先天性人巨细胞病毒感染的防治进展

摘要/Abstract

摘要： 先天性人巨细胞病毒（human cytomegalovirus,HCMV）感染是目前我国胎儿畸形及新生儿迟发性感音神经性耳聋的重要原因之一。本文从先天性巨细胞病毒感染的流行病学、不同感染类型的胎儿预后、预防和治疗等方面阐述了先天性HCMV感染的最新进展,希望通过深入探讨目前妊娠期HCMV感染及新生儿HCMV感染的治疗方式,为治疗先天性巨细胞病毒感染带来新的思路。

关键词: 先天性巨细胞病毒感染, 胎儿预后, 治疗进展

Abstract: Congenital cytomegalovirus infection is one of the most common causes of fetal malformation and delayed sensorineural hearing loss. The paper reviews the prospect of congenital CMV infection from the aspects of epidemiology, prognosis, prevention and treatment of different types of infection. We hope to bring new ideas on the treatment of congenital human cytomegalovirus（HCMV） infection through in-depth discussion on the treatment of CMV infection in pregnancy and neonatal CMV infection.

Key words: Congenital cytomegalovirus infection, Fetal prognosis, Progress of treatment

杨林, 吴诗品. 先天性人巨细胞病毒感染的防治进展[J]. 新发传染病电子杂志, 2020, 5(2): 131-135.

Yang Lin, Wu Shipin. Prevention and treatment progress of congenital human cytomegalovirus infection[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(2): 131-135.

参考文献

[1] Pass RF, Arav-Boger R.Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention [version 1; peer review: 3 approved][J]. F1000Research, 2018,7(1):255.
[2] Lanzieri TM, Dollard SC, Bialek SR, et al.Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries[J]. Int J Infect Dis, 2014,22:44-48.
[3] Rawlinson WD, Boppana SB, Fowler KB, et al.Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy[J]. Lancet Infect Dis, 2017,17(6):e177-e188.
[4] 中华医学会围产医学分会, 中华医学会儿科学分会, 中华医学会医学病毒学分会, 等. 先天性巨细胞病毒感染筛查与临床干预指南[J]. 中国实用妇科与产科杂志, 2019,35(4):417-423.
[5] Antona D, Lepoutre A, Fonteneau L, et al.Seroprevalence of cytomegalovirus infection in France in 2010[J]. Epidemiol Infect, 2017,145(7):1471-1478.
[6] Jin QE, Su J, Wu S.Cytomegalovirus Infection among pregnant women in Beijing: seroepidemiological survey and intrauterine transmissions[J]. J Microbiol Biotechnol, 2017, 27(5): 1005-1009.
[7] Wang S, Wang T, Zhang W, et al.Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China[J]. Medicine, 2017,96(5):e6007.
[8] Goderis J, Keymeulen A, Smets K, et al.Hearing in Children with Congenital Cytomegalovirus Infection: Results of a Longitudinal Study[J]. J Pediatr, 2016,172:110-115.
[9] Foulon I, Naessens A, Faron G, et al.Hearing thresholds in children with a congenital CMV infection: A prospective study[J]. Int J Pediatr Otorhi, 2012, 76(5): 712-717.
[10] Naing ZW, Scott GM, Shand A, et al.Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention[J]. Aust N Z J Obstet Gynaecol, 2016, 56(1): 9-18.
[11] Picone O, Fellous CV, Cordier AG, et al.A series of 238 cytomegalovirus primary infections during pregnancy: description and outcome[J]. Prenatal Diag, 2013, 33(8): 751-758.
[12] Enders G, Daiminger A, Bäder U, et al.Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age[J]. J Clin Virol, 2011, 52(3): 244-246.
[13] Foulon I, Brucker Y, Buyl R, et al.Hearing loss with congenital cytomegalovirus infection[J]. Pediatrics, 2019, 144(2): e20183095.
[14] Hughes BL, Gyamfi-Bannerman C.Diagnosis and antenatal management of congenital cytomegalovirus infection[J]. Am J Obstet Gynecol, 2016,214(6):B5-B11.
[15] 中华医学会围产医学分会, 中华医学会妇产科学分会产科学组, 编辑委员会中华围产医学杂志. 妊娠期巨细胞病毒感染筛查与处理专家共识[J]. 中华围产医学杂志, 2017,20(8):553-556.
[16] Townsend CL, Marianne F, Karin A, et al.Long-term outcomes of congenital cytomegalovirus infection in Sweden and the United Kingdom[J]. Clin Infect Dis, 2013, 56(9): 1232-1239.
[17] Tanimura K, Tairaku S, Morioka I, et al.Universal screening with use of immunoglobulin G avidity for congenital cytomegalovirus infection[J]. Clin Infect Dis, 2017, 65(10): 1652-1658.
[18] Razonable RR, Paya CV, Smith TF.Role of the Laboratory in diagnosis and management of cytomegalovirus infection in hematopoietic stem cell and solid-organ transplant recipients[J]. J Clin Microbiol, 2002, 40(3): 746-752.
[19] Rodrigues S, Goncalves D, Taipa R, et al.Nonprimary cytomegalovirus fetal infection[J]. Rev Bras Ginecol Obstet, 2016,38(4):196-200.
[20] Picone O, Grangeot-Keros L, Senat M, et al.Cytomegalovirus non-primary infection during pregnancy. Can serology help with diagnosis?[J]. J Matern Fetal Neonatal Med, 2016, 30(2): 1-4.
[21] Beksaç M S, Özlü T, Dikensoy E, et al.Management of severe non immune hydrops fetalis cases: the role of diagnostic and/or therapeutic interventions[J]. Gorm, 2009, 15(2): 85-88.
[22] Nicole LD, Caroline CK, Athena PK, et al.Cytomegalovirus infection in pregnancy[J]. Birth Defects Res, 2017, 109(5): 336-346.
[23] Yamamoto AY, Mussi-Pinhata MM, Marin LJ, et al.Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection?[J]. J Clin Virol, 2006, 36(3): 228-230.
[24] Boppana SB, Ross SA, Shimamura M, et al.Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns[J]. N Engl J Med, 2011, 364(22): 2111-2118.
[25] Exler S, Daiminger A, Grothe M, et al.Primary cytomegalovirus (CMV) infection in pregnancy: Diagnostic value of CMV PCR in saliva compared to urine at birth[J]. J Clin Virol, 2019, 117(1): 33-36.
[26] Ross SA, Michaels MG, Ahmed A, et al.Contribution of breastfeeding to false-positive saliva polymerase chain reaction for newborn congenital cytomegalovirus screening[J]. J Infect Dis, 2018, 217(10): 1612-1615.
[27] Hamilton ST, van Zuylen W, Shand A, et al. Prevention of congenital cytomegalovirus complications by maternal and neonatal treatments: a systematic review[J]. Rev Med Virol, 2014, 24(6):420-433.
[28] Pass RF, Zhang C, Evans A, et al.Vaccine prevention of maternal cytomegalovirus infection[J]. N Engl J Med, 2009, 360(12):1191-1199.
[29] Anderholm KM, Bierle CJ, Schleiss MR.Cytomegalovirus vaccines: current status and future prospects[J]. Drugs, 2016, 76(17):1625-1645.
[30] Steffanie S, Robert FP, Sylvie P, et al. Glycoprotein B vaccine is capable of boosting both antibody and CD4 T-cell responses to cytomegalovirus in chronically infected women[J]. J Infect Dis, 2011(11)::1534-41.
[31] Bernstein DI, Munoz FM, Callahan ST, et al.Safety and efficacy of a cytomegalovirus glycoprotein B (gB) vaccine in adolescent girls: A randomized clinical trial[J]. Vaccine, 2016, 34(3):313-319.
[32] Britt WJ.Congenital kuman cytomegalovirus infection and the enigma of maternal immunity[J]. J Virol, 2017, 91(15): 405-416.
[33] Revello MG, Tibaldi C, Masuelli G, et al.Prevention of Primary Cytomegalovirus Infection in Pregnancy[J]. Ebiomedicine, 2015, 2(9):1205-1210.
[34] Adler SP, Finney JW, Manganello AM, et al.Prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: A randomized controlled trial[J]. Pediatr Infect Dis J, 1996, 15(3): 240-246.
[35] Kagan KO, Enders M, Schampera MS, et al.Prevention of maternal-fetal transmission of cytomegalovirus after primary maternal infection in the first trimester by biweekly hyperimmunoglobulin administration[J]. Ultrasound Obst Gyn, 2019, 53(3): 383-389.
[36] Chiaie LD, Neuberger P, Vochem M, et al.No evidence of obstetrical adverse events after hyperimmune globulin application for primary cytomegalovirus infection in pregnancy: experience from a single centre[J]. Arch Gynecol Obstet, 2018, 297(6): 1389-1395.
[37] Revello MG, Lazzarotto T, Guerra B, et al.A randomized trial of hyperimmune globulin to prevent congenital cytomegalovirus[J].N Engl J Med,2014,370(14): 1316-1326.
[38] Nigro G, Capretti I, Manganello A, et al.Primary maternal cytomegalovirus infections during pregnancy: association of CMV hyperimmune globulin with gestational age at birth and birth weight[J]. J Matern Fetal Neonatal Med, 2014, 28(2): 168-171.
[39] Yamada H.A trial of immunoglobulin fetal therapy for symptomatic congenital cytomegalovirus infection[J]. J Reprod Immunol, 2012, 95(1-2): 73-79.
[40] Visentin S, Manara R, Milanese L, et al.Early Primary Cytomegalovirus Infection in Pregnancy: Maternal Hyperimmunoglobulin Therapy Improves Outcomes Among Infants at 1 Year of Age[J]. Clin Infect Dis, 2012, 55(4): 497-503.
[41] Nigro G, Adler SP, La Torre R, et al.Passive immunization during pregnancy for congenital cytomegalovirus infection[J]. N Engl J Med, 2005, 353(13): 1350-1362.
[42] Perrottet N, Csajka C, Pascual M, et al.Population pharmacokinetics of ganciclovir in solid-organ transplant recipients receiving oral valganciclovir.[J]. Antimicrob Agents Ch, 2009, 53(7): 3017-3023.
[43] Leruez-Ville M, Ghout I, Bussières L, et al.In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicentre, open-label, phase II study[J]. Am J Obstet Gynecol, 2016, 215(4):e1-e10.
[44] Mark RS.The Value of Hyperimmune Globulin (HIG) in Pregnancies Complicated by Cytomegalovirus Infection: A Continuing Saga[J]. Clin Infect Dis, 2019, 208(5): 527-531.
[45] Kimberlin DW, Acosta EP, Sanchez PJ, et al.Pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease[J]. J Infect Dis, 2008, 197(6): 836-845.
[46] Kimberlin DW, Lin CY, Sánchez PJ, et al.Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial[J]. J Pediatr, 2003, 143(1): 16-25.
[47] Whitley RJ, Gretchen C, William G, et al.Ganciclovir Treatment of Symptomatic Congenital Cytomegalovirus Infection: Results of a Phase II Study[J]. J Infect Dis, 1997, 175(5):1080-1086.
[48] Kimberlin DW, Jester PM, Sanchez PJ, et al.Valganciclovir for symptomatic congenital cytomegalovirus disease[J]. N Engl J Med, 2015, 372(10): 933-943.
[49] McCrary H, Sheng X, Greene T, et al. Long-term hearing outcomes of children with symptomatic congenital CMV treated with valganciclovir[J]. Int J Pediatr Otorhinolaryngol, 2019, 118(1): 124-127.