1
|
Aldawood E, Aldawood Z, Alfhili M. Awareness and Knowledge of Congenital Cytomegalovirus (cCMV) Among Audiologists and Speech-Language Pathologists in Saudi Arabia: A Cross Sectional Survey. J Multidiscip Healthc 2024; 17:4155-4163. [PMID: 39220329 PMCID: PMC11366255 DOI: 10.2147/jmdh.s474581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024] Open
Abstract
Congenital cytomegalovirus (cCMV) is the most prevalent congenital infection in the world. It can result in various neurodevelopmental disorders, one of which is environmental hearing loss among children. This study aimed to assess the awareness and knowledge of cCMV among audiologists and speech-language pathologists (SLPs) in Saudi Arabia and to seek their perception of it. An online survey was conducted from May to June 2023, targeting participants through social media, and a descriptive and inferential analysis was performed. A total of 107 participants (31 audiologists and 76 SLPs) were enrolled in this study. Awareness about cCMV was significantly higher among audiologists (84%) compared to SLPs (49%) (p-value < 0.001). However, both groups exhibited poor cCMV knowledge, which was revealed by their low mean knowledge scores (6.8/14 for audiologists and 5.7/14 for SLPs). The difference between their mean scores was non-significant (p-value > 0.05). The majority of SLPs and audiologists agreed that it is crucial for them to learn more about cCMV to enrich their professional backgrounds. This study emphasized the necessity for cCMV education for audiologists and SLPs. Increased awareness and knowledge may allow them to be more mindful of cCMV symptoms and therefore provide enhanced service to their pediatric patients.
Collapse
Affiliation(s)
- Esraa Aldawood
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, 11433, Kingdom of Saudi Arabia
| | - Zainab Aldawood
- Family and Child Support Center, International Medical Center (IMC), Thuwal, 6900, Kingdom of Saudi Arabia
| | - Mohammad Alfhili
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, 11433, Kingdom of Saudi Arabia
| |
Collapse
|
2
|
Jaing TH, Wang YL, Chiu CC. Antiviral Agents for Preventing Cytomegalovirus Disease in Recipients of Hematopoietic Cell Transplantation. Viruses 2024; 16:1268. [PMID: 39205242 PMCID: PMC11359103 DOI: 10.3390/v16081268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/01/2024] [Accepted: 08/03/2024] [Indexed: 09/04/2024] Open
Abstract
This systematic review discusses the use of prophylaxis to prevent cytomegalovirus (CMV) infection in recipients who have undergone hematopoietic cell transplantation. It highlights the need for new approaches to control and prevent CMV infection. The approval of the anti-CMV drug letermovir has made antiviral prophylaxis more popular. CMV-specific T cell-mediated immunity tests are effective in identifying patients who have undergone immune reconstitution and predicting disease progression. Maribavir (MBV) has been approved for the treatment of post-transplant CMV infection/disease in adolescents. Adoptive T-cell therapy and the PepVax CMV vaccine show promise in tackling refractory and resistant CMV. However, the effectiveness of PepVax in reducing CMV viremia/disease was not demonstrated in a phase II trial. Cell-mediated immunity assays are valuable for personalized management plans, but more interventional studies are needed. MBV and adoptive T-cell therapy are promising treatments, and trials for CMV vaccines are ongoing.
Collapse
Affiliation(s)
- Tang-Her Jaing
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan;
| | - Yi-Lun Wang
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan;
| | - Chia-Chi Chiu
- Division of Nursing, Chang Gung Memorial Hospital, Taoyuan 33315, Taiwan;
| |
Collapse
|
3
|
Howard A, Nishikawa JK, Sánchez PJ. "Minimally symptomatic" congenital cytomegalovirus infection: latest data and emerging concepts. Curr Opin Pediatr 2024; 36:480-488. [PMID: 38747205 DOI: 10.1097/mop.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW Universal and targeted screening of newborns for congenital cytomegalovirus (CMV) infection is increasing globally. Questions remain concerning the management of infants who have been identified with congenital CMV infection, especially those with "minimally symptomatic" or clinically inapparent infection. Our objective is to discuss current management of CMV-infected neonates with a focus on less affected infants with or without sensorineural hearing loss (SNHL). RECENT FINDINGS Valganciclovir is being prescribed increasingly in neonates with congenital CMV infection for improvement in hearing outcomes through 2 years of age. Treatment initiated in the first month of age is recommended for clinically apparent disease. A recent study showed hearing improvement at 18-22 months of age when therapy was initiated at age 1-3 months in infants with clinically inapparent CMV infection and isolated SNHL. SUMMARY Antiviral therapy with either ganciclovir or valganciclovir has shown moderate benefit in prevention of hearing deterioration among infants with clinically apparent CMV infection or isolated SNHL. Sustainability of benefit beyond 2 years of age remains unknown. At present, infants with clinically inapparent CMV infection (normal complete evaluation including hearing) should not receive antiviral therapy. All CMV-infected infants require close audiological and neurodevelopmental follow-up.
Collapse
Affiliation(s)
- Ashley Howard
- Department of Pediatric Infectious Diseases and Immunology, Connecticut Children's Hospital, Hartford, Connecticut
- Department of Pediatrics, University of Connecticut, Farmington, Connecticut
| | - Javier K Nishikawa
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pablo J Sánchez
- Department of Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children's Hospital, Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Perinatal Research, Ohio Perinatal Research Network, The Ohio State University College of Medicine, Columbus, Ohio, USA
| |
Collapse
|
4
|
Webb E, Hodgson J, Gillespie AN, Jones CA, Poulakis Z, Wong J, Sung V. Hearing Screening for Congenital CytoMegaloVirus-Exploring Parents' Experiences of Completing Targeted Congenital Cytomegalovirus Screening at the Time of Their Infants' Newborn Hearing Screening. J Clin Med 2024; 13:4367. [PMID: 39124634 PMCID: PMC11313214 DOI: 10.3390/jcm13154367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: Congenital cytomegalovirus (cCMV) is the leading infectious cause of sensorineural hearing loss and neurodevelopmental disabilities, with prompt detection (<21 days of life) required to enable accurate diagnosis and anti-viral treatment where clinically appropriate. International guidelines recommend cCMV screening for infants who do not pass their Universal Newborn Hearing Screening (UNHS). This study aimed to explore parental experiences of targeted cCMV screening through the UNHS in Victoria, Australia between 2019 and 2020 (HearS-cCMV study). Methods: A qualitative study comprising 18 semi-structured interviews with parents who took saliva swabs from their infants who did not pass their UNHS. A maximum variation sampling strategy was used with data analysed using thematic analysis. Results: Four themes described 18 parents' experiences of cCMV screening: (1) parents' lack of CMV awareness prior to cCMV screening; (2) overall positive experience; (3) varied understanding of CMV post screening; and (4) parents were glad to screen their infant for cCMV. Enablers of targeted cCMV screening included the swab being simple and non-invasive, being easier to complete in the hospital than at home, and the screening being well delivered by the staff. Barriers included a potential increase in anxiety, especially with false positives, and the timing of cCMV screening coinciding with their infant not passing UNHS being difficult for some parents. Conclusions: Parent experiences of targeted cCMV screening were positive. Increasing public knowledge of cCMV and training staff members to complete the CMV swab would reduce the risk of false positives and associated parental anxiety. This would facilitate successful routine targeted cCMV screening.
Collapse
Affiliation(s)
- Emma Webb
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.W.)
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
| | - Jan Hodgson
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
| | - Alanna N. Gillespie
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.W.)
| | - Cheryl A. Jones
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
- Medicine and Health, The University of New South Wales, Sydney, NSW 2050, Australia
- Sydney Children’s Hospital Network (Westmead), Sydney, NSW 2145, Australia
| | - Zeffie Poulakis
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.W.)
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
- The Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Janis Wong
- Faculty of Medicine, The University of Melbourne, Melbourne, VIC 3052, Australia
| | - Valerie Sung
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia; (E.W.)
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia
- The Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| |
Collapse
|
5
|
Ma J, Choi SJ, Kim S, Hong M. Performance Comparison of Convolutional Neural Network-Based Hearing Loss Classification Model Using Auditory Brainstem Response Data. Diagnostics (Basel) 2024; 14:1232. [PMID: 38928647 PMCID: PMC11202863 DOI: 10.3390/diagnostics14121232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/06/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
This study evaluates the efficacy of several Convolutional Neural Network (CNN) models for the classification of hearing loss in patients using preprocessed auditory brainstem response (ABR) image data. Specifically, we employed six CNN architectures-VGG16, VGG19, DenseNet121, DenseNet-201, AlexNet, and InceptionV3-to differentiate between patients with hearing loss and those with normal hearing. A dataset comprising 7990 preprocessed ABR images was utilized to assess the performance and accuracy of these models. Each model was systematically tested to determine its capability to accurately classify hearing loss. A comparative analysis of the models focused on metrics of accuracy and computational efficiency. The results indicated that the AlexNet model exhibited superior performance, achieving an accuracy of 95.93%. The findings from this research suggest that deep learning models, particularly AlexNet in this instance, hold significant potential for automating the diagnosis of hearing loss using ABR graph data. Future work will aim to refine these models to enhance their diagnostic accuracy and efficiency, fostering their practical application in clinical settings.
Collapse
Affiliation(s)
- Jun Ma
- Department of Software Convergence, Soonchunhyang University, Asan 31538, Republic of Korea;
| | - Seong Jun Choi
- Department of Otorhinolaryngology—Head and Neck Surgery, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea;
| | - Sungyeup Kim
- Insitute for Artificial Intelligence and Software, Soonchunhyang University, Asan 31538, Republic of Korea;
| | - Min Hong
- Department of Computer Software Engineering, Soonchunhyang University, Asan 31538, Republic of Korea
| |
Collapse
|
6
|
Aldè M, Ambrosetti U, Piatti G, Romanini C, Filipponi E, Di Berardino F, Zanetti D, Pignataro L, Cantarella G, Barozzi S. Sudden Sensorineural Hearing Loss in Patients Aged from 15 to 40 Years. J Clin Med 2024; 13:3303. [PMID: 38893014 PMCID: PMC11172854 DOI: 10.3390/jcm13113303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: The purpose of this study was to investigate the hearing characteristics and causes of sudden sensorineural hearing loss (SSNHL) in patients aged from 15 to 40 years, focusing on audiological outcomes one year after the diagnosis. Methods: The medical records of individuals with SSNHL who were referred to our tertiary-level audiologic center were reviewed. All patients had undergone comprehensive diagnostic evaluations, including high-resolution 3D-FLAIR delayed magnetic resonance imaging (MRI), cone beam computed tomography (CBCT), and screening for coagulation, infectious, and autoimmune diseases. Results: Overall, 56 patients (mean age 28.1 ± 7.6 years) were included in the study. The hearing threshold in the affected ear improved significantly from 56.0 ± 18.0 dB at the diagnosis to 46.9 ± 22.3 dB after one year (p = 0.02). The degree of hearing loss, audiometric configurations, hearing improvements, and adherence to hearing treatments showed considerable variability among patients. Aural fullness, tinnitus, and hyperacusis were the predominant symptoms associated with SSNHL, and their prevalence decreased significantly over time. The diagnostic protocol led to the identification of the specific cause of SSNHL in 75% (42/56) of patients. The known etiology was found to be otological (39.3%), infectious (21.4%), autoimmune (7.1%), vascular (5.4%), or neoplastic (1.8%). In particular, Menière's disease (n = 12), isolated cochlear endolymphatic hydrops (n = 6), HSV-1 (n = 5), and EBV (n = 4) infections were the most frequent causes of SSNHL. Conclusions: The identification of the specific etiology of SSNHL may facilitate a more personalized approach to management and treatment.
Collapse
Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
| | - Gioia Piatti
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Unit of Bronchopneumology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Camilla Romanini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
| | - Eliana Filipponi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Diego Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
- Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (U.A.); (C.R.); (E.F.); (F.D.B.); (D.Z.); (L.P.); (G.C.); (S.B.)
| |
Collapse
|
7
|
Herbein G. Cellular Transformation by Human Cytomegalovirus. Cancers (Basel) 2024; 16:1970. [PMID: 38893091 PMCID: PMC11171319 DOI: 10.3390/cancers16111970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Epstein-Barr virus (EBV), Kaposi sarcoma human virus (KSHV), human papillomavirus (HPV), hepatitis B and C viruses (HBV, HCV), human T-lymphotropic virus-1 (HTLV-1), and Merkel cell polyomavirus (MCPyV) are the seven human oncoviruses reported so far. While traditionally viewed as a benign virus causing mild symptoms in healthy individuals, human cytomegalovirus (HCMV) has been recently implicated in the pathogenesis of various cancers, spanning a wide range of tissue types and malignancies. This perspective article defines the biological criteria that characterize the oncogenic role of HCMV and based on new findings underlines a critical role for HCMV in cellular transformation and modeling the tumor microenvironment as already reported for the other human oncoviruses.
Collapse
Affiliation(s)
- Georges Herbein
- Department Pathogens & Inflammation-EPILAB EA4266, University of Franche-Comté (UFC), 25000 Besançon, France;
- Department of Virology, CHU Besançon, 25000 Besançon, France
| |
Collapse
|
8
|
Izquierdo G, Guerra C, Reyes R, Araya L, Sepulveda B, Cabrera C, Medina P, Mardones E, Villavicencio L, Montecinos L, Tarque F, Acevedo W, Barraza M, Farfán M, Mendez J, Torres JP. Universal and Expanded Screening Strategy for Congenital Cytomegalovirus Infection: Is Pool Testing by a Rapid Molecular Test in Saliva a New Choice in Developing Countries? Viruses 2024; 16:772. [PMID: 38793653 PMCID: PMC11125597 DOI: 10.3390/v16050772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Several screening strategies for identifying congenital CMV (cCMV) have been proposed; however, the optimal solution has yet to be determined. We aimed to determine the prevalence of cCMV by universal screening with saliva pool testing and to identify the clinical variables associated with a higher risk of cCMV to optimize an expanded screening strategy. METHODS We carried out a prospective universal cCMV screening (September/2022 to August/2023) of 2186 newborns, analyzing saliva samples in pools of five (Alethia-LAMP-CMV®) and then performed confirmatory urine CMV RT-PCR. Infants with risk factors (small for gestational age, failed hearing screening, HIV-exposed, born to immunosuppressed mothers, or <1000 g birth weight) underwent expanded screening. Multivariate analyses were used to assess the association with maternal/neonatal variables. RESULTS We identified 10 infants with cCMV (prevalence: 0.46%, 95% CI 0.22-0.84), with significantly higher rates (2.1%, 95% CI 0.58-5.3) in the high-risk group (p = 0.04). False positives occurred in 0.09% of cases. No significant differences in maternal/neonatal characteristics were observed, except for a higher prevalence among infants born to non-Chilean mothers (p = 0.034), notably those born to Haitian mothers (1.5%, 95% CI 0.31-4.34), who had higher odds of cCMV (OR 6.82, 95% CI 1.23-37.9, p = 0.04). Incorporating maternal nationality improved predictive accuracy (AUC: 0.65 to 0.83). CONCLUSIONS For low-prevalence diseases such as cCMV, universal screening with pool testing in saliva represents an optimal and cost-effective approach to enhance diagnosis in asymptomatic patients. An expanded screening strategy considering maternal nationality could be beneficial in resource-limited settings.
Collapse
Affiliation(s)
- Giannina Izquierdo
- Department of Pediatrics, Faculty of Medicine, University of Chile, Santiago 8820808, Chile
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
- Centro de Investigación Clínica Avanzada (CICA), Hospital Exequiel González Cortés, Santiago, Chile
| | - Carolina Guerra
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Roberto Reyes
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Leslie Araya
- Department of Pediatrics, Faculty of Medicine, University of Chile, Santiago 8820808, Chile
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Belén Sepulveda
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Camila Cabrera
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Pamela Medina
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Eledier Mardones
- Neonatal Intensive Care Unit, Hospital Barros Luco Trudeau, Santiago, Chile
| | | | - Luisa Montecinos
- Molecular Biology Laboratory, Hospital Lucio Córdova, Santiago, Chile
| | - Felipe Tarque
- Molecular Biology Laboratory, Hospital Lucio Córdova, Santiago, Chile
| | - William Acevedo
- Molecular Biology Laboratory, Hospital Lucio Córdova, Santiago, Chile
| | - Marlon Barraza
- Pharmacy Unit Santiago, Hospital Luis Calvo Mackenna, Santiago, Chile;
| | - Mauricio Farfán
- Molecular Biology Laboratory, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - Jocelyn Mendez
- Molecular Biology Laboratory, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - Juan Pablo Torres
- Department of Pediatrics, Faculty of Medicine, University of Chile, Santiago 8820808, Chile
- Division of Pediatric Infectious Diseases, Hospital Luis Calvo Mackenna, Santiago, Chile
| |
Collapse
|
9
|
Mocanu AG, Stoian DL, Daescu AMC, Motofelea AC, Ciohat IM, Navolan DB, Vilibic-Cavlek T, Bogdanic M, Nemescu D, Tomescu L, Carabineanu A. The Impact of Latent Cytomegalovirus Infection on Spontaneous Abortion History and Pregnancy Outcomes in Romanian Pregnant Women. Microorganisms 2024; 12:731. [PMID: 38674675 PMCID: PMC11052013 DOI: 10.3390/microorganisms12040731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Cytomegalovirus (CMV), a DNA virus that belongs to the Orthoherpesviridae family, infects 40-100% of people. Primary/non-primary CMV infection during pregnancy could cause fetal disabilities. After primary infection, CMV causes a latent infection and resides in cells of the myeloid compartment (CD34+, monocytes). Few studies have analyzed the impact of latent CMV infections on miscarriage history, pregnancy complications, and neonatal outcomes. METHODS Serum samples from 806 pregnant women (28.29 ± 4.50 years old) who came for a consultation at the Timisoara Clinical Emergency City Hospital between 2008 and 2010 were tested for anti-CMV IgM/IgG antibodies, and data about demography, obstetrical history, pregnancy complications, birth, and neonate were collected. The data were compared between the groups with and without latent CMV infection, and statistical significance was calculated. RESULTS We did not find a difference regarding cesarean section (OR = 0.916, p = 0.856), placental abruption (OR = 1.004, p = 1.00), pregnancy-induced hypertension rate (OR = 1.078, p = 1.00), secondary sex ratio (0.882, p = 0.857), APGAR score (p = 0.225), gestational age at birth (p = 0.434), or birth weight (p = 0.365). A borderline significant difference was found regarding the presence of miscarriage history: OR = 8.467, p = 0.051. CONCLUSIONS The presence of latent CMV infection does not affect the likelihood of complications in healthy women. A borderline significantly higher prevalence of miscarriage history was found in women with latent CMV infection.
Collapse
Affiliation(s)
- Adelina Geanina Mocanu
- Department of Obstetrics-Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania; (A.G.M.); (L.T.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania
| | - Dana Liana Stoian
- Department of Endocrinology, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania;
| | - Ana-Maria Cristina Daescu
- Department of Psychiatry, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania;
| | - Alexandru Catalin Motofelea
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania;
| | - Ioana Mihaela Ciohat
- Laboratory of Antenatal Medicine, Timisoara City Emergency Hospital, 300202 Timisoara, Romania;
| | - Dan Bogdan Navolan
- Department of Obstetrics-Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania; (A.G.M.); (L.T.)
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
| | - Dragos Nemescu
- Department of Obstetrics-Gynecology, Gr. T. Popa University of Medicine and Pharmacy Iasi, Universitatiistr. nr. 16, 700115 Iasi, Romania;
| | - Larisa Tomescu
- Department of Obstetrics-Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania; (A.G.M.); (L.T.)
| | - Adrian Carabineanu
- Department of Surgery, Victor Babes University of Medicine and Pharmacy Timisoara, P-ta Eftimie Murgu nr. 2, 300041 Timisoara, Romania;
| |
Collapse
|
10
|
Piret J, Boivin G. Management of Cytomegalovirus Infections in the Era of the Novel Antiviral Players, Letermovir and Maribavir. Infect Dis Rep 2024; 16:65-82. [PMID: 38247977 PMCID: PMC10801527 DOI: 10.3390/idr16010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
Cytomegalovirus (CMV) infections may increase morbidity and mortality in immunocompromised patients. Until recently, standard antiviral drugs against CMV were limited to viral DNA polymerase inhibitors (val)ganciclovir, foscarnet and cidofovir with a risk for cross-resistance. These drugs may also cause serious side effects. This narrative review provides an update on new antiviral agents that were approved for the prevention and treatment of CMV infections in transplant recipients. Letermovir was approved in 2017 for CMV prophylaxis in CMV-seropositive adults who received an allogeneic hematopoietic stem cell transplant. Maribavir followed four years later, with an indication in the treatment of adult and pediatric transplant patients with refractory/resistant CMV disease. The target of letermovir is the CMV terminase complex (constituted of pUL56, pUL89 and pUL51 subunits). Letermovir prevents the cleavage of viral DNA and its packaging into capsids. Maribavir is a pUL97 kinase inhibitor, which interferes with the assembly of capsids and the egress of virions from the nucleus. Both drugs have activity against most CMV strains resistant to standard drugs and exhibit favorable safety profiles. However, high-level resistance mutations may arise more rapidly in the UL56 gene under letermovir than low-grade resistance mutations. Some mutations emerging in the UL97 gene under maribavir can be cross-resistant with ganciclovir. Thus, letermovir and maribavir now extend the drug arsenal available for the management of CMV infections and their respective niches are currently defined.
Collapse
Affiliation(s)
| | - Guy Boivin
- Centre de Recherche en Infectiologie, CHU de Québec-Université Laval, Quebec City, QC G1V 4G2, Canada;
| |
Collapse
|
11
|
Aldè M, Ambrosetti U. Maternal serological screening for cytomegalovirus infection may play an important role nowadays. Prenat Diagn 2023; 43:1477-1478. [PMID: 37712133 DOI: 10.1002/pd.6441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
12
|
Lazzerini F, Bruschini L, Fiacchini G, Canzi P, Berrettini S, Forli F. The Role of Bone-Anchored Hearing Devices and Remote Microphones in Children with Congenital Unilateral Hearing Loss. Brain Sci 2023; 13:1379. [PMID: 37891748 PMCID: PMC10605185 DOI: 10.3390/brainsci13101379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Congenital unilateral hearing loss (UHL) represents a contemporary audiologic challenge. Children with UHL can struggle with understanding speech in noise, localizing sounds, developing language, and maintaining academic performance, leading to low self-esteem, anxiety, and decreased social support. Two specific conditions related to UHL in children are single-sided deafness (SSD) and unilateral auris atresia (UAA). This was a retrospective observational study on a group of children with UHL. The Simplified Italian Matrix Sentence Test was used for the assessment of speech reception threshold (SRT) in different conditions: speech and noise from the front (S0N0), speech at 45° from the side of the better ear and noise at 45° from the opposite side (SbNw), and vice versa (SwNb). Each test was conducted unaided, with a bone-anchored hearing device (BAHD), and with a remote microphone (RM) system. The use of a BAHD and RM led to an improvement in SRT in S0N0 and SwNb conditions. The SSD subgroup demonstrated significant benefits with both devices in SwNb, and the UAA subgroup from the use of BAHD in S0N0. In conclusion, the study underscores the potential benefits of both devices in enhancing speech perception for UHL children, providing insights into effective intervention strategies for these challenging cases.
Collapse
Affiliation(s)
- Francesco Lazzerini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Luca Bruschini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giacomo Fiacchini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Stefano Berrettini
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
- Clinical Science, Intervention and Technology, Karolinska Institute, 17177 Stockholm, Sweden
| | - Francesca Forli
- Otolaryngology, Audiology and Phoniatrics Unit, University of Pisa, 56126 Pisa, Italy; (L.B.); (G.F.); (S.B.)
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| |
Collapse
|