Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up. (4th February 2017)

• Record Type: Journal Article
• Authors: Goycochea-Valdivia, Walter-Alfredo; Baquero-Artigao, Fernando; del Rosal, Teresa; Frick, Marie-Antoinette; Rojo, Pablo; Echeverría, María-Juncal; Noguera-Julian, Antoni; Bringué, Xavier; Saavedra-Lozano, Jesús; Vives-Oñós, Isabel; Moliner, Elisenda; Cilleruelo, María-José; Cuadrado, Irene; Colino, Elena; Castells, Laura; Tagarro, Alfredo; Vilas, Javier; Soler-Palacin, Pere; Blázquez-Gamero, Daniel
• Is Part Of: Clinical infectious diseases. Volume 64:Number 10(2017)
• Page Start: 1335
• Page End: 1342
• Publication Date: 2017-02-04
• Subjects: human cytomegalovirus -- congenital infection -- polymerase chain reaction -- cerebrospinal fluid -- pediatrics.; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/cix105
• Languages: English
• ISSNs: 1058-4838

Abstract

Summary: Human cytomegalovirus DNA detection in cerebrospinal fluid by polymerase chain reaction has been previously considered a risk factor for hearing loss or neurological sequelae in congenital infection. In the present study, it was not associated with neurological or audiological outcomes. Abstract: Background: DNA detection of human cytomegalovirus (hCMV) in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR) is a marker of central nervous system (CNS) involvement in congenital hCMV infection (cCMV), but its prognostic value is unknown. Methods: A multicenter, retrospective study was performed using the Spanish Congenital Cytomegalovirus Infection Database (REDICCMV; http://www.cmvcongenito.es ). Newborns with cCMV and a lumbar puncture performed were included and classified according to their hCMV-PCR in CSF result (positive/negative). Clinical characteristics, neuroimaging abnormalities, plasma viral load, and audiological and neurological outcomes of both groups were compared. Results: A total of 136 neonates were included in the study: 21 (15.4%) with positive CSF hCMV-PCR and 115 (84.6%) with negative results. Seventeen patients (81%) in the positive group were symptomatic at birth compared with 52.2% of infants in the negative group (odds ratio [OR], 3.86; 95% confidence interval [CI], 1.28–14.1; P = .01). Only 4 asymptomatic newborns (6.8%) had a positive CSF hCMV-PCR. There were no differences between groups regarding the rate of microcephaly, neuroimaging abnormalities, neurological sequelae at 6 months of age, or plasma viral load. Sensorineural hearing loss (SNHL) at birth was associated with a positive CSF hCMV-PCR result (OR, 3.49; 95% CI, 1.08–11.27; P = .04), although no association was found at 6 months of age. Conclusions: A positive hCMV-PCR result in CSF is associated with symptomatic cCMV and SNHL at birth. However, no differences in neuroimaging studies, plasma viral load, or outcomes at 6 months were found. These results suggest that hCMV-PCR in CSF may not be a useful prognostic marker in cCMV.