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Gilad N, Agrawal S, Philippopoulos E, Murphy KE, Shinar S. Is a Higher Amniotic Fluid Viral Load Associated with a Greater Risk of Fetal Injury in Congenital Cytomegalovirus Infection-A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:2136. [PMID: 38610901 PMCID: PMC11012373 DOI: 10.3390/jcm13072136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Numerous studies have aimed to predict prenatal and neonatal outcomes for pregnancies complicated by congenital cytomegalovirus (CMV). Presently, assessing CMV severity prenatally relies largely on fetal imaging. A controversy exists regarding CMV viral load (VL) and its association with fetal and neonatal sequelae. Objective: To perform a systematic review and meta-analysis investigating the association between CMV DNA VL in amniotic fluid and fetal and neonatal outcomes in pregnancies with congenital CMV. Results: All cohort, case-control and observational studies that compared outcomes of fetuses with congenital CMV and provided information on individual patient CMV VL quantified in copies per milliliter (c/mL) from inception to January 2023 were included, with no geographical or language restrictions. A total of 1251 citations were reviewed with eight studies meeting inclusion criteria and included in meta-analysis. Affected pregnancies had a higher VL in the amniotic fluid compared to those unaffected with a mean difference of 2.2e+7 (range 1.5e+7 to 2.8e+7). In subgroup analysis, the VL was significantly higher in the fetuses, with imaging findings related to CMV compared to asymptomatic fetuses with a mean difference of 4.1e+7 (95% CI 2.8e+7-5.4e+7). However, among babies with congenital CMV, the VL was not significantly different between symptomatic and asymptomatic babies. Conclusions: Amniotic fluid CMV VL is associated with fetal sequalae in congenital CMV, with a higher VL conferring a greater risk for prenatal injury.
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Affiliation(s)
- Noa Gilad
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada; (N.G.); (E.P.); (K.E.M.)
| | - Swati Agrawal
- Department of Obstetrics and Gynecology, University of McMaster, Hamilton, ON L8S 4K1, Canada;
| | - Eleni Philippopoulos
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada; (N.G.); (E.P.); (K.E.M.)
| | - Kellie E. Murphy
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada; (N.G.); (E.P.); (K.E.M.)
| | - Shiri Shinar
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada; (N.G.); (E.P.); (K.E.M.)
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Vasiljevic T, Jankovic M, Tomic A, Bakrac I, Radenovic S, Miljanovic D, Knezevic A, Jovanovic T, Djunic I, Todorovic-Balint M. Significance of Cytomegalovirus gB Genotypes in Adult Patients Undergoing Hematopoietic Stem Cell Transplantation: Insights from a Single-Centre Investigation. Pharmaceuticals (Basel) 2024; 17:428. [PMID: 38675390 PMCID: PMC11054653 DOI: 10.3390/ph17040428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Cytomegalovirus (CMV) infection is a major clinical issue after allogeneic hematopoietic stem cell transplantation (HSCT). The CMV envelope glycoproteins are key in viral pathogenesis; the glycoprotein B (gB) encoded by the UL55 gene might be an important determinant of viral virulence and disease severity marker in patients treated with allogeneic HSCT. Our aim was to investigate the molecular diversity of CMV gB and inquire into the associations between UL55 gene variations and clinical manifestations in adult patients treated with allogeneic HSCT. RESULTS The most prevalent genotypes were gB1 and gB4 (11/27, 40.7%). Patients with genotype gB1 infection had earlier platelet engraftment (p < 0.033) and less frequent minimal/measurable residual disease post HSCT than those without this genotype. Patients with gB4 glycoprotein infection had a significantly lower CD4+/CD8+ ratio at D90 (p < 0.026). Interestingly, patients with gB5 glycoprotein infection had shorter overall survival from base condition diagnosis (p < 0.042), as well as shorter overall survival after HSCT (p < 0.036). Acute GvHD was noted more frequently in those with mixed-genotype infection (p = 0.047). MATERIAL AND METHODS The study included fifty-nine adult patients treated with allogeneic HSCT. Peripheral venous blood was sampled typically per week, with detection of CMV performed by quantitative real-time PCR. Multiplex nested PCR was used to determine specific gB genotypes, which were then statistically compared vis-à-vis specific clinical variables. CONCLUSIONS Our study points to variations in the viral UL55 locus imparting both beneficial (earlier platelet engraftment, less frequent MRD post HSCT) and adverse effects (shorter overall survival, more frequent acute GvHD, less frequent 100% chimerism at day 90) to the transplanted host. Comprehensive molecular investigations are necessary to validate this apparent duality, as the potential benefits of CMV could perhaps be utilized for the benefit of the patient in the future.
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Affiliation(s)
- Tamara Vasiljevic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
| | - Marko Jankovic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
- Department of Virology, Institute of Microbiology and Immunology, 1 Dr Subotica Street, 11000 Belgrade, Serbia
| | - Ana Tomic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
| | - Ida Bakrac
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
| | - Stefan Radenovic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
| | - Danijela Miljanovic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
- Department of Virology, Institute of Microbiology and Immunology, 1 Dr Subotica Street, 11000 Belgrade, Serbia
| | - Aleksandra Knezevic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
- Department of Virology, Institute of Microbiology and Immunology, 1 Dr Subotica Street, 11000 Belgrade, Serbia
| | - Tanja Jovanovic
- Institute for Biocides and Medical Ecology, 16 Trebevicka Street, 11000 Belgrade, Serbia;
| | - Irena Djunic
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
- Clinic of Haematology, University Clinical Centre of Serbia, University of Belgrade, 2 Dr Koste Todorovica Street, 11000 Belgrade, Serbia
| | - Milena Todorovic-Balint
- Faculty of Medicine, University of Belgrade, 8 Dr Subotica Street, 11000 Belgrade, Serbia; (T.V.); (I.B.); (S.R.); (D.M.); (A.K.); (I.D.); (M.T.-B.)
- Clinic of Haematology, University Clinical Centre of Serbia, University of Belgrade, 2 Dr Koste Todorovica Street, 11000 Belgrade, Serbia
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Li KK, Lau B, Suárez NM, Camiolo S, Gunson R, Davison AJ, Orton RJ. Direct Nanopore Sequencing of Human Cytomegalovirus Genomes from High-Viral-Load Clinical Samples. Viruses 2023; 15:1248. [PMID: 37376548 DOI: 10.3390/v15061248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Nanopore sequencing is becoming increasingly commonplace in clinical settings, particularly for diagnostic assessments and outbreak investigations, due to its portability, low cost, and ability to operate in near real-time. Although high sequencing error rates initially hampered the wider implementation of this technology, improvements have been made continually with each iteration of the sequencing hardware and base-calling software. Here, we assess the feasibility of using nanopore sequencing to determine the complete genomes of human cytomegalovirus (HCMV) in high-viral-load clinical samples without viral DNA enrichment, PCR amplification, or prior knowledge of the sequences. We utilised a hybrid bioinformatic approach that involved assembling the reads de novo, improving the consensus sequence by aligning reads to the best-matching genome from a collated set of published sequences, and polishing the improved consensus sequence. The final genomes from a urine sample and a lung sample, the former with an HCMV to human DNA load approximately 50 times greater than the latter, achieved 99.97 and 99.93% identity, respectively, to the benchmark genomes obtained independently by Illumina sequencing. Thus, we demonstrated that nanopore sequencing is capable of determining HCMV genomes directly from high-viral-load clinical samples with a high accuracy.
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Affiliation(s)
- Kathy K Li
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | - Betty Lau
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Nicolás M Suárez
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Salvatore Camiolo
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Rory Gunson
- West of Scotland Specialist Virology Centre, NHS Greater Glasgow & Clyde, Glasgow G31 2ER, UK
| | - Andrew J Davison
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Richard J Orton
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
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Huang CY, Cheng YC, Hwang YS, Kang EYC, Hsiao CH. Cytomegalovirus Glycoprotein B Genotype in Patients with Anterior Segment Infection. Int J Mol Sci 2023; 24:ijms24076304. [PMID: 37047276 PMCID: PMC10094332 DOI: 10.3390/ijms24076304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Abstract
(1) The glycoprotein B (gB) on the viral envelope, encoded by the most widely characterised polymorphic gene, gpUL55, is responsible for cytomegalovirus (CMV) entry into the host and could serve as a potential marker of pathogenicity. The aim of the present study is to investigate the distribution of the CMV gB genotype in anterior segment infection in Taiwan and its correlation with clinical manifestations and outcomes. (2) Fifty-seven patients with CMV anterior segment infection were identified according to clinical features and positivity for CMV DNA in aqueous humour samples. CMV gB genotyping was performed through polymerase chain reaction assays. Patients’ medical records were retrospectively reviewed. (3) Among the 57 aqueous humour samples tested for gB, 40 (70.28%) had multiple gB genotypes, and only 17 (29.82%) had a single gB genotype. Compared with single-genotype infection, multiple-genotype infection was correlated with higher CMV loads (p < 0.001) but not correlated with outcome. A higher proportion of patients with the gB3 genotype had received filtering surgery before antiviral treatment than those without the gB3 genotype (p = 0.046). (4) Multiple-genotype infection was highly prevalent in CMV anterior segment infection in Taiwan, and gB1 and gB3 were predominant. Multiple-genotype infection was correlated with higher CMV loads but not with specific clinical manifestations or prognostic outcomes. The gB3 genotype may be correlated with poor intraocular pressure control.
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Dong N, Cao L, Zheng D, Su L, Lu L, Dong Z, Xu M, Xu J. Distribution of CMV envelope glycoprotein B, H and N genotypes in infants with congenital cytomegalovirus symptomatic infection. Front Pediatr 2023; 11:1112645. [PMID: 37009289 PMCID: PMC10057549 DOI: 10.3389/fped.2023.1112645] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/20/2023] [Indexed: 04/04/2023] Open
Abstract
Background Cytomegalovirus (CMV) is the leading cause of congenital infections worldwide and contributes to long-term sequelae in neonates and children. CMV envelope glycoproteins play a vital role in virus entry and cell fusion. The association between CMV polymorphisms and clinical outcomes remains controversial. The present study aims to demonstrate the distribution of glycoprotein B (gB), H (gH) and N (gN) genotypes in congenitally CMV (cCMV) infected symptomatic infants and attempts to figure out the association between viral glycoprotein genotypes and clinical outcomes. Methods Genotyping of gB, gH and gN was performed in 42 cCMV symptomatic infants and 149 infants with postnatal CMV (pCMV) infection in Children's hospital of Fudan university. Nested PCR, gene sequencing and phylogenetic analyses were used to identify the genotypes. Results Our study demonstrated that: 1. The CMV gB1, gH1 and gN1 were the predominant genotypes among symptomatic cCMV infected infants, while gB1, gH1 and gN3a were more prevalent in pCMV group. gH1 genotype has a significant association with symptomatic cCMV infection (p = 0.006). 2. No significant correlation was found between CMV genotypes and hearing impairment. However, gH1 was more prevalent among cCMV infected infants with moderate/severe hearing loss although without statistical difference (p = 0.130). 3. gB3 was more prevalent among infants with skin petechiae (p = 0.049) and found to be associated with an increased risk of skin petechiae (OR = 6.563). The gN4a subtype was significantly associated with chorioretinitis due to cCMV infection (p = 0.007). 4. Urine viral loads were not significantly associated with different genotypes or hearing impairment among symptomatic cCMV infected infants. Conclusions Our findings demonstrated the overall distribution of gB, gH and gN genotypes in infants with symptomatic cCMV infection in Shanghai for the first time. The findings in our study may suggest a possible association between gH1 genotype and early infancy hearing loss. gB3 genotype was associated with a 6.5-fold increased risk of petechiae while gN4a strongly correlated with chorioretinitis due to cCMV infection. No significant correlation was found between urine viral loads and CMV genotypes or hearing impairment in cCMV infected infants.
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Affiliation(s)
- Niuniu Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Danni Zheng
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zuoquan Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Correspondence: Jin Xu
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Waters S, Lee S, Irish A, Price P. Challenging the Conventional Interpretation of HCMV Seronegativity. Microorganisms 2021; 9:2382. [PMID: 34835508 DOI: 10.3390/microorganisms9112382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
The majority of adults in the world (around 83%) carry antibodies reactive with HCMV and are thought to retain inactive or latent infections lifelong. The virus is transmitted via saliva, so infection events are likely to be common. Indeed, it is hard to imagine a life without exposure to HCMV. From 45 seronegative individuals (13 renal transplant recipients, 32 healthy adults), we present seven cases who had detectable HCMV DNA in their blood and/or saliva, or a CMV-encoded homologue of IL-10 (vIL-10) in their plasma. One case displayed NK cells characteristic of CMV infection before her HCMV DNA became undetectable. In other cases, the infection may persist with seroconversion blocked by vIL-10. Future research should seek mechanisms that can prevent an individual from seroconverting despite a persistent HCMV infection, as HCMV vaccines may not work well in such people.
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Wang HY, Valencia SM, Pfeifer SP, Jensen JD, Kowalik TF, Permar SR. Common Polymorphisms in the Glycoproteins of Human Cytomegalovirus and Associated Strain-Specific Immunity. Viruses 2021; 13:v13061106. [PMID: 34207868 PMCID: PMC8227702 DOI: 10.3390/v13061106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Human cytomegalovirus (HCMV), one of the most prevalent viruses across the globe, is a common cause of morbidity and mortality for immunocompromised individuals. Recent clinical observations have demonstrated that mixed strain infections are common and may lead to more severe disease progression. This clinical observation illustrates the complexity of the HCMV genome and emphasizes the importance of taking a population-level view of genotypic evolution. Here we review frequently sampled polymorphisms in the glycoproteins of HCMV, comparing the variable regions, and summarizing their corresponding geographic distributions observed to date. The related strain-specific immunity, including neutralization activity and antigen-specific cellular immunity, is also discussed. Given that these glycoproteins are common targets for vaccine design and anti-viral therapies, this observed genetic variation represents an important resource for future efforts to combat HCMV infections.
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Affiliation(s)
- Hsuan-Yuan Wang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10065, USA;
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA;
| | - Sarah M. Valencia
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA;
| | - Susanne P. Pfeifer
- Center for Evolution & Medicine, School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA; (S.P.P.); (J.D.J.)
| | - Jeffrey D. Jensen
- Center for Evolution & Medicine, School of Life Sciences, Arizona State University, Tempe, AZ 85281, USA; (S.P.P.); (J.D.J.)
| | - Timothy F. Kowalik
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA 01655, USA;
| | - Sallie R. Permar
- Department of Pediatrics, Weill Cornell Medicine, New York, NY 10065, USA;
- Correspondence: ; Tel.: +1-212-746-4111
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Dong N, Cao L, Su L, Lu L, Dong Z, Xu M, Xu J. Human cytomegalovirus envelope glycoprotein B, H, and N polymorphisms among infants of Shanghai area in China. J Med Virol 2020; 92:3674-3681. [PMID: 32567060 DOI: 10.1002/jmv.26210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 11/11/2022]
Abstract
Human cytomegalovirus (HCMV) is the leading cause of congenital infection and an opportunistic pathogen capable of establishing lifelong latency. In the present study, we aimed to investigate the distribution of glycoprotein B, H, and N in infants of Shanghai and correlate the genotype with active and latent HCMV infection. A total of 129 urine samples were collected between August 2014 and December 2015 from infants under 3 years with HCMV infection. Nested PCR was used to amplify the regions of UL55 (gB), UL75 (gH), and UL73 (gN). Gene sequencing and phylogenetic analyses were used to classify the genotypes. Overall, regarding gB, gB1 (57.27%) was predominant, followed by gB3 (41.82%) and gB4 (0.91%). gH1 (54.33%) was the most prevalent genotype of gH, followed by gH2 (45.67%). Concerning gN, we detected gN1 (17.44%), gN2 (2.33%), gN3a (29.07%), gN3b (8.14%), gN4a (13.95%), gN4b (15.12%), and gN4c (13.95%), among which gN3a was the dominant genotype. All the expected genotypes were present except gB2 in children with active infection: gB1 (56.25%), gB3 (42.5%), gB4 (1.25%), gH1 (58.70%), gH2 (41.30%), gN1 (19.05%), gN2 (3.17%), gN3a (25.40%), gN3b (6.35%), gN4a (15.87%), gN4b (17.46%), and gN4c (12.70%). However, among latent cases, we detected gB1 (60%), gB3 (40%), gH1 (42.86%), gH2 (57.14%), gN1 (13.04%), gN3a (39.13%), gN3b (13.04%), gN4a (8.70%), gN4b (8.70%), and gN4c (17.39%), respectively. gB2, gB4, and gN2 were absent in this group. The results revealed that gB1, gH1, and gN3a were predominant in the infants of Shanghai. gH showed different trends among children with active and latent infection.
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Affiliation(s)
- Niuniu Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Liyun Su
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Lijuan Lu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Zuoquan Dong
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Menghua Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
| | - Jin Xu
- Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai, China
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de la Cruz-de la Cruz A, Moreno-verduzco ER, Martínez-alarcón O, González-alvarez DL, Valdespino-vázquez M, Helguera-repetto A, Fonseca-coronado S, Lozano-cuenca J, Ramírez-ramírez A, Soriano-becerril D, Mancilla-herrera I, Figueroa-damián R, Herrera-salazar A. Utility of two DNA extraction methods using formalin-fixed paraffin-embedded tissues in identifying congenital cytomegalovirus infection by polymerase chain reaction. Diagn Microbiol Infect Dis 2020; 97:115075. [DOI: 10.1016/j.diagmicrobio.2020.115075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 03/28/2020] [Accepted: 05/02/2020] [Indexed: 11/18/2022]
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10
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Puhakka L, Pati S, Lappalainen M, Lönnqvist T, Niemensivu R, Lindahl P, Nieminen T, Seuri R, Nupponen I, Boppana S, Saxen H. Viral shedding, and distribution of cytomegalovirus glycoprotein H (UL75), glycoprotein B (UL55), and glycoprotein N (UL73) genotypes in congenital cytomegalovirus infection. J Clin Virol 2020; 125:104287. [PMID: 32086150 DOI: 10.1016/j.jcv.2020.104287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 10/13/2019] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children with congenital CMV infection (cCMV) shed virus in urine and saliva for prolonged periods of time. Outcome of cCMV varies from asymptomatic infection with no sequelae in most cases, to severe longterm morbidity. The factors associated with asymptomatic cCMV are not well defined. We evaluated the viral shedding in a cohort of infants with cCMV identified on newborn screening. In addition, we describe the distribution of viral genotypes in our cohort of asymptomatic infants and previous cohorts of cCMV children in the literature. METHODS Study population consisted of 40 children with cCMV identified in screening of 19,868 infants, a prevalence of 2/1000. The viral shedding was evaluated at 3 and 18 months of age by real-time CMV-PCR of saliva and plasma, and CMV culture of urine. CMV positive saliva samples were analyzed for genotypes for CMV envelope glycoproteins gB (UL55), and gH (UL75) by genotype specific real-time PCR, and gN (UL73) by cloning and sequencing RESULTS: At 3 months age 40/40 saliva and urine samples, and 19/40 plasma samples were positive for CMV. At 18 months age all urine samples tested (33/33), 9/37 of saliva samples, and 2/34 plasma samples were positive for CMV. The genotype distribution did not differ from the published data CONCLUSIONS: The urinary virus shedding is more persistent than salivary shedding in children with cCMV. The genotype distribution was similar to previous literature and does not explain the low disease burden of cCMV in our population.
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Affiliation(s)
- Laura Puhakka
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Sunil Pati
- Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maija Lappalainen
- Laboratory Services (HUSLAB), Division of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Tuula Lönnqvist
- Department of Child Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riina Niemensivu
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi Lindahl
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tea Nieminen
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Raija Seuri
- Department of Pediatric Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Irmeli Nupponen
- Department of Neonatology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Suresh Boppana
- Pediatrics and Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harri Saxen
- Department of Pediatric Infectious Diseases, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Dobbins GC, Patki A, Chen D, Tiwari HK, Hendrickson C, Britt WJ, Fowler K, Chen JY, Boppana SB, Ross SA. Association of CMV genomic mutations with symptomatic infection and hearing loss in congenital CMV infection. BMC Infect Dis 2019; 19:1046. [PMID: 31822287 PMCID: PMC6905059 DOI: 10.1186/s12879-019-4681-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/29/2019] [Indexed: 12/23/2022] Open
Abstract
Background Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and a leading cause of long-term neurological and sensory sequelae, the most common being sensorineural hearing loss (SNHL). Despite extensive research, clinical or laboratory markers to identify CMV infected children with increased risk for disease have not been identified. This study utilizes viral whole-genome next generation-sequencing (NGS) of specimens from congenitally infected infants to explore viral diversity and specific viral variants that may be associated with symptomatic infection and SNHL. Methods CMV DNA from urine specimens of 30 infants (17 asymptomatic, 13 symptomatic) was target enriched and next generation sequenced resulting in 93% coverage of the CMV genome allowing analysis of viral diversity. Results Variant frequency distribution was compared between children with symptomatic and asymptomatic cCMV and those with (n = 13) and without (n = 17) hearing loss. The CMV genes UL48A, UL88, US19 and US22 were found to have an increase in nucleotide diversity in symptomatic children; while UL57, UL20, UL104, US14, UL115, and UL35 had an increase in diversity in children with hearing loss. An analysis of single variant differences between symptomatic and asymptomatic children found UL55 to have the highest number, while the most variants associated with SNHL were in the RL11 gene family. In asymptomatic infants with SNHL, mutations were observed more frequently in UL33 and UL20. Conclusion CMV genomes from infected newborns can be mapped to 93% of the genome at a depth allowing accurate and reproducible analysis of polymorphisms for variant and gene discovery that may be linked to symptomatic and hearing loss outcomes.
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Affiliation(s)
- G Clement Dobbins
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.
| | - Amit Patki
- Department of Biostatistics, The University of Alabama School of Public Health, Birmingham, AL, USA
| | - Dongquan Chen
- Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hemant K Tiwari
- Department of Biostatistics, The University of Alabama School of Public Health, Birmingham, AL, USA
| | - Curtis Hendrickson
- Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - William J Britt
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.,Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Fowler
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA
| | - Jake Y Chen
- Informatics Institute, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suresh B Boppana
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA.,Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shannon A Ross
- Department of Pediatrics, The University of Alabama School of Medicine, CHB 116, 1600 6th Avenue South, Birmingham, AL, USA. .,Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
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12
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Berg C, Friis MB, Rosenkilde MM, Benfield T, Nielsen L, Lüttichau HR, Sundelin T. Development of highly efficient protocols for extraction and amplification of cytomegalovirus DNA from dried blood spots for detection and genotyping of polymorphic immunomodulatory genes. PLoS One 2019; 14:e0222053. [PMID: 31513621 DOI: 10.1371/journal.pone.0222053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022] Open
Abstract
Congenital cytomegalovirus (CMV) infection is a major cause of birth defects ranging from developmental disorders to stillbirth. Most newborns affected by CMV do not present with symptoms at birth but are at risk of sequelae at later stages of their childhood. Stored dried blood spots (DBS) taken at birth can be used for retrospective diagnosis of hereditary diseases, but detection of pathogens is challenged by potentially low pathogen concentrations in the small blood volume available in a DBS. Here we test four different extraction methods for optimal recovery of CMV DNA from DBS at low to high CMV titers. The recovery efficiencies varied widely between the different extractions (from 3% to 100%) with the most efficient method extracting up to 113-fold more CMV DNA than the least efficient and 8-fold more than the reference protocol. Furthermore, we amplified four immunomodulatory CMV genes from the extracted DNA: the UL40 and UL111A genes which occur as functional knockouts in some circulating CMV strains, and the highly variable UL146 and US28 genes. The PCRs specifically amplified the CMV genes at all tested titers with sufficient quality for sequencing and genotyping. In summary, we here report an extraction method for optimal recovery of CMV DNA from DBSs that can be used for both detection of CMV and for genotyping of polymorphic CMV genes in congenital CMV infection.
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Sarkar A, Das D, Ansari S, Chatterjee RP, Mishra L, Basu B, Ghosh SK, Bhattacharyay M, Chakraborty N. Genotypes of glycoprotein B gene among the Indian symptomatic neonates with congenital CMV infection. BMC Pediatr 2019; 19:291. [PMID: 31438890 PMCID: PMC6704666 DOI: 10.1186/s12887-019-1666-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/13/2019] [Indexed: 12/28/2022] Open
Abstract
Background Cytomegalovirus [CMV] is a causative agent of congenital infection worldwide and often leads to neurological deficits and hearing loss in newborns. Infants born with symptomatic congenital Cytomegalovirus infection [cCMV] are at significant high risk for developing adverse long-term outcomes. In this study, we look into the sequence variability of surface glycoprotein B [gB] encoding region in newborns with symptomatic CMV infection for the first time in Eastern region of India. Methods 576 suspected newborns from seropositive mothers were subjected to the study and ELISA was used to confirm CMV infection. Different genotypes and their subtypes were determined using multiplex nested-PCR. Viral load of different glycoprotein B [gB] genotypes was measured using RT-PCR. Sequencing and phylogenetic analysis was then performed using Bayesian interference. Results The overall frequency of cCMV infection was 18.4%, where 16.0% neonates were symptomatic. Among the different gB genotypes, gB1 had the highest frequency [23.5%] and gB4 showed the lowest occurrence [5.8%]. 23.5% of symptomatic neonates had mixed genotypes of gB, probably indicating matrenal reinfection with CMV strains in Indian population. Significant genotypic clades [gB1-gB2-gB3-gB5] were grouped closely based on gene sequences, but the gB4 sequence was in the outlier region of the phylogenetic tree indicating the genetic polymorphism. Conclusion This is the first study on cCMV genotyping and its phylogenetic analysis from Eastern Indian neonatal population. The study holds importance in the assessment of cCMV seroprevalence in global perspective. gB protein can be used as a potential therapeutic target against CMV infection.
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Affiliation(s)
- Agniswar Sarkar
- Virus Unit [NICED-ICMR], GB4-1st Floor, ID and BG Hospital, 57, Dr. S. C. Banerjee Road, Beliaghata, Kolkata, West Bengal, 700 010, India.
| | - Dipanwita Das
- Virus Unit [NICED-ICMR], GB4-1st Floor, ID and BG Hospital, 57, Dr. S. C. Banerjee Road, Beliaghata, Kolkata, West Bengal, 700 010, India
| | - Sabbir Ansari
- Virus Unit [NICED-ICMR], GB4-1st Floor, ID and BG Hospital, 57, Dr. S. C. Banerjee Road, Beliaghata, Kolkata, West Bengal, 700 010, India
| | - Rajendra Prasad Chatterjee
- Virus Unit [NICED-ICMR], GB4-1st Floor, ID and BG Hospital, 57, Dr. S. C. Banerjee Road, Beliaghata, Kolkata, West Bengal, 700 010, India
| | - Lopamudra Mishra
- Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, 111, Narkeldanga Mail Road, Phool Bagan, Kankurgachi, Kolkata, West Bengal, 700 054, India
| | - Biswanath Basu
- Department of Pediatric Nephrology, Nil Ratan Sircar Medical College and Hospital, 138, Acharya Jagadish Chandra Bose Road, Sealdah, Kolkata, West Bengal, 700 014, India
| | - Sanat Kumar Ghosh
- Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, 111, Narkeldanga Mail Road, Phool Bagan, Kankurgachi, Kolkata, West Bengal, 700 054, India
| | - Mala Bhattacharyay
- Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, 111, Narkeldanga Mail Road, Phool Bagan, Kankurgachi, Kolkata, West Bengal, 700 054, India
| | - Nilanjan Chakraborty
- Virus Unit [NICED-ICMR], GB4-1st Floor, ID and BG Hospital, 57, Dr. S. C. Banerjee Road, Beliaghata, Kolkata, West Bengal, 700 010, India.
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Alwan SN, Shamran HA, Ghaib AH, Kadhim HS, Al-Mayah QS, AL-Saffar AJ, Bayati AH, Arif HS, Fu J, Wickes BL. Genotyping of Cytomegalovirus from Symptomatic Infected Neonates in Iraq. Am J Trop Med Hyg 2019; 100:957-963. [PMID: 30810104 PMCID: PMC6447132 DOI: 10.4269/ajtmh.18-0152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Among all other viruses, human cytomegalovirus (HCMV) is the most frequent cause of congenital infection worldwide. Strain variation in HCMV may predict severity or outcome of congenital HCMV disease. Previous studies have associated a particular genotype with specific sequelae or more severe illness, but the results were contradictory. There are no previous studies addressing the genotype of HCMV in Iraq. Therefore, the present study is aimed at molecular detection and genotyping of HCMV isolated from symptomatic congenitally/perinatally infected neonates. This prospective study comprised 24 serum samples from symptomatic neonates with congenital/perinatal infection. Viral DNA was extracted from these serum samples; nested polymerase chain reaction was used to amplify the HCMV gB (UL55) gene. Polymerase chain reaction products of the second round of amplification were subjected to direct Sanger sequencing. Bioedit and MEGA5 software (EMBL-EBI, Hinxton, Cambridgeshire, UK) were used for alignment and construction of a phylogenetic tree. Human cytomegalovirus DNA was detected in 23 of 24 samples (95.8%). According to the phylogenetic analysis, three genotypes of the virus were identified; gB1, gB2, and gB3 genotypes. However, the gB4 genotype was not detected. Human cytomegalovirus gB3 was the most frequent genotype: 14 of 24 (58.33%) among symptomatic infected infants, followed by gB1 (6/24; 25%) and gB2 (4/24; 16.67%). A mixed HCMV infection with gB3/gB1 was detected in only one case. Human cytomegalovirus gB3 was the most predominant genotype among symptomatic congenitally/perinatally HCMV-infected neonates. No association was found between B3 genotype and specific clinical presentation. Jaundice was the most common clinical feature among symptomatically infected neonates, followed by hepatosplenomegaly.
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Affiliation(s)
- Sevan N. Alwan
- Department of Biochemistry and Structural Biology, UT Health at San Antonio, San Antonio, Texas
| | - Haidar A. Shamran
- Medical Research Unit, College of Medicine, University of AL-Nahrain, Baghdad, Iraq
| | - Avan H. Ghaib
- Microbiology and Immunology Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq
| | - Haider S. Kadhim
- Microbiology Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Qasim S. Al-Mayah
- Medical Research Unit, College of Medicine, University of AL-Nahrain, Baghdad, Iraq
| | - Atheer J. AL-Saffar
- Community and Family Medicine Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Ali H. Bayati
- Community Health Department, Technical College of Health, Sulaimani Polytechnic University, Sulaymaniyah, Kurdistan Region, Iraq
| | - Hala S. Arif
- Pediatric Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq
| | - Jianmin Fu
- Department of Microbiology, Immunology, and Molecular Genetics, UT Heath at San Antonio, San Antonio, Texas
| | - Brian L. Wickes
- Department of Microbiology, Immunology, and Molecular Genetics, UT Heath at San Antonio, San Antonio, Texas
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Huang Y, Song Q, Guo X, Wang H, Shen H, Wu T, Fu TM, Zhang J. Risk factors associated with the vertical transmission of cytomegalovirus in seropositive pregnant women. Future Virol 2019. [DOI: 10.2217/fvl-2018-0183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Congenital cytomegalovirus infection (cCMV) is the leading cause of childhood disabilities. More recent data indicates that cCMV following maternal nonprimary infection occurs frequently and can cause similar rates of sequelae as those following maternal primary infection. However, the risks associated with cCMV especially in CMV-seropositive women remain unclear. This review summarizes potential risk factors of cCMV in seropositive women with perspectives on the causal link including sociodemographic factors, virological characteristics, the host immune system, genomics, metabonomics and proteomics. These observations and some new molecular markers, although not yet validated as a reliable tool predictive of cCMV, could be the basis for designing future prospective studies.
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Affiliation(s)
- Yue Huang
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Qiaoqiao Song
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xiaoyi Guo
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Han Wang
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Heqing Shen
- Key Lab of Urban Environment & Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Tong-Ming Fu
- Merck Research Laboratories, Merck & Company, Inc., Kenilworth, NJ 07033, USA
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology & Molecular Diagnostics, National Institute of Diagnostics & Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine & Pharmaceutics, School of Public Health, Xiamen University, Xiamen 361102, China
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Correa C, Kourí V, Pérez L, Soto Y, Limia C. Diagnosis, gB genotype distribution and viral load of symptomatic congenitally infected CMV patients in Cuba. J Perinatol 2016; 36:837-42. [PMID: 27309627 DOI: 10.1038/jp.2016.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/08/2016] [Accepted: 05/11/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cytomegalovirus (CMV) is the leading cause of viral congenital infection. Some viral factors have been proposed to be CMV pathogenicity markers. The objective of this study was to investigate the frequency of congenital CMV infection in symptomatic patients and the possible association with the CMV glycoprotein B (gB) genotype and viral load. STUDY DESIGN A total of 361 newborns (NB) and 158 pregnant women (PW) with clinically suspected CMV infection were enrolled. Studied samples included urine, saliva, serum, vaginal swabs and amniotic fluid. CMV infection was diagnosed by multiplex nested PCR. CMV gB genotyping was performed on infected samples, followed by viral load determination. RESULTS Overall, 18.7% of the tested patients were positive for CMV infection, 19.7% of NB were congenitally infected and 16.5% of PW showed active CMV infection. gB-2 was the most prevalent genotype detected (39/97 patients). gB CMV mixed infections were detected in 12 patients. gB-2 was associated with mono-infections (P<0.01). Mixed infections showed higher levels of viral load compared with gB mono-infection (P=0.03). Hepatomegaly, splenomegaly, jaundice, sepsis-like syndrome and malformations were the most prevalent clinical findings. gB-4 was more frequently associated with sepsis-like syndrome than other gB genotypes (P=0.04, odds ratio=4.3, confidence interval: 0.9 to 21.6). The difference in medians of CMV load was statistically significant among patients presenting different clinical signs (P=0.04). CONCLUSIONS This study showed that CMV is a frequent cause of congenital infection in symptomatic Cuban patients. Despite gB2 being the most frequently detected, gB-4 was the only genotype associated with clinical features (sepsis-like syndrome in NB). No other associations among specific genotypes and clinical characteristics were found. Further studies are needed to clarify the role that viral load and genotype play in the outcome of congenital infection.
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Affiliation(s)
- C Correa
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - V Kourí
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - L Pérez
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - Y Soto
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - C Limia
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
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Mujtaba G, Khurshid A, Sharif S, Alam MM, Aamir UB, Shaukat S, Angez M, Rana MS, Umair M, Shah AA, Zaidi SSZ. Distribution of Cytomegalovirus Genotypes among Neonates Born to Infected Mothers in Islamabad, Pakistan. PLoS One 2016; 11:e0156049. [PMID: 27367049 PMCID: PMC4930188 DOI: 10.1371/journal.pone.0156049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 05/09/2016] [Indexed: 01/27/2023] Open
Abstract
Background Congenital cytomegalovirus (cCMV) infection contributes to considerable long-term sequelae in neonates and children all over the world. The association between viral genotypes and severity of clinical cytomegalovirus (CMV) infection is yet to be defined. The objective of this study was to find the impact of active CMV infection during pregnancy and the clinical significance of genotypes in neonates with congenital cytomegalovirus infections in Pakistan. Methods A total of 409 blood samples from pregnant women seeking health care services at the two antenatal hospitals of Islamabad during January to December 2012 were tested by ELISA and nested-PCR. Pregnant women with active infection (detected as IgM positive, PCR positive or positive on both assays) were followed until delivery, to detect the outcome of overt cCMV infection in neonates. Genetic characterization of CMV strains was performed by sequence analysis of envelope glycoproteins: gB, gN and gH to detect the contributing CMV genotypes. Results The seroprevalence of anti-CMV IgG and IgM was 97.5% (399 out of 409) and 12.7% (52 out of 409), respectively, while 20% (82/409) pregnant women were found positive for CMV DNA by PCR. Logistic regression analysis showed a significant association of active infection with parity [OR = 2.56, 95% CI = 1.82–2.62, p = 0.04], febrile illness [OR = 1.84, 95% CI = 1.76–3.65, p = 0.01] and jaundice [OR = 22.5, 95% CI = 4.53–85.02, p = 0.002]. We were able to isolate virus in 41 out of 70 neonates; 36.6% (15 out of 41) of them were symptomatic at birth while 63.4% (26 out of 41) were asymptomatic. The most prominent clinical feature observed in symptomatic neonates was hepatosplenomegaly (26.6%; 4 out of 15). All three genotypes gB, gN and gH were found with the highest frequency of gB1 genotype, found in 75% infants with hepatic damage. Phylogenetic analysis of Pakistani strains showed 96%-100% homology to their prototype strains. Conclusions Active CMV infection during pregnancy is a major cause of congenital CMV infection with comparable distribution of all three genotypes: gB, gN and gH in symptomatic and asymptomatic neonates. Our findings emphasize to conduct a comprehensive large scale survey and introduction of country wide routine screening at maternity clinics for early diagnosis of CMV to reduce its associated devastating outcomes.
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Affiliation(s)
- Ghulam Mujtaba
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Adnan Khurshid
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Salmaan Sharif
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | | | - Uzma Bashir Aamir
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Shahzad Shaukat
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Mehar Angez
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | | | - Massab Umair
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Aamer Ali Shah
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
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Arcangeletti MC, Vasile Simone R, Rodighiero I, De Conto F, Medici MC, Martorana D, Chezzi C, Calderaro A. Combined genetic variants of human cytomegalovirus envelope glycoproteins as congenital infection markers. Virol J 2015; 12:202. [PMID: 26611326 PMCID: PMC4662005 DOI: 10.1186/s12985-015-0428-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/16/2015] [Indexed: 11/22/2022] Open
Abstract
Background Human cytomegalovirus (HCMV) is still considered to be the main viral cause of birth defects and long-term neurological and sensory sequelae following congenital infection. Several Authors sustain a key role of HCMV envelope glycoproteins, such as gB, gN and gO - mainly involved in cell targeting, viral penetration and spread - as putative virulence factors. The genes coding for these glycoproteins possess hypervariable regions, resulting in a number of genetic variants in circulating clinical strains. Considering that the genetic polymorphisms underlying the specific differences between gB, gN and gO genotypes can influence the ability of HCMV to preferentially target specific host cells, it is very likely that they play an important role in defining HCMV infection outcome. In the present study, we analysed HCMV gB, gN and gO gene polymorphisms in viral strains isolated from paediatric patients with congenital or post-natal infection, to investigate whether specific genetic variants may be associated with congenital infection. Methods The restriction fragment polymorphisms of genes coding for HCMV gB (UL55), gN (UL73) and gO (UL74) were investigated by analysing viral DNA extracted from 40 urine samples of as many paediatric patients with congenital or post-natal HCMV infection. Randomly selected samples were subjected to DNA sequencing and phylogenetic analysis. Statistical analysis was performed using Fisher’s exact test to assess the significance of single and combined glycoprotein genotypes frequency distribution. Statistical significance was considered at a P <0.05. Results While gB genomic variants were quite homogeneously represented in both paediatric groups, the gN4 genotype significantly prevailed in congenitally infected children (89.5 %) vs post-natally infected children (47.6 %), with a predominance of the gN4c variant (47.4 %). A similar trend was observed for gO3 (52.6 % vs 19 %). Concerning genotypes association, a statistically significant (P = 0.037) gN4-gO3 combination was found specifically in the congenitally infected group. Conclusions The results indicate that the gN4 (mostly the gN4c variant) and gO3 combined genotypes could provide useful markers of congenital infection and represent suitable candidate molecules for prophylactic vaccine preparations.
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Affiliation(s)
- Maria-Cristina Arcangeletti
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Rosita Vasile Simone
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Isabella Rodighiero
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Flora De Conto
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Maria-Cristina Medici
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Davide Martorana
- Unit of Molecular Genetics, University-Hospital of Parma, Parma, Italy.
| | - Carlo Chezzi
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Adriana Calderaro
- Unit of Microbiology and Virology - Department of Clinical and Experimental Medicine, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
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Paradowska E, Studzińska M, Suski P, Kasztelewicz B, Wiśniewska-Ligier M, Zawilińska B, Gaj Z, Nowakowska D. Human cytomegalovirus UL55, UL144, and US28 genotype distribution in infants infected congenitally or postnatally. J Med Virol 2015; 87:1737-48. [DOI: 10.1002/jmv.24222] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Edyta Paradowska
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Mirosława Studzińska
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Patrycja Suski
- Laboratory of Molecular Virology and Biological Chemistry; Institute of Medical Biology; Polish Academy of Sciences; Lodz Poland
| | - Beata Kasztelewicz
- Department of Clinical Microbiology and Immunology; The Children's Memorial Health Institute; Warsaw Poland
| | | | - Barbara Zawilińska
- Department of Virology; Jagiellonian University Medical College; Cracow Poland
| | - Zuzanna Gaj
- Department of Fetal-Maternal Medicine and Gynaecology; Polish Mother's Memorial Hospital Research Institute; Lodz Poland
| | - Dorota Nowakowska
- Department of Fetal-Maternal Medicine and Gynaecology; Polish Mother's Memorial Hospital Research Institute; Lodz Poland
- Department of Fetal-Maternal Medicine and Gynaecology; 3rd Chair of Gynaecology and Obstetrics; Medical University; Lodz Poland
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Rycel M, Wujcicka W, Zawilińska B, Paradowska E, Suski P, Gaj Z, Wilczyński J, Leśnikowski Z, Nowakowska D. Mixed infections with distinct cytomegalovirus glycoprotein B genotypes in Polish pregnant women, fetuses, and newborns. Eur J Clin Microbiol Infect Dis 2015; 34:585-91. [PMID: 25348608 DOI: 10.1007/s10096-014-2266-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/15/2014] [Indexed: 12/24/2022]
Abstract
The purpose of this investigation was to describe a distribution of cytomegalovirus (CMV) single and multiple genotypes among infected pregnant women, their fetuses, and newborns coming from Central Poland, as well as congenital cytomegaly outcome. The study involved 278 CMV-seropositive pregnant women, of whom 192 were tested for viral DNAemia. Human cytomegalovirus (HCMV) genotyping was performed for 18 of 34 pregnant women carrying the viral DNA and for 12 of their 15 offspring with confirmed HCMV infections. Anti-HCMV antibodies levels were assessed by chemiluminescence immunoassay (CLIA) and enzyme-linked fluorescence assay (ELFA) tests. Viral DNA loads and genotypes were determined by real-time polymerase chain reaction (PCR) assays for the UL55 gene. In the pregnant women, we identified HCMV gB1, gB2, gB3, and gB4 genotypes. Single gB2, gB3, or gB4 genotypes were observed in 14 (77.8 %) women, while multiple gB1–gB2 or gB2–gB3 genotypes were observed in four (22.2 %). Maternal HCMV genotypes determined the genotypes identified in their fetuses and newborns (p ≤ 0.050). Half of them were infected with single HCMV gB1, gB2, or gB3 genotypes and the other half with multiple gB1–gB2 or gB2–gB3 genotypes. Single and multiple genotypes were observed in both asymptomatic and symptomatic congenital cytomegaly, although no gB3 genotype was identified among asymptomatic cases. In Central Poland, infections with single and multiple HCMV strains occur in pregnant women, as well as in their fetuses and neonates, with both asymptomatic and symptomatic infections. HCMV infections identified in mothers seem to be associated with the viral genotypes in their children.
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Nijman J, Mandemaker FS, Verboon-Maciolek MA, Aitken SC, van Loon AM, de Vries LS, Schuurman R. Genotype distribution, viral load and clinical characteristics of infants with postnatal or congenital cytomegalovirus infection. PLoS One 2014; 9:e108018. [PMID: 25268349 DOI: 10.1371/journal.pone.0108018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 08/17/2014] [Indexed: 11/19/2022] Open
Abstract
Background Congenital cytomegalovirus infection is a leading cause of long-term sequelae. Cytomegalovirus is also frequently transmitted to preterm infants postnatally, but these infections are mostly asymptomatic. A correlation between cytomegalovirus genotypes and clinical manifestations has been reported previously in infants with congenital infection, but not in preterm infants with postnatal infection. Objectives The main objective of this study was to investigate cytomegalovirus genotype distribution in postnatal and congenital cytomegalovirus infection and its association with disease severity. Methods Infants admitted to the neonatal intensive care unit of the University Medical Center Utrecht, The Netherlands between 2003–2010 and diagnosed with postnatal or congenital cytomegalovirus infection were included. Classification of cytomegalovirus isolates in genotypes was performed upon amplification and sequencing of the cytomegalovirus UL55 (gB) and UL144 genes. Clinical data, cerebral abnormalities, neurodevelopmental outcome and viral load were studied in relation to genotype distribution. Results Genotyping results were obtained from 58 preterm infants with postnatal cytomegalovirus infection and 13 infants with congenital cytomegalovirus infection. Postnatal disease was mild in all preterm infants and all had favourable outcome. Infants with congenital infection were significantly more severely affected than infants with postnatal infection. Seventy-seven percent of these infants were symptomatic at birth, 2/13 died and 3/13 developed long-term sequelae (median follow-up 6 (range 2–8) years). The distribution of cytomegalovirus genotypes was comparable for postnatal and congenital infection. UL55 genotype 1 and UL144 genotype 3 were predominant genotypes in both groups. Conclusions Distribution of UL55 and UL144 genotypes was similar in asymptomatic postnatal and severe congenital CMV infection suggesting that other factors rather than cytomegalovirus UL55 and UL144 genotype are responsible for the development of severe disease.
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Fu X, Li L, Huang C, Li X, Wang H, Xie Z, Chen Z. Polymorphism of human cytomegalovirus (HCMV) UL144 gene in low passage clinical isolates. Chin Sci Bull 2014. [DOI: 10.1007/s11434-014-0353-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Paradowska E, Jabłońska A, Płóciennikowska A, Studzińska M, Suski P, Wiśniewska-Ligier M, Dzierżanowska-Fangrat K, Kasztelewicz B, Woźniakowska-Gęsicka T, Leśnikowski ZJ. Cytomegalovirus alpha-chemokine genotypes are associated with clinical manifestations in children with congenital or postnatal infections. Virology 2014; 462-463:207-17. [PMID: 24999045 DOI: 10.1016/j.virol.2014.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/10/2014] [Accepted: 06/17/2014] [Indexed: 01/29/2023]
Abstract
Human cytomegalovirus (HCMV) is the leading cause of congenital infections. The aim of our study was to determine the prevalence of genotypes based on the highly polymorphic UL146 and UL147 HCMV genes and the relationship between the genotype and symptoms or viral load. We analyzed samples from 121 infants with symptomatic HCMV infection, including 32 congenitally infected newborns. The G7 and G5 genotypes were predominant in postnatal infection, whereas the G1 genotype was prevalent in congenital infection. Central nervous system (CNS) damage and hepatomegaly were detected more frequently among children infected with the G1 genotype than in those infected by other genotypes. An association between the viral genotype and viruria level was found. There was a strong correlation between HCMV genotypes determined through the UL146 and UL147 sequences (ĸ=0.794). In conclusion, we found that certain vCXCL genotypes are associated with clinical sequelae following HCMV infection.
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Affiliation(s)
- Edyta Paradowska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland.
| | - Agnieszka Jabłońska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | - Agnieszka Płóciennikowska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | - Mirosława Studzińska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | - Patrycja Suski
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | | | | | - Beata Kasztelewicz
- Department of Clinical Microbiology and Immunology, The Children׳s Memorial Health Institute, Warsaw, Poland
| | | | - Zbigniew J Leśnikowski
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
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Sharma A, Jaiswal S, Shukla M, Lal J. Dried blood spots: Concepts, present status, and future perspectives in bioanalysis. Drug Test Anal 2014; 6:399-414. [DOI: 10.1002/dta.1646] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 01/14/2023]
Affiliation(s)
- Abhisheak Sharma
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Swati Jaiswal
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Mahendra Shukla
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Jawahar Lal
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
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Paradowska E, Jabłońska A, Studzińska M, Kasztelewicz B, Zawilińska B, Wiśniewska-Ligier M, Dzierżanowska-Fangrat K, Woźniakowska-Gęsicka T, Kosz-Vnenchak M, Leśnikowski ZJ. Cytomegalovirus glycoprotein H genotype distribution and the relationship with hearing loss in children. J Med Virol 2014; 86:1421-7. [PMID: 24615599 DOI: 10.1002/jmv.23906] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2014] [Indexed: 01/29/2023]
Abstract
Cytomegalovirus (CMV) is a leading cause of congenital infection and a leading infectious cause of hearing loss in children. The ORF UL75 gene encodes envelope glycoprotein H (gH), which is essential for CMV entry into host cells and the target of the immune response in humans. However, the distribution of gH variants and the relationship between the viral genotype, viral load, and sequelae in children infected with CMV is debated. The UL75 genetic variation of CMV isolates from 42 newborns infected congenitally with CMV and 93 infants with postnatal or unproven congenital CMV infection was analyzed. Genotyping was performed by analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR. There were no differences in the distribution of gH genotypes in the children infected congenitally and postnatally. Mixed-genotype infections with both gH1 and gH2 variants were detected in approximately 25% of the examined patients. No relationship between UL75 gene polymorphisms and the symptoms at birth was observed. The results suggest that the infection with gH2 genotype diminishes the risk of hearing loss in children (P = 0.010). In addition, sensorineural hearing loss was associated with CMV gH1 genotype infection in infants (P = 0.032) and a high viral load in urine (P = 0.005). In conclusion, it was found that the gH genotype does not predict clinical sequelae in newborn infants following congenital CMV infection. However, these results suggest that the gH genotype might be associated with hearing loss in children.
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Affiliation(s)
- Edyta Paradowska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
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Vives-Oñós I, Soler-Palacín P, Codina-Grau MG, Martín-Nalda A, López-Galera RM, Marín-Soria JL, Figueras-Nadal C. [Can we rule out a congenital cytomegalovirus infection when the result of polymerase chain reaction in dried blood spots is negative?]. Enferm Infecc Microbiol Clin 2014; 32:570-3. [PMID: 24268671 DOI: 10.1016/j.eimc.2013.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/24/2013] [Accepted: 09/27/2013] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The detection of cytomegalovirus (CMV) DNA by real time polymerase chain reaction (rt-PCR) in dried blood spots collected routinely for metabolic screening has been assessed for the retrospective diagnosis of congenital CMV (cCMV) infection in many studies, but not in Spain. The aim of this study is to analyze the diagnostic accuracy of this technique in our hospital. METHODS A cross-sectional retrospective observational study was conducted including all patients born between January, 2007 and September, 2012 with confirmed cCMV infection. The assessment of CMV DNA was made by using rt-PCR in dried blood spots of these patients. RESULTS Fourteen patients were included: 4/14 were symptomatic and 4/14 had sequelae. The detection of CMV DNA by rt-PCR was positive in only 7 patients. A statistically significant relationship between low viral load at birth and negative rt-PCR in dried blood spots was demonstrated. CONCLUSIONS Despite the low number of patients included, our data highlight an important amount of false negative results in the DNA CMV detection by rt-PCR in these samples for the retrospective diagnosis of cCMV infection, especially in cases with low viral load at birth.
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Paradowska E, Jabłońska A, Studzińska M, Suski P, Kasztelewicz B, Zawilińska B, Wiśniewska-Ligier M, Dzierżanowska-Fangrat K, Woźniakowska-Gęsicka T, Czech-Kowalska J, Lipka B, Kornacka M, Pawlik D, Tomasik T, Kosz-Vnenchak M, Leśnikowski ZJ. Distribution of cytomegalovirus gN variants and associated clinical sequelae in infants. J Clin Virol 2013; 58:271-5. [PMID: 23806667 DOI: 10.1016/j.jcv.2013.05.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 04/25/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Human cytomegalovirus (HCMV) is the most widespread cause of congenital infection. The effects of various viral strains and viral loads on the infection outcome have been under debate. OBJECTIVES To determine the distribution of gN variants in HCMV strains isolated from children with congenital or postnatal infection and to establish the relationship between the viral genotype, the viral load, and the sequelae. STUDY DESIGN The study population included congenitally HCMV-infected newborns and children with postnatal or unproven congenital HCMV infection. The genotyping was performed by RFLP analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR. RESULTS Our results demonstrated that the HCMV genotypes gN3b, gN4b, and gN4c were prevalent in the patients examined. There were no differences in the distributions of gN genotypes in the congenitally and postnatally infected children. Multiple HCMV strains were detected in both groups of children. A significant association between the HCMV gN4 genotype and the incidence of neurological disorders was observed (p=0.045). Our results suggest that the detection of the gN2 or the gN4 genotype may be indicative of serious manifestations in children. In contrast, the gN3b and the gN1 genotypes represent less pathogenic HCMV strains. The HCMV load in urine was significantly higher in children with congenital infection compared with children with postnatal infection. No correlation was found between the viral load and the genotype. CONCLUSION Our results suggest that the gN genotype may be a virological marker of symptomatic HCMV infection in newborns.
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Affiliation(s)
- Edyta Paradowska
- Laboratory of Molecular Virology and Biological Chemistry, Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland.
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de Vries JJC, Vesseur A, Rotteveel LJC, Korver AMH, Rusman LG, Wessels E, Kroes ACM, Mylanus EA, Oudesluys-Murphy AM, Frijns JHM, Vossen ACTM. Cytomegalovirus DNA detection in dried blood spots and perilymphatic fluids from pediatric and adult cochlear implant recipients with prelingual deafness. J Clin Virol 2012; 56:113-7. [PMID: 23141930 DOI: 10.1016/j.jcv.2012.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/17/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is the leading cause of non-genetic congenital hearing loss. The contribution of congenital CMV to prelingual deafness and the pathophysiology is largely unknown. OBJECTIVE (1) To analyze the prevalence of congenital CMV among cochlear implant (CI) recipients with prelingual deafness. (2) To genotype CMV present in dried blood spots (DBS) and in the inner ear years after birth. STUDY DESIGN Children and adults with prelingual deafness who received a CI in 2010-2011 were included prospectively. Perilymphatic fluids were collected during CI surgery and, in the pediatric cases, DBS were retrieved for CMV DNA detection. Furthermore, a cohort of children with prelingual deafness who received a CI between 2003 and 2008 were included retrospectively. CMV detection in DBS and perilymph was followed by gB and gH genotyping. RESULTS Seventysix pediatric CI recipients were included. Seventy DBS were tested for CMV DNA, resulting in a prevalence of congenital CMV of 14% (10/70). Perilymphatic fluid was available from 29 pediatric CI recipients. One perilymph fluid, of a 21-month old girl with congenital CMV, asymptomatic at birth, was CMV DNA positive. The CMV strain in the perilymph was genotypically identical to the strain present in her DBS (gB1/gH2). Perilymph samples from 21 adult CI recipients were CMV DNA negative. CONCLUSIONS Our study stresses the important contribution of congenital CMV among pediatric CI recipients. Furthermore, our genotyping data support the hypothesis that CMV-related hearing loss is associated with ongoing viral replication in the inner ear up to years after birth.
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Affiliation(s)
- Jutte J C de Vries
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
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Gandhoke I, Hussain SA, Pasha ST, Chauhan LS, Khare S. Glycoprotein B genotyping in congenital/perinatal Cytomegalovirus infection in symptomatic infants. Indian Pediatr 2012; 50:663-7. [PMID: 23255693 DOI: 10.1007/s13312-013-0199-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 10/31/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Molecular epidemiological studies on circulating strains of CMV in cogenital/perinatal infections have not been done earlier in this region. OBJECTIVE To study the glycoprotein B genotypes in babies with symptomatic congenital/perinatal CMV infection and to assess the possible influence of genotype on the outcome of the infection. METHODS Clinical samples (blood and urine) of symptomatic babies are sent to the Virology Department of NCDC, Delhi for the diagnosis of congenital infections. 375 clinical samples of infants (newborn - 6 months old) were included for the study. Serum samples were subjected to ELISA for detection of IgM antibodies against CMV. DNA isolation and amplification of CMV genomic DNA targeting gB gene fragment by nested PCR, was carried out in the samples. The amplified fragment including the cleavage site was subjected to RFLP using restriction enzymes Rsal and Hinf1. They were also verified by sequencing using Big Dye Terminator chemistry. RESULTS 75 samples out of 375 tested were confirmed positive for CMV infection by serology and PCR. Both RFLP and sequencing of gB gene fragment showed that gB 1, 2 and 3 genotypes were in circulation. gB 3 was the most prevalent genotype in symptomatic infants. Hepatosplenomegaly was the most common feature in gB-3 genotype of CMV. gB2 congenital CMV infection was more commonly associated with long term sequelae.
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Affiliation(s)
- Inderjeet Gandhoke
- Department of Microbiology, National Centre for Disease Control, (NCDC) 22 Shamnath Marg, India
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de Vries JJ, Wessels E, Korver AM, van der Eijk AA, Rusman LG, Kroes AC, Vossen AC. Rapid genotyping of cytomegalovirus in dried blood spots by multiplex real-time PCR assays targeting the envelope glycoprotein gB and gH genes. J Clin Microbiol 2012; 50:232-7. [PMID: 22116158 DOI: 10.1128/JCM.05253-11] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Genotyping of cytomegalovirus (CMV) is useful to examine potential differences in the pathogenicity of strains and to demonstrate coinfection with multiple strains involved in CMV disease in adults and congenitally infected newborns. Studies on genotyping of CMV in dried blood spots (DBS) are rare and have been hampered by the small amount of dried blood available. In this study, two multiplex real-time PCR assays for rapid gB and gH genotyping of CMV in DBS were developed. Validation of the assays with 39 CMV-positive plasma samples of transplant recipients and 21 urine specimens of congenitally infected newborns was successful in genotyping 100% of the samples, with gB1 and gB3 being the most prevalent genotypes. Multiple gB and gH genotypes were detected in 36% and 33% of the plasma samples, respectively. One urine sample from a newborn with symptomatic congenital CMV was positive for gB1 and gB2. DBS of congenitally infected newborns (n = 41) were tested using 9 μl of dried blood, and genotypes were detected in 81% (gB) and 73% (gH) of the samples, with gB3 being the most prevalent genotype. No clear association of specific genotypes with clinical outcome was observed. In conclusion, the CMV gB and gH PCR assays were found to be rapid, sensitive for detecting mixed infections, and suitable for direct usage on DBS. These assays are efficient tools for genotyping of CMV in DBS of congenitally infected newborns.
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Ross SA, Novak Z, Pati S, Patro RK, Blumenthal J, Danthuluri VR, Ahmed A, Michaels MG, Sánchez PJ, Bernstein DI, Tolan RW, Palmer AL, Britt WJ, Fowler KB, Boppana SB. Mixed infection and strain diversity in congenital cytomegalovirus infection. J Infect Dis 2011; 204:1003-7. [PMID: 21881114 DOI: 10.1093/infdis/jir457] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV), the most common cause of congenital infection, exhibits extensive genetic variability. We sought to determine whether multiple CMV strains can be transmitted to the fetus and to describe the distribution of genotypes in the saliva, urine, and blood. METHODS Study subjects consisted of a convenience sampling of 28 infants found to be CMV-positive on newborn screening as part of an ongoing study. Genotyping was performed on saliva specimens obtained during newborn screening and urine, saliva, and blood obtained at a later time point within the first 3 weeks of life. RESULTS Six (21.4%) of the 28 saliva samples obtained within the first 2 days of life contained >1 CMV genotype. Multiple CMV genotypes were found in 39% (5/13) of urine, saliva, and blood samples obtained within the first 3 weeks of life from 13 of the 28 newborns. There was no predominance of a CMV genotype at a specific site; however, 4 infants demonstrated distinct CMV strains in different compartments. CONCLUSIONS Infection with multiple CMV strains occurs in infants with congenital CMV infection. The impact of intrauterine infection with multiple virus strains on the pathogenesis and long-term outcome remains to be elucidated.
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Affiliation(s)
- Shannon A Ross
- Department of Pediatrics, University of Alabama, Birmingham, AL 35233, USA.
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Paradowska E, Studzińska M, Nowakowska D, Wilczyński J, Rycel M, Suski P, Gaj Z, Kaczmarek B, Zbróg Z, Leśnikowski ZJ. Distribution of UL144, US28 and UL55 genotypes in Polish newborns with congenital cytomegalovirus infections. Eur J Clin Microbiol Infect Dis 2011; 31:1335-45. [PMID: 22048843 DOI: 10.1007/s10096-011-1447-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 10/01/2011] [Indexed: 12/23/2022]
Abstract
Human cytomegalovirus (HCMV) is the most common congenital infection. HCMV strains display genetic variability in different regions. Distribution of HCMV genotypes in the population of congenitally infected newborns from Central Poland and viral load in newborns' blood is described and discussed. HCMV isolates were analysed by sequencing at three sites on the genome: the UL144 tumour necrosis factor-alpha (TNFα)-like receptor gene, the US28 beta-chemokine receptor gene and the UL55 envelope glycoprotein B (gB) gene. The newborns' blood was examined for HCMV DNA with a nested (UL144, UL55) or heminested (US28) polymerase chain reaction, and the genotypes were determined by sequence analysis. HCMV DNA was detectable in 25 out of 55 examined newborns born by HCMV-infected mothers (45.5%). The blood viral load in mother-infant pairs was determined. Most of the newborns had identical virus genotype, gB2 (96%), UL144 B1 (88%) and US28 A2 (84%). These genotypes were detected in all newborns with asymptomatic congenital infection. The occurrence of UL144 B1 or US28 A2 genotypes in the babies examined was significant in comparison to other genotypes (p=0.0002 and p=0.040 respectively). There was no association between specific gB subtypes in all patients groups (p=0.463). There was no correlation between HCMV genotypes and the outcome.
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Affiliation(s)
- E Paradowska
- Institute of Medical Biology, Polish Academy of Sciences, Laboratory of Molecular Virology and Biological Chemistry, Lodowa 106, 93-232, Lodz, Poland.
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Wu KG, Hung MC, Chang YT, Chen CJ, Yang SP, Liu CY, Ho DMT, Chan YJ. Occurrence of human cytomegalovirus glycoprotein B genotypes in immunocompetent and immunosuppressed Taiwanese patients. Intervirology 2011; 54:196-201. [PMID: 21242663 DOI: 10.1159/000322382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 10/25/2010] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate the differences of genotypic distributions among isolates between immunosuppressed and immunocompetent patients in a Taiwanese population. METHODS Human cytomegalovirus (HCMV) isolates from 76 patients with adequate chart data were analyzed. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to define gB genotypes which include gB1 to gB4. The clinical data of the 76 patients were retrospectively collected by chart review and classified into an immunosuppressed (n = 32) or immunocompetent (n = 44) group. RESULTS Among the 32 immunosuppressed patients, the most commonly identified HCMV genotypes were gB1 (27/32, 84.3%) and gB3 (4/32, 12.5%). 59.1% (26/44) of the immunocompetent patients were infected by gB1 while 38.6% (17/44) of them were infected by gB3. The frequency of gB1 infection in the immunosuppressed group was significantly higher than that in the immunocompetent group (p = 0.025). However, there was no statistically significant difference between gB1 and gB3 distributions by clinical diagnosis within each group. CONCLUSIONS Only gB1 and gB3 genotypes were identified in this Taiwanese population. Although there is no significant difference between clinical diagnosis and gB genotyping, gB1 infection is significantly more predominant in immunosuppressed patients.
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Affiliation(s)
- Keh-Gong Wu
- Department of Pediatrics, Taipei Veterans General Hospital, Taiwan, ROC. yjchan @ vghtpe.gov.tw
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Abstract
Congenital cytomegalovirus (CMV) infection occurs in 0.6-0.7% of all newborns and is the most prevalent infection-related cause of congenital neurological handicap. Vertical transmission occurs in around 30% of cases, but the fetus is not always affected. Symptomatic newborns at birth have a much higher risk of suffering severe neurological sequelae. Detection of specific IgG and IgM and IgG avidity seem to be the most reliable tests to identify a primary infection but interpretation in a clinical context may be difficult. If a seroconversion is documented or a fetal infection is suspected by ultrasound markers, an amniocentesis should be performed to confirm a vertical transmission. In the absence of a confirmed fetal infection with fetal structural anomalies, a pregnancy termination should be discouraged. Fetal prognosis is mainly correlated to the presence of brain damage. Despite promising results with the use of antiviral drugs and CMV hyperimmune globulin (HIG), results have to be interpreted with caution. Pregnant women should not be systematically tested for CMV during pregnancy. Managing CMV screening should be restricted to pregnancies where a primary infection is suspected or among women at high risk. The magnitude of congenital CMV disease and the value of interventions to prevent its transmission or to decrease the sequelae need to be established before implementing public health interventions. In this paper, aspects of CMV infection in the pregnant woman and her infant are reviewed.
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Affiliation(s)
- Oriol Coll
- Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Abstract
The aim is to investigate the spectrum of disease in 378 infants with human cytomegalovirus infection. In these patients, 27.78% were systemic infection and 72.22% involved single organ infection. Hepatitis, thrombocytopenic purpura, pneumonia were predominant with 33.07%, 13.49%, 6.35% respectively. The rate of HCMV systemic infection in infants younger than 2 weeks was higher than in those older than 2 weeks. The gB genotype analysis in 107 cases showed 53 gBI, 20 gBII, 18 gBIII, 7 gBI+gBII, 5 gBI+gBIII and 4 gBII+gBIII. These results suggest that HCMV can infect multiorgan and has varietal clinic feature. The gBI genotype is most prevalent.
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Affiliation(s)
- Zheng Shen
- The Children's Hospital of Zhejiang University School of Medicine and Zhejiang Key Laboratory for Diagnosis and Therapy of Neonatal Diseases
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36
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Choi KY, Schimmenti LA, Jurek AM, Sharon B, Daly K, Khan C, McCann M, Schleiss MR. Detection of cytomegalovirus DNA in dried blood spots of Minnesota infants who do not pass newborn hearing screening. Pediatr Infect Dis J 2009; 28:1095-8. [PMID: 19820425 DOI: 10.1097/inf.0b013e3181af6230] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Up to 15% of infants with asymptomatic congenital cytomegalovirus (CMV) infection will experience some degree of sensorineural hearing loss. Many infants who fail newborn hearing screening (NHS) are likely to have congenital CMV infection, but may escape definitive virologic identification because diagnostic evaluation may not commence until several weeks or months of age, making differentiation between congenital and postnatal CMV infection difficult. Early diagnosis linking virologic identification of congenital CMV infection to infants failing NHS may improve diagnostic precision and enhance opportunities for therapeutic intervention. METHODS The goal of this study was to compare newborn dried blood spots from Minnesota infants who had failed NHS, and were designated for referral, with control infants who passed NHS, for the presence of CMV DNA by real-time PCR, using hybridization probes for the CMV gene UL54. RESULTS Of 479 infants with a failed NHS (bilateral failure), 13 had CMV DNA present in the blood spot (2.7%). This compared with only 2/479 positive results from a control group of infants who passed the NHS (0.4%; P = 0.007, Fisher exact test). Comparisons of the glycoprotein B (gB) genotype as well as direct DNA sequencing of selected positives revealed that PCR positive samples represented unique clinical isolates. The mean viral load among the 15 positive samples was 1.6 x 10(3) genomes/microgram of total DNA. CONCLUSIONS Newborn bloodspot CMV screening by real-time PCR may be a useful and rapid adjunct to functional NHS and may enable more rapid etiologic diagnosis of sensorineural hearing loss in newborns.
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Affiliation(s)
- K Yeon Choi
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455-0374, USA
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37
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Goossens VJ, Wolffs PF, van Loo IH, Bruggeman CA, Verbon A. CMV DNA levels and CMV gB subtypes in ART-naive HAART-treated patients: a 2-year follow-up study in The Netherlands. AIDS 2009; 23:1425-9. [PMID: 19531930 DOI: 10.1097/QAD.0b013e32832c165c] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In the pre-HAART period, HIV-1 patients were greatly at risk for cytomegalovirus (CMV) disease. In HAART-treated patients, the incidence of CMV disease has decreased dramatically and the timing and presentation of CMV infection may be different. Also the relevance of different CMV genotypes is part of debate. DESIGN AND METHODS A total of 132 antiretroviral naive patients starting HAART were selected for a 2-year follow-up study in the Netherlands. RESULTS In 105 (80%) patients, CMV DNA were less than 100 copies/ml in all plasma samples during follow-up. In 27 (20%) patients, a detectable CMV load was found during follow-up. In seven patients, the initial decrease in HIV-1 loads during HAART was accompanied by an increase in CMV loads. Of 1348 plasma samples, only 50 (3.7%) samples were positive with a CMV load more of than 100 copies/ml plasma. CMV loads more than 1000 copies/ml were found only in samples with CD4 levels less than 250 x 10 cells/l and with detectable HIV-1 loads. CMV glycoprotein B (gB) typing was possible in 19 patients. Among these patients, including four patients with triple CMV infection and seven patients with double infection, the most prevalent genotype was gB3 (16x) followed by gB2 (9x), gB1 (5x) and gB4 (4x). CONCLUSION CMV disease during HAART is very unlikely as soon as the HIV-1 viral load becomes undetectable (<50 copies/ml) and/or CD4 cell levels are restored to more than 250 x 10 cells/l. Within Dutch HAART treated patients, infection with CMV gB3 is most prevalent, but also double or triple infection with other CMV gB strains are common.
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38
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Abstract
This study investigated human cytomegalovirus (HCMV) glycoprotein genotypes in the genital tract tissue of 125 tubal pregnancy patients. The HCMV glycoprotein-B N-terminus (gBn, 54 - 485 NT), gB endoprotease cleavage site (gBclv, 1284 - 1600 NT) and glycoproteinH (gH, -58 - 213 NT) gene fragments were amplified by nested polymerase chain reaction and sequenced to identify gB and gH genotypes. Of 16 gBn-positive samples, four were gBn1, one was gBn2 and 11 were the gBn3 genotype. Of 13 positive gBclv samples, seven were gBclv1, two were gBclv2 and four were the gBclv3 genotype. Of 20 positive gH samples, 10 were gH1, six were gH2 and four were a combined gH1/gH2 genotype. In 10 of the samples that were positive for the gBn and gBclv genotypes, the gBn and gBclv genotypes were not consistent (four were gBclv1-gBn3). This study showed that: (i) HCMV infection with the gB1 - gB3 glycoprotein genotypes is present in tubal pregnancy; (ii) the gBclv and gBn genotypes are not strictly consistent; and (iii) intragenetic variability within the gB gene due to homologous recombination occurs frequently.
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Affiliation(s)
- H-L Qian
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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39
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Yan H, Koyano S, Inami Y, Yamamoto Y, Suzutani T, Mizuguchi M, Ushijima H, Kurane I, Inoue N. Genetic linkage among human cytomegalovirus glycoprotein N (gN) and gO genes, with evidence for recombination from congenitally and post-natally infected Japanese infants. J Gen Virol 2008; 89:2275-2279. [DOI: 10.1099/vir.0.83685-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Investigation of sequence polymorphisms in the glycoprotein N (gN; gp4273), gO (gp4274) and gH (gp4275) genes of human cytomegalovirus (HCMV) strains collected from 63 Japanese children revealed that their gO genotype distribution differed slightly from that of Caucasian populations and that there was a significant linkage between the gN and gO genotypes. Linkage of these genotypes in strains obtained from Caucasian populations has been reported, so our similar findings in Japanese infants are consistent with this, and suggest generality of this linkage. Sequence analysis suggests that recombination between two strains of different linkage groups occurred approximately 200 bp upstream of the 3′-end of the gO gene. Further studies are required to elucidate differences in biological characteristics among the linkage groups and the selective constraints that maintain the linkage.
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Affiliation(s)
- Hainian Yan
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shin Koyano
- Department of Pediatrics, Asahikawa Medical College, Hokkaido, Japan
| | - Yuhki Inami
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yumiko Yamamoto
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tatsuo Suzutani
- Department of Microbiology, Fukushima Medical University, Fukushima, Japan
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroshi Ushijima
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Ichiro Kurane
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naoki Inoue
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
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Revello MG, Campanini G, Piralla A, Furione M, Percivalle E, Zavattoni M, Gerna G. Molecular epidemiology of primary human cytomegalovirus infection in pregnant women and their families. J Med Virol 2008; 80:1415-25. [PMID: 18551604 DOI: 10.1002/jmv.21243] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The source of human cytomegalovirus (HCMV) infection was investigated in 29 pregnant women with primary HCMV infection by comparing DNA sequences of UL146, UL144 and a portion of UL55 gene of HCMV strains circulating within each family. Thirteen families were identified in which the pregnant woman, the husband and/or a child were shedding HCMV. In three of these families, both the woman and the husband suffered from a concomitant primary HCMV infection. Phylogenetic analysis of UL146, UL144, and UL55 genes indicated that strains circulating within each family were identical, whereas strains from different families appeared to be distinct. However, identical UL146, UL144, and UL55 DNA sequences were observed sporadically among unrelated strains. A child rather than the husband was the virus source for the great majority of pregnant women. No association was observed between UL144 polymorphisms and intrauterine transmission.
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Affiliation(s)
- Maria Grazia Revello
- Servizio di Virologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.
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41
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Benoist G, Jacquemard F, Leruez-ville M, Ville Y. Infection congénitale à Cytomégalovirus (CMV). ACTA ACUST UNITED AC 2008; 36:248-60. [DOI: 10.1016/j.gyobfe.2008.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Accepted: 01/21/2008] [Indexed: 12/20/2022]
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42
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Yan H, Koyano S, Inami Y, Yamamoto Y, Suzutani T, Mizuguchi M, Ushijima H, Kurane I, Inoue N. Genetic variations in the gB, UL144 and UL149 genes of human cytomegalovirus strains collected from congenitally and postnatally infected Japanese children. Arch Virol 2008; 153:667-74. [PMID: 18273679 DOI: 10.1007/s00705-008-0044-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 01/28/2008] [Indexed: 12/15/2022]
Abstract
Human cytomegalovirus (CMV) is the leading cause of intrauterine viral infection. The association of genetic polymorphisms in some particular genes with the incidence and severity of congenital infection has been controversial. To address this issue, we analyzed the genotypes of the glycoprotein B (gB), UL144 and UL149 genes of CMV clinical strains obtained from 33 congenitally and 31 postnatally infected Japanese children. Our results demonstrated that (1) CMV strains with any combination of genotypes could be vertically transmitted from mother to fetus, potentially causing neurological abnormalities, (2) the gB3 genotype was more prevalent in the congenital cases than in postnatally infected children (P < 0.05), particularly in congenital cases with sensorineural hearing loss (P = 0.009), (3) there was no relationship between gB genotype and viral load in the urine and dried umbilical cord specimens in the congenital cases, and (4) the UL144 and UL149 genotype distributions had no bias for congenial infection. In future studies, it would be interesting to see whether the gB genotypes serve as a prognostic indicator of CMV-associated diseases.
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Wu YM, Yan J, Ojcius DM, Chen LL, Gu ZY, Pan JP. Correlation between infections with different genotypes of human cytomegalovirus and Epstein-Barr virus in subgingival samples and periodontal status of patients. J Clin Microbiol 2007; 45:3665-70. [PMID: 17804655 PMCID: PMC2168512 DOI: 10.1128/jcm.00374-07] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Accumulating evidence indicates that herpesviruses may be putative pathogens in various types of periodontal diseases. The present study was performed to examine infections with different genotypes of human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV) in subgingival samples from a Chinese population and to analyze the correlation with periodontal status. A nested PCR assay was used to identify the presence of HCMV, EBV type 1 (EBV-1), and EBV-2; and the amplicons were further analyzed by restriction fragment length polymorphism analysis. HCMV was detected in 79.0% of 143 chronic periodontitis (CP) patients, 78.5% of 65 gingivitis patients, and 76.3% of 76 periodontally healthy individuals, while EBV was found in 63.6%, 32.3%, and 30.3% of the three groups of subjects, respectively. The HCMV-positive PCR products from all the samples were identified as corresponding to gB genotype I (gB-I) or gB-II. HCMV gB-II (62.9%), EBV-1 (43.4%), and EBV-2 (18.2%) were associated with CP at higher frequencies (P < 0.05), whereas HCMV gB-I was more often observed in gingivitis patients (40.0%) and healthy individuals (40.8%) (P < 0.05). Furthermore, a higher rate of coinfection with HCMV and EBV was shown in CP patients (52.4%), especially dual infections with HCMV gB-II and EBV-1 (30.8%) or HCMV gB-II and EBV-2 (12.6%), compared with the rates of single infections with HCMV or EBV (P < 0.05). Infection with HCMV gB-II, EBV-1, or EBV-2 was correlated with higher rates of bleeding on probing (P < 0.05). In patients infected with HCMV gB-II or both HCMV and EBV, including HCMV gB-II and EBV-1, a deeper probing depth or more serious attachment loss was found (P < 0.05). These findings clearly indicate that HCMV gB-II is the dominant genotype detected in subgingival samples in CP. HCMV gB-II infection and HCMV gB-II coinfection with EBV-1 are closely associated with periodontal tissue inflammation and destruction.
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Affiliation(s)
- Yan-Min Wu
- Department of Stomatology, Second Affiliated Hospital, Hangzhou, China
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44
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Yamamoto AY, Mussi-Pinhata MM, de Deus Wagatsuma VM, Marin LJ, Duarte G, Figueiredo LTM. Human cytomegalovirus glycoprotein B genotypes in Brazilian mothers and their congenitally infected infants. J Med Virol 2007; 79:1164-8. [PMID: 17597488 DOI: 10.1002/jmv.20903] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A case-control study design was used in order to compare the distribution of human cytomegalovirus (HCMV) glycoprotein B (gB) genotypes in 48 mothers of 49 congenitally infected infants with that observed in 144 mothers of 146 uninfected infants to study genetic variation of HCMV strains and maternal-fetal transmission. Congenital infection with HCMV was characterized by DNA detection and virus isolation from two urine or saliva samples collected prior to the third week of life. Genotyping of HCMV was carried out by a polymerase chain reaction-restriction fragment length polymorphism analysis of the variable region of the gB gene, testing for four genotypes. Genotype frequency was similar among the 28 non-transmitting mothers who were shedding virus (gB1: 25%; gB2: 28.6%; gB3: 42.8%; gB4: 0%), the 37 transmitting mothers (gB1: 21.6%; gB2: 46%; gB3: 27%; gB4: 0%), and the 49 infected infants (gB1: 39%; gB2: 37%; gB3: 24%; gB4: 0%). The same genotype was detected at different body sites (urine, saliva, and blood) of each infected newborn and in the respective mother (breast milk, urine, and saliva). Co-infection with multiple genotypes was observed in the immediate postpartum period in two mothers of infected infants (5.4%) and one non-transmitting mother (3.6%). The gB genotype was not correlated with intrauterine HCMV transmission. The genotype distribution found reflects the overall frequency of wild strains circulating in this geographic region. A single genotype is responsible for congenital HCMV infection. Co-infection with more than one strain, as characterized by gB genotype, was infrequent in women who were presumably immunocompetent.
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Affiliation(s)
- Aparecida Yulie Yamamoto
- Department of Pediatrics, University of São Paulo at Ribeirão Preto School of Medicine, Ribeirão Preto, Brazil.
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45
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Jin H, Wang X, Li S. Human Cytomegalovirus Glycoprotein B Genotype Correlates with Different Symptoms of Infected Infants. Intervirology 2007; 50:219-23. [PMID: 17356299 DOI: 10.1159/000100564] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Accepted: 10/02/2006] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Human cytomegalovirus (HCMV) is the pathogen of cytomegalic inclusion disease of infants. HCMV strains can be classified into four genotypes of glycoprotein B (gB). There are limited data concerning links between clinical symptoms and HCMV genotypes. The aims of the present study were to determine the genotype of HCMV isolates from pediatric patients who have different symptoms on the assumption that the gB genotype may influence the outcomes of congenital and prenatal HCMV infection. METHODS The gB types of HCMV were determined in urine specimens from 208 infected infants using nested polymerase chain reaction and restriction fragment length polymorphism. RESULTS These data showed the dominance of the gB1 genotype in HCMV-infected infants. The distributions of HCMV gB genotypes in jaundice, malformation, and pneumonia patients are different. CONCLUSION There are some relationships between the gB genotypes and the different symptoms of HCMV infection. The four gB genotypes of HCMV may have different clinical outcomes in infected infants.
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Affiliation(s)
- Hong Jin
- Department of Microbiology and Parasitology, China Medical University, Shenyang, PR China.
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46
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Paradowska E, Przepiórkiewicz M, Nowakowska D, Studzińska M, Wilczyński J, Emery VC, Leśnikowski ZJ. Detection of cytomegalovirus in human placental cells by polymerase chain reaction. APMIS 2007; 114:764-71. [PMID: 17078856 DOI: 10.1111/j.1600-0463.2006.apm_31.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Human cytomegalovirus (HCMV) is the most common cause of viral intrauterine infection. Progress in rapid, specific, and dependable detection of HCMV has recently been achieved by the use of DNA hybridization techniques and other molecular methods. We examined 21 placentas after delivery for the presence of HCMV DNA by polymerase chain reaction (PCR). To test the reliability of the PCR for the detection of HCMV DNA in clinical specimens, two simple PCR assays and a real-time quantitative PCR were used. PCR analysis of villous and decidual cells showed that HCMV DNA was present in 16 placentas (76.2%). Transmission of HCMV infection to chorionic villi was confirmed in 11 organs (52.4%), and congenital infections in newborns were detected in 9 cases (42.8%). These results suggest that HCMV genome detection in placentas at later gestational ages is common. Our results demonstrated that detection of HCMV DNA in placental tissues by DNA amplification provides a specific and sensitive method for diagnosis of intrauterine HCMV infection.
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Affiliation(s)
- Edyta Paradowska
- Center for Medical Biology, Polish Academy of Sciences, Laboratory of Molecular Virology and Biological Chemistry, Lódź, Poland.
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47
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Puchhammer-Stöckl E, Görzer I. Cytomegalovirus and Epstein-Barr virus subtypes—The search for clinical significance. J Clin Virol 2006; 36:239-48. [PMID: 16697698 DOI: 10.1016/j.jcv.2006.03.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 03/23/2006] [Indexed: 11/19/2022]
Abstract
Cytomegalovirus (CMV) as well as Epstein Barr virus (EBV) genomes include regions which show in part substantial polymorphisms. Characterization of several polymorphic regions led to the identification of various CMV and EBV subtypes. Within the last years there have been undertaken numerous efforts to find out whether the diverse subtypes differentially contribute to clinical manifestations. However, although some associations have been described so far between a certain virus subtype and the development of individual diseases these analyses were greatly complicated by the huge genomic background of CMV and EBV, by the large variety of individual host-virus relations and by differences in the geographic or demographic subtype distribution. In addition, it was shown meanwhile that a substantial proportion of virus infections is due to mixed infections with different subtypes. In this review we will give an overview of the current knowledge concerning the clinical significance of individual CMV and EBV subtypes, defined by characterization of selected polymorphisms. In addition, we also focus on recent analyses which show that infection with mixed virus subtype populations may be disadvantageous compared to single virus subtype infections.
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48
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Chow SSW, Craig ME, Jacques CFH, Hall B, Catteau J, Munro SC, Scott GM, Camaris C, McIver CJ, Rawlinson WD. Correlates of placental infection with cytomegalovirus, parvovirus B19 or human herpes virus 7. J Med Virol 2006; 78:747-56. [PMID: 16628574 DOI: 10.1002/jmv.20618] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Vertical transmission of viruses is an important cause of morbidity in the fetus and neonate. Placental viral infection indicates risk of vertical transmission, but not always transmission to, or disease of the fetus. Specimens from mothers and babies from three groups-two prospective and one retrospective cohort-were tested for pathogens of teratogenic potential using multiplex PCR. Placental infection was present in 13% of the 105 samples collected. Assessment of the prospective cohorts showed cytomegalovirus (CMV) detected in 4% of placentae from unselected women, parvovirus B19 in 1% and Ureaplasma parvum in 1% of placentae. In a retrospective cohort of women at high risk of transmitting congenital infection due to seroconversion during pregnancy, miscarriage or stillbirth, CMV was detected in 64% and human herpes virus type 7 in 9% of placentae. Of 14 PCR-positive placentae, two were associated with the birth of a living symptomatic infant, two with stillbirth, one with miscarriage, and two with elective terminations of pregnancy. Directed laboratory assessment of women at high risk of transmitting congenital infection, on the basis of clinical or laboratory markers, is important for accurate diagnosis of adverse outcomes of pregnancy. However, routine screening for viruses in the placentae from women with a low-risk serological profile for transmitting congenital infection is unlikely to result in significant numbers of additional diagnoses and is confounded by inadequacy of current diagnostic methods. The major pathogen detected in all cases of placental infection associated with fetal death was human CMV.
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Affiliation(s)
- S S W Chow
- Department of Microbiology, Virology Division, SEALS, Prince of Wales Hospital, Randwick, New South Wales, Australia
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49
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Ross DS, Dollard SC, Victor M, Sumartojo E, Cannon MJ. The Epidemiology and Prevention of Congenital Cytomegalovirus Infection and Disease: Activities of the Centers for Disease Control and Prevention Workgroup. J Womens Health (Larchmt) 2006; 15:224-9. [PMID: 16620180 DOI: 10.1089/jwh.2006.15.224] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Perhaps no single cause of birth defects and developmental disabilities in the United States currently provides greater opportunity for improved outcomes in more children than congenital cytomegalovirus (CMV). --Cannon and Davis. BMC Public Health 2005;5:70 Each year in the United States, thousands of children and their families are affected by congenital cytomegalovirus (CMV) infection. More children may be affected by congenital CMV than by other, better known childhood conditions, such as Down syndrome, fetal alcohol syndrome, and spina bifida. The Centers for Disease Control and Prevention (CDC) has formed a Workgroup on Congenital CMV, led by the National Center on Birth Defects and Developmental Disabilities and the National Center on Infectious Diseases. This report provides background on congenital CMV infection and describes the goals and activities of the workgroup for reducing the burden of sequelae of congenital CMV infection.
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Affiliation(s)
- Danielle S Ross
- National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disabilities, Atlanta, GA 30333, USA.
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50
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Sowmya P, Madhavan HN, Therese KL. Failure to genotype Human Cytomegalovirus by PCR-RFLP method due to sequence variation within the primer binding site. J Virol Methods 2006; 134:250-1. [PMID: 16417928 DOI: 10.1016/j.jviromet.2005.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 11/30/2005] [Accepted: 12/05/2005] [Indexed: 11/17/2022]
Abstract
Polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) is one of the rapid methods for genotyping Human Cytomegalovirus (HCMV). When genotyping clinical samples by a sensitive nested PCR-based RFLP method for the glycoprotein B (gB) gene of HCMV, it was found that some of the clinical specimens did not give an amplification signal. Analysis of the prototype sequences of the different genotypes showed base pair mismatches over the primer binding site. An alternative assay is suggested for genotyping of HCMV.
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Affiliation(s)
- P Sowmya
- L and T Microbiology Research Centre, Vision Research Foundation, 18, College Road, Chennai 600006, India
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