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Congenital cytomegalovirus infection: management update

Congenital cytomegalovirus infection: management update
Congenital cytomegalovirus infection: management update
Purpose of review: Until recently, management options in congenital cytomegalovirus (cCMV) infection have been either conservative or termination of pregnancy. However, medical therapies aimed at reducing the risk of infection and/or its severity have recently been investigated.

Recent findings: In a phase 2 open label, nonrandomized trial, valaciclovir (ValACV) was given to women carrying a CMV-infected fetus. ValACV was associated with a greater proportion of asymptomatic neonates when compared with a historical cohort (82 vs. 43%). However, the study design and the small number of treated women limit its applicability. Even though initial observational data suggested that hyperimmune globulin (HIG) therapy in pregnancy was associated with a significantly lower risk of cCMV, its efficacy has not been borne out in a subsequent phase 2 randomized, placebo controlled, double-blind study [cCMV 30% in the HIG group, 44% in the placebo group (P = 0.13)]. Furthermore, 11% of fetuses in the HIG group had transient or permanent abnormalities, compared with 16% in the placebo group.

Summary: ValACV might have a promising role in the antenatal treatment of cCMV infection, but definitive recommendations require further research. The use of HIG should currently be limited to the research setting.
0951-7375
Khalil, Asma
4a8ca35d-4afc-49ed-a295-1e8f1b8441bb
Jones, Christine
48229079-8b58-4dcb-8374-d9481fe7b426
Ville, Yves
109e0d72-b9d2-4444-96df-597a5e39f5d7
Khalil, Asma
4a8ca35d-4afc-49ed-a295-1e8f1b8441bb
Jones, Christine
48229079-8b58-4dcb-8374-d9481fe7b426
Ville, Yves
109e0d72-b9d2-4444-96df-597a5e39f5d7

Khalil, Asma, Jones, Christine and Ville, Yves (2017) Congenital cytomegalovirus infection: management update. Current opinion in infectious diseases. (doi:10.1097/QCO.0000000000000368).

Record type: Article

Abstract

Purpose of review: Until recently, management options in congenital cytomegalovirus (cCMV) infection have been either conservative or termination of pregnancy. However, medical therapies aimed at reducing the risk of infection and/or its severity have recently been investigated.

Recent findings: In a phase 2 open label, nonrandomized trial, valaciclovir (ValACV) was given to women carrying a CMV-infected fetus. ValACV was associated with a greater proportion of asymptomatic neonates when compared with a historical cohort (82 vs. 43%). However, the study design and the small number of treated women limit its applicability. Even though initial observational data suggested that hyperimmune globulin (HIG) therapy in pregnancy was associated with a significantly lower risk of cCMV, its efficacy has not been borne out in a subsequent phase 2 randomized, placebo controlled, double-blind study [cCMV 30% in the HIG group, 44% in the placebo group (P = 0.13)]. Furthermore, 11% of fetuses in the HIG group had transient or permanent abnormalities, compared with 16% in the placebo group.

Summary: ValACV might have a promising role in the antenatal treatment of cCMV infection, but definitive recommendations require further research. The use of HIG should currently be limited to the research setting.

Text
congenital CMV Current opinion submitted COID-S-17-00011 - Accepted Manuscript
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More information

Accepted/In Press date: 14 February 2017
e-pub ahead of print date: 23 March 2017
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 407362
URI: https://eprints.soton.ac.uk/id/eprint/407362
ISSN: 0951-7375
PURE UUID: dd771184-6c37-4d51-9537-06cd1efeef0b
ORCID for Christine Jones: ORCID iD orcid.org/0000-0003-1523-2368

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Date deposited: 04 Apr 2017 01:07
Last modified: 29 Oct 2019 06:11

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Contributors

Author: Asma Khalil
Author: Christine Jones ORCID iD
Author: Yves Ville

University divisions

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