among seronegative pregnant women. We report here on a recently completed controlled study in which seronegative women at high risk of infection because of close contacts with children <36 months, were identified and informed about risky and protective behaviours. Informed women seroconverted at a significantly lower rate than non-informed women.

Assessment of Immunoblot for Early Detection of Seroconversion in Pregnant Women

The recently commercialized LDBIO Toxo II IgG® immunoblot test has been shown to be very reliable in the early detection of toxoplasmic seroconversion in pregnant woman. A positive result is defined by the presence of at least three among the five following bands: 30, 31, 33, 40 and 45 kDa, the 30 kDa band being required as a positivity criteria. Moreover, it has been reported that the detection of the sole 30 kDa band was sufficient for this purpose. We report herein the result of serologic follow-up of three initially seronegative pregnant woman by using ELISAIgG, IFAT-IgG, ELISA-IgM and LDBIO Toxo II IgG®. In two of them, seroconversion was highly suspected on the detection of 30 kDa band and positivity of IgM test and further confirmed by the positivity of conventional tests for IgG. In contrast, in the third case, despite the appearance of the 30 kDa band during the follow-up, seroconversion was discarded as ELISA-IgG and IFAT-IgG tests remained negative and only one additional band was later detected on LDBIO Toxo II IgG®. Our findings suggest that the detection of the 30 kDa band together with the positivity of IgM test can be considered as a seroconversion criteria but confirmation by further positivity of conventional tests is recommended.

Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women.

BackgroundToxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively.MethodsAnti-Toxoplasma IgG and IgM antibodies were screened by using standard commercial ELISA kits. The socio-demographic, obstetrics and risk factors associated with Toxoplasma infection data were compared between the two countries.ResultsThe overall prevalence of Toxoplasma infection in Malaysian pregnant women (42.47%; 95% CI = 36.11-49.09) was significantly higher (p < 0.05) than Myanmar pregnant women (30.70%; 95% CI = 27.92-37.16). By univariate analysis, this study identified that age group, education, parity, awareness on toxoplasmosis and consumption of undercooked meat were significantly associated (p < 0.05) with Toxoplasma seropositive Malaysian pregnant women but none of these factors associated with Toxoplasma seropositive Myanmar pregnant women. In comparison using univariate analysis between the two countries, it was found that Toxoplasma seropositive Malaysian pregnant women was associated with aged 30 years and above, secondary or lower-secondary level of education, the third trimester of pregnancy, having one child or more, lacking awareness of toxoplasmosis, absence of bad obstetrics history, having no history of close contact with cats or soil, living on a farm and also consumption of undercooked meat, unpasterized milk or untreated water. Avidity measurement was used to confirm the stages of Toxoplasma infection in pregnant women who were positive for both IgG and IgM antibodies and found all were infected in the past.ConclusionFrom our study, Toxoplasma screening and its risk measurement in pregnant women is firmly recommended for monitoring purposes and assisting proper management, including diagnosis and treatment during antenatal period. Also, it is necessary to initiate preventive measures for Toxoplasma infection among reproductive-age women in general and seronegative pregnant women in particular. Avidity measurement should be incorporated in Toxoplasma routine screening, especially with the availability of a single serum sample to assist in the diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-014-0564-9) contains supplementary material, which is available to authorized users.

Effect of antiretroviral drugs on prolactin in HIV infected pregnant women

The world has finally settled living with Human immunodeficiency Virus (HIV) with no cure discovered so far. Yong people with HIV infection under HIV management drugs get married and eventually end up being pregnant and bearing babies. The need therefore to investigate the effect of HIV infection and antiretroviral drugs on body chemistry especially the hormones concerned with pregnancy and lactation cannot be over emphasized as this is important to intervene when necessary for the overall benefit for the mother and child. We investigated the effect of anti-retroviral drugs and human immune deficiency virus (HIV) infection on prolactin production and stimulation in HIV-infected pregnant women. A total of 120 subjects participated in the study. Sixty (group 1) of these subjects were HIV seropositive pregnant women who commenced treatment with zidovudine in combination with lamivudine, that is highly anti-retroviral therapy (HAART) at 2nd trimester. The 2nd group made up of 60 HIV seronegative pregnant women who received no drug and as control to the study. The blood samples of both groups were collected at the beginning of the second and at the end of the third trimesters. For group 1 (seropositive pregnant women), the blood collection was done just before commencingthe HAART treatment. The prolactin level of HIV seropositive pregnant women were significantly (P &lt; 0.05) lower than the HIV seronegative pregnant women at the 2nd trimester. Also, the prolactin level of HIV seropositive pregnant women at 2nd trimester was not significantly increased (P&gt; 0.05) compared with third trimester level. The reverse was the case with HIV seronegative pregnant women where prolactin level of 3rdtrimester was significantly increased when compared with 2nd trimester. HIV infection has prolactin suppressive effect on pregnant women and HAART treatment did not significantly raise prolactin level.Keywords: Prolactin, pregnancy, HIV, highly active retroviral therapy (HAART).

Management of Congenital Toxoplasmosis

Prompt diagnosis and rapid initiation of medical treatment are critical for the best outcomes in infants with congenital toxoplasmosis. This is important for pregnant women, fetuses, and infants, including those with active retinitis and choroidal neovascular membranes. For hydrocephalus, prompt placement of a ventriculoperitoneal shunt is key for improved outcomes. Pyrimethamine and Sulfadiazine with Leucovorin are first-line medicines. For later recurrences of active retinitis, Azithromycin or Clindamycin are sometimes substituted for Sulfadiazine as second-line treatments, given with Pyramethamine. Following resolution of active retinitis, these medicines may be useful without Pyrimethamine for suppression and avoid the risk of hypersensitivity from Trimethoprim/Sulfamethoxazole. Antibody to VEGF, in conjunction with antimicrobial therapy, results in resolution of choroidal neovascular membranes. Serologic screening of seronegative pregnant women to detect primary infection during gestation, and facilitating medicine administration and thereby preventing or treating fetal infection, is an optimal, apparently cost-effective, means to reduce disease. Definitively curative medicines currently being developed likely will improve future management and outcomes of this disease.

Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women

Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively. Anti-Toxoplasma IgG and IgM antibodies were screened by using standard commercial ELISA kits. The socio-demographic, obstetrics and risk factors associated with Toxoplasma infection data were compared between the two countries. The overall prevalence of Toxoplasma infection in Malaysian pregnant women (42.47%; 95% CI = 36.11-49.09) was significantly higher (p < 0.05) than Myanmar pregnant women (30.70%; 95% CI = 27.92-37.16). By univariate analysis, this study identified that age group, education, parity, awareness on toxoplasmosis and consumption of undercooked meat were significantly associated (p < 0.05) with Toxoplasma seropositive Malaysian pregnant women but none of these factors associated with Toxoplasma seropositive Myanmar pregnant women. In comparison using univariate analysis between the two countries, it was found that Toxoplasma seropositive Malaysian pregnant women was associated with aged 30 years and above, secondary or lower-secondary level of education, the third trimester of pregnancy, having one child or more, lacking awareness of toxoplasmosis, absence of bad obstetrics history, having no history of close contact with cats or soil, living on a farm and also consumption of undercooked meat, unpasterized milk or untreated water. Avidity measurement was used to confirm the stages of Toxoplasma infection in pregnant women who were positive for both IgG and IgM antibodies and found all were infected in the past. From our study, Toxoplasma screening and its risk measurement in pregnant women is firmly recommended for monitoring purposes and assisting proper management, including diagnosis and treatment during antenatal period. Also, it is necessary to initiate preventive measures for Toxoplasma infection among reproductive-age women in general and seronegative pregnant women in particular. Avidity measurement should be incorporated in Toxoplasma routine screening, especially with the availability of a single serum sample to assist in the diagnosis.

Prevention of Maternal-Fetal Transmission of Cytomegalovirus

Reported maternal-to-fetal rates of primary cytomegalovirus (CMV) infection during pregnancy have been between 30% and 50%. The highest rate of symptomatic congenital infection and sequelae occurs in about 25% of infected infants born of mothers with a primary infection during pregnancy. Symptomatic infants demonstrate a constellation of clinical features that reflect placental dysfunction and probable viral infection of the central nervous system of the fetus. In the United States, we estimate that about 8000 affected infants are born each year. Two options may be available to prevent or treat maternal CMV infection during pregnancy, especially for women with exposure to young children in the home. The first is hygienic intervention. Two studies support the simplicity, harmlessness, and effectiveness of hygienic intervention to prevent child-to-mother transmission of CMV among high-risk pregnant women who know they are susceptible. The second is CMV immunoglobulin. A meta-analysis of 2 clinical trials showed an efficacy of 50% if immunoglobulin is given to pregnant women who have acquired a primary CMV infection during pregnancy. These results mean that seronegative pregnant women have options to prevent fetal infection.

Incidence and prevalence ofToxoplasma gondiiinfection in women in France, 1980–2020: model-based estimation

Toxoplasmosis is a worldwide zoonosis due to Toxoplasma gondii, a ubiquitous protozoan parasite of warm-blooded animals including humans. In pregnant women, primary infection can cause congenital toxoplasmosis resulting in severe malformations in the newborn. Since 1978, public health authorities in France have implemented a congenital toxoplasmosis prevention programme, including monthly serological screening of all seronegative pregnant women, and treatment in case of seroconversion. However, this programme does not produce systematic surveillance data on incidence and prevalence. Our objective was to estimate the incidence and prevalence of T. gondii infection, and the incidence of seroconversion during pregnancy in women in France. We used a catalytic model to estimate incidence and prevalence of Toxoplasma infection between 1980 and 2020 in women of childbearing age. We used age- and time-specific seroprevalence data obtained from the National Perinatal Surveys (NPS) conducted in 1995, 2003 and 2010. We assumed that incidence depends both on age and calendar time, and can be expressed as the product of two unknown functions. We also estimated incidence of seroconversion during pregnancy in 2010 from the NPS and the National Surveillance of Congenital Toxoplasmosis (ToxoSurv). We combined data of 42208 women aged 15-45 years with serology available from the three NPS. For women aged 30 years the modelled incidence decreased from 7·5/1000 susceptible women in 1980 to 3·5/1000 in 2000. In 2010 the incidence was 2·4/1000. The predicted incidence and prevalence for 2020 was 1·6/1000 and 27%, respectively. The incidence of seroconversion during pregnancy in 2010 was estimated at 2·1/1000 susceptible pregnant women (95% CI 1·3-3·1) from the NPS and 1·9 (95% CI 1·8-2·1) from ToxoSurv. Incidence and prevalence of Toxoplasma infection has decreased markedly during the last 30 years. This decrease may be explained by a lower exposure to the parasite by changes in food habits and by improved hygiene practices in meat production. Modelled estimations were consistent with estimates observed in other studies conducted previously in France. The catalytic modelling provides reliable estimates of incidence and prevalence of Toxoplasma infection over time. This approach might be useful for evaluating preventive programme for toxoplasmosis.

Effects of pH, Sodium Chloride, and Curing Salt on the Infectivity of Toxoplasma gondii Tissue Cysts

Toxoplasma gondii is one of the most common zoonotic parasites in the world. The parasite causes no or mild symptoms in immunocompetent humans. However, a high potential hazard exists for seronegative pregnant women and immunocompromised patients. The consumption of meat containing tissue cysts or oocyst-contaminated vegetables and fruits or the handling of cat feces poses a high risk of infection with T. gondii. It is known that raw minced meat, raw fresh sausages, and locally produced raw meat products are possible causes of T. gondii infection. The infectivity of T. gondii tissue cysts in meat products depends, among other factors, on the pH and the salt concentration. Therefore, the impact of these two factors on the tissue cysts was examined. For this purpose, dissected musculature and brain from experimentally infected mice (donor mice) were placed in a cell culture medium (RPMI 1640). The medium was adjusted to different pH values (pH 5, 6, and 7) with lactic acid and to different salt concentrations (2.0, 2.5, and 3.0%) with sodium chloride (NaCl) or nitrite-enriched curing salt (NCS) for the various tests. After storage at 4°C for different time periods, the materials were fed to bioassay mice. Later, the brains were examined for presence of T. gondii to assess the infectivity. The data show that T. gondii tissue cysts have a high pH tolerance. Cysts were infectious in the muscle for up to 26 days (pH 5). In contrast to their tolerance to pH, cysts were very sensitive to salt. Muscle cysts survived at an NaCl concentration of up to 2.0% only, and for no longer than 8 days. At NaCl concentrations of 2.5 and 3.0%, the cysts lost their infectivity after 1 day. When NCS instead of NaCl was used under the same conditions, T. gondii muscle cysts retained infectivity for only 4 days at 2.0%. Consequently, NCS (NaCl plus 0.5% nitrite) has a stronger effect on T. gondii cysts than does common table salt. Sausages produced with low NaCl concentration and short contact times pose a potential risk for susceptible individuals.

Toxoplasma Seroconversion with Negative or Transient Immunoglobulin M in Pregnant Women: Myth or Reality? A French Multicenter Retrospective Study

Classically, Toxoplasma infection is associated with high levels of specific IgM antibody and a rise in specific IgG levels 1 to 3 weeks later. Atypical IgG seroconversion, without IgM detection or with transient IgM levels, has been described during serologic follow-up of seronegative pregnant women and raises difficulties in interpreting the results. To evaluate the frequency and the characteristics of these atypical cases of seroconversion, an investigation was conducted within the French National Reference Center for Toxoplasmosis, from which 26 cases collected from 12 laboratories belonging to the network were identified. The aim of this work was to retrospectively analyze the results of serologic testing, the treatments administered, and the results of prenatal and postnatal follow-up for these women. In each case, IgG antibodies were detected using both screening and confirmatory tests. IgM antibodies were not detected in 15 cases, and the levels were equivocal or low-positive in 11 cases. The IgG avidity results were low in 16 cases and high in one case. Most of the pregnant women (22/26) were treated with spiramycin from the time that IgG antibodies appeared until delivery. Amniotic fluid was analyzed for Toxoplasma gondii DNA by PCR in 11/26 cases, and the results were negative in all cases. Congenital toxoplasmosis was ruled out in 12/26 newborns. There was no abnormality observed at birth for 10 newborns and no information available for 4 newborns. In conclusion, when the interpretation of serological results is so difficult, it seems cautious to initiate treatment by spiramycin and to follow the pregnant women and their newborns.

The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population‐based prediction model

Because maternal seropositivity for CMV is associated with substantial protection against congenital CMV infection, prevention measures have focused mainly on seronegative pregnant women for decades. However, population-wide insight in the contribution of nonprimary infection (reactivation and/or re-infection with a different strain) on the most common sequela, hearing loss, is missing. A population-based prediction model was developed to estimate the proportion of congenital CMV-related hearing loss resulting from nonprimary maternal infection. Incorporated was a meta-analysis of the risk of hearing loss, calculating pooled proportions of children with hearing loss after nonprimary and primary infection. Subsequently, the model was applied for worldwide present population seroprevalences (range 30-95%). It was estimated that, for all population seroprevalences, nonprimary maternal infections are responsible for the majority of congenital CMV infections. This proportion increased with seroprevalence, ranging from 57% (95%CI 24-85%) to 96% (95% CI 88-99%) for seroprevalences of 30% to 95%. Our meta-analysis (six reports) showed that the risk of hearing loss after nonprimary infection was 11% (28/253 children, 95% CI 7-15%) versus 13% (50/385 children, 95% CI 10-16%) after primary infection. Incorporating this risk into our model, we estimated that nonprimary infections also accounted for the majority of CMV-related hearing loss. This proportion ranged from 53% (95% CI 13-86%) to 95% (95% CI 62-99%) for seroprevalences of 30% to 95%. Our data underline the worldwide contribution of nonprimary infections in causing CMV-related hearing loss. These results imply that prevention research such as vaccine and hygiene studies should not only be directed at seronegative but also seropositive pregnant women.

Blissful Ignorance When Managing Pregnant Women With Syphilis and Nonreactive Nontreponemal Tests?

Blissful Ignorance When Managing Pregnant Women With Syphilis and Nonreactive Nontreponemal Tests?

Evaluation of a New Recombinant Antigen-Based Virotech Treponema Pallidum Screen ELISA for Diagnosis of Syphilis

The purpose of this study was to evaluate the diagnostic performance of the new Sekisui Virotech Treponema pallidum Screen ELISA in comparison with the currently used treponemal tests, TPPA and FTA-abs, and to compare this new ELISA to the FDA approved Phoenix Trep-Sure ELISA. To establish the sensitivity and specificity of the Virotech Screen, 421 serum samples from different panels of infected and noninfected patients, sera from seronegative pregnant women as well as international syphilis standard sera and panels were tested. In comparison to combined TPPA/FTA-abs, Phoenix Trep-Sure and Virotech Screen demonstrated a sensitivity of 100% and a specificity of 93.9% and 98.3%, respectively. All samples of a well defined syphilis serum panel were correctly identified by the Virotech test, whereas the Phoenix test identified two Treponema negative samples as equivocal. Results of both ELISAs highly correlated with TPPA negative and positive samples. The analytical sensitivity of the Virotech Screen with international standards 05/122 and 05/132 was determined at 0.02 IU/mL and 0.03 IU/mL, respectively, and was slightly superior to the Phoenix Trep-Sure. The Virotech Screen ELISA demonstrated good diagnostic sensitivity and specificity when evaluated as a screening test for syphilis among various patient populations, including samples with increased rates of false-positive nontreponemal test results. Thus, the new Virotech ELISA may be used in automatic analysers as an alternative to the manual TPPA. However, the use of a confirmatory test remains a must in order to avoid false-positive results.

Use of specific‐pathogen‐free (SPF) rhesus macaques to better model oral pediatric cytomegalovirus infection

Congenital human cytomegalovirus (HCMV) infection can result in lifelong neurological deficits. Seronegative pregnant woman often acquire primary HCMV from clinically asymptomatic, but HCMV-shedding children. Potential age-related differences in viral and immune parameters of primary RhCMV infection were examined in an oral rhesus CMV infection model in specific pathogen free macaques. RhCMV shedding was measured by real time PCR in plasma, saliva and urine. Immune parameters, including neutralizing and binding antibodies and RhCMV-specific T cell responses, were assessed in longitudinally collected blood samples. The oral RhCMV infection model in infant SPF rhesus macaques demonstrated that (i) the susceptibility to oral RhCMV infection declines with age, and (ii) infant macaques shed RhCMV more persistently and at higher titers compared to adult macaques. (iii) The oral infant RhCMV infection model appears to reflect viral pathogenesis in human HCMV-infected children. Larger studies are needed to define immune parameters associated with better control of RhCMV in adult compared to young animals.