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Chapter 16 : Congenital Cytomegalovirus Infection

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Abstract:

This chapter describes some of the key epidemiologic characteristics of human cytomegalovirus (HCMV) maternal-fetal infection, including sources of maternal infection and maternal populations with increased rates of infection and fetal transmission, and provides a limited description of maternal immune responses associated with protection from fetal transmission and disease. The seemingly complex natural history of congenital HCMV infection can be greatly simplified by an understanding of the maternal component of the maternal-fetal infection. Primary infection during pregnancy can develop as a result of exposure to infectious virus from several sources. Epidemiologic studies have documented that exposure to infected children and sexual exposure represent the two most common modes of community acquisition of HCMV. The consequences of intrauterine HCMV infection can range from mild, clinically inapparent infection to severe, life-threatening multiorgan disease. Progressive hearing loss is limited almost exclusively to infants with congenital infections which follow primary maternal infection. The most obvious method of limiting disease caused by intrauterine HCMV infection is to develop and use an effective vaccine. This may be accomplished by active vaccination, as has been demonstrated by universal rubella immunization. Live, replicating HCMV vaccines have been proposed as a means of doing this, but to date no direct evidence has been provided to suggest that current live virus vaccine formulations can provide such immunity.

Citation: Britt W. 1999. Congenital Cytomegalovirus Infection, p 269-281. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch16
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References

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Tables

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Table 1

HCMV as a cause of congenital infection in the United States

Citation: Britt W. 1999. Congenital Cytomegalovirus Infection, p 269-281. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch16
Generic image for table
Table 2

Influence of maternal age on prevalence of congenital HCMV infection

Citation: Britt W. 1999. Congenital Cytomegalovirus Infection, p 269-281. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch16
Generic image for table
Table 3

Clinical and laboratory abnormalities of neonates associated with symptomatic congenital HCMV infection

Citation: Britt W. 1999. Congenital Cytomegalovirus Infection, p 269-281. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch16

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