Cytomegalovirus and its role in congenital infection: A narrative-review study

Document Type : Review Article

Authors

1 M.Sc. student of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

2 Professor, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

3 Associate professor, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

4 Assistant professor, Department of Virology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

5 PhD student of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Human cytomegalovirus (HCMV) is a major cause of congenital infection worldwide. HCMV seroprevalence is higher in Asian regions than in European societies. Pregnant women can transmit the virus to their fetuses depending on the type of infection (primary or non-primary). Congenital HCMV infection is the leading cause of sensorineural hearing loss in children. Given the importance of HCMV, this narrative-review study was performed with aim to determine the role of HCMV in congenital infection.
Methods: In this narrative-review study, to find the related articles, the English and Persian databases including Google Scholar, PubMed and Magiran were searched from 2002 to 2019. The keywords of cytomegalovirus, congenital cytomegalovirus infection, diagnosis and prevalence both in Persian and English and also their combination used.
Results: Developing countries estimated that the incidence of HCMV congenital infection is 6%-14%. While in developed countries such as Western Europe, United States, Canada and Australia, the incidence rate is 0.5-0.7%. Although HCMV infection is a significant cause of hearing loss and disability in children, there is still little awareness among general population and some physicians in this field. Several European countries routinely screen the pregnant women for HCMV but this screening is not currently performed in Iran.  
Conclusion: The studies in different societies highlighted the importance of congenital HCMV infection and its long-term complications in infants.

Keywords

References

  1. Lachmann R, Loenenbach A, Waterboer T, Brenner N, Pawlita M, Michel A, et al. Cytomegalovirus (CMV) seroprevalence in the adult population of Germany. PloS One 2018; 13(7):e0200267.
  2. Mocarski E, Shenk T, Griffiths P, Pass R. Cytomegaloviruses. In: Knipe DM, Howley PM, editors. Fields Virology. New York: Lippincott Williams & Wilkins; 2015. p. 1960-2014.
  3. Jackson JW, Sparer T. There is always another way! cytomegalovirus’ multifaceted dissemination schemes. Viruses 2018; 10(7):383.
  4. Noorbakhsh F, Abdolmohammadi K, Fatahi Y, Dalili H, Rasoolinejad M, Rezaei F, et al. Zika virus infection, basic and clinical aspects: A review article. Iran J Public Health 2019; 48(1):20-31.
  5. Davison A. International Committee on Taxonomy of Viruses (ICTV). Available at: URL:https://talk.ictvonline.org/taxonomy/. Accessed Oct 14, 2019.
  6. de Vries JJ, Wessels E, Korver AM, van der Eijk AA, Rusman LG, Kroes AC, et al. 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(2):232-7.
  7. Rycel M, Wujcicka W, Zawilińska B, Paradowska E, Suski P, Gaj Z, et al. Mixed infections with distinct cytomegalovirus glycoprotein B genotypes in Polish pregnant women, fetuses, and newborns. Eur J Clin Microbiol Infect Dis 2015; 34(3):585-91.
  8. Leng SX, Kamil J, Purdy JG, Lemmermann NA, Reddehase MJ, Goodrum FD. Recent advances in CMV tropism, latency, and diagnosis during aging. Geroscience 2017; 39(3):251-259.
  9. Cannon MJ, Hyde TB, Schmid DS. Review of cytomegalovirus shedding in bodily fluids and relevance to congenital cytomegalovirus infection. Rev Med Virol 2011; 21(4):240-55.
  10. Gerna G, Kabanova A, Lilleri D. Human Cytomegalovirus Cell Tropism and Host Cell Receptors. Vaccines (Basel) 2019; 7(3):pii: E70.
  11. Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK. The “silent” global burden of congenital cytomegalovirus. Clin Microbiol Rev 2013; 26(1):86-102.
  12. Navti O, Hughes BL, Tang JW, Konje J. Comprehensive review and update of cytomegalovirus infection in pregnancy. The Obstetrician & Gynaecologist 2016; 18:301-7.
  13. Giannattasio A, Di Costanzo P, De Matteis A, Milite P, De Martino D, Bucci L, et al. Outcomes of congenital cytomegalovirus disease following maternal primary and non-primary infection. J Clin Virol 2017; 96:32-36.
  14. Pass RF, Arav-Boger R. Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention. F1000Res 2018;7:255.
  15. Davis NL, King CC, Kourtis AP. Cytomegalovirus infection in pregnancy. Birth Defects Res 2017; 109(5):336-46.
  16. Spano LC, Lima Pereira FE, Gomes da Silva Basso N, Mercon-de-Vargas PR. Human cytomegalovirus infection and abortion: an immunohistochemical study. Med Sci Monit 2002; 8(6):BR230-5.
  17. Britt WJ. Maternal immunity and the natural history of congenital human cytomegalovirus infection. Viruses 2018; 10(8):405.
  18. Mathias CR, Joung SJS. Diagnostic challenges in congenital cytomegalovirus infection in pregnancy: A case report. Case Rep Women's Health 2019; 22:e00119.
  19. Society for Maternal-Fetal Medicine (SMFM), Hughes BL, Gyamfi-Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol 2016; 214(6):B5-B11.
  20. Boppana SB, Ross SA, Fowler KB. Congenital cytomegalovirus infection: clinical outcome. Clin Infect Dis 2013; 57(suppl_4):S178-81.
  21. Pass RF, Anderson B. Mother-to-child transmission of cytomegalovirus and prevention of congenital infection. J Pediatric Infect Dis Soc 2014; 3(suppl_1):S2-S6.
  22. Anderholm K, Bierle CJ, Schleiss MR. Cytomegalovirus vaccines: current status and future prospects. Drugs 2016; 76(17):1625-45.
  23. Plotkin SA, Boppana SB. Vaccination against the human cytomegalovirus. Vaccine. 2019; 37(50):7437-7442.
  24. Adler SP, Lewis N, Conlon A, Christiansen MP, Al-Ibrahim M, Rupp R, et al. Phase 1 Clinical Trial of a Conditionally Replication-Defective Human Cytomegalovirus (CMV) Vaccine in CMV-Seronegative Subjects. The Journal of infectious diseases 2019; 220(3):411-9.
  25. Walker SP, Palma-Dias R, Wood EM, Shekleton P, Giles ML. Cytomegalovirus in pregnancy: to screen or not to screen. BMC Pregnancy Childbirth 2013; 13:96.
  26. Kazemi A, Norouzi H, Nazarpour S. Comparison the Diagnostic Value of Culture and Polymerase Chain Reaction Methods in Diagnosis of Cytomegalovirus Infections in Spontaneous Abortions. Iran J Obstet Gynecol Infertil 2013; 16(53):1-6.(Persian).
  27. Ross SA, Novak Z, Pati S, Boppana SB. Diagnosis of cytomegalovirus infections. Infect Disord Drug Targets 2011; 11(5):466-74.
  28. Prince HE, Lapé-Nixon M. Role of cytomegalovirus (CMV) IgG avidity testing in diagnosing primary CMV infection during pregnancy. Clin Vaccine Immunol 2014; 21(10):1377-84.
  29. Abdullahi Nasir I, Babayo A, Shehu MS. Clinical significance of IgG avidity testing and other considerations in the diagnosis of congenital cytomegalovirus infection: a review update. Med Sci (Basel) 2016; 4(1):5.
  30. Vilibić-Čavlek T, Ljubin-Sternak S, Vojnović G, Sviben M, Mlinarić-Galinović G. The role of IgG avidity in diagnosis of cytomegalovirus infection in newborns and infants. Coll Antropol 2012; 36(1):297-300.
  31. Seyed-Khorrami SM, Mokhtari-Azad T, Yavarian J, Moghadam-Nia N, Shadab A, Adjaminezhad-Fard F, et al. Positive predictive value of IgM detection in diagnosis of acute rubella infection. Journal of Isfahan Medical School 2016; 33(360):2049-53. (persian).
  32. Khorrami SM, Mokhtari‐Azad T, Yavarian J, Nasab GS, Naseri M, Jandaghi NZ. The etiology of Rubella IgM positivity in patients with rubella‐like illness in Iran from 2011 to 2013. J Med Virol 2015; 87(11):1846-52.
  33. Shafiei Jondaghi NZ, Tabatabaei H, Sarijlou M, Hamkar R, Mokhtari Azad T, Mahmoudi M, et al. Application of rubella specific IgG avidity assay EIA format in differential diagnosis of primary. Hakim Research Journal 2005; 8(3):38-44.
  34. Lim Y, Lyall H. Congenital cytomegalovirus–who, when, what-with and why to treat? J Infect 2017; 74 Suppl 1:S89-S94.
  35. Saldan A, Forner G, Mengoli C, Gussetti N, Palù G, Abate D. Testing for cytomegalovirus in pregnancy. J Clin Microbiol 2017; 55(3):693-702.
  36. Nassetta L, Kimberlin D, Whitley R. Treatment of congenital cytomegalovirus infection: implications for future therapeutic strategies. J Antimicrob Chemother 2009; 63(5):862-7.
  37. Marsico C, Kimberlin DW. Congenital Cytomegalovirus infection: advances and challenges in diagnosis, prevention and treatment. Ital J Pediatr 2017; 43(1):38.
  38. Zuhair M, Smit GSA, Wallis G, Jabbar F, Smith C, Devleesschauwer B, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: A systematic review and meta‐analysis. Rev Med Virol 2019; 29(3):e2034.
  39. Cannon MJ, Schmid DS, Hyde TB. Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev Med Virol 2010; 20(4):202-13.
  40. van Zuylen WJ, Hamilton ST, Naing Z, Hall B, Shand A, Rawlinson WD. Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention. Obstet Med 2014; 7(4):140-6.
  41. Lanzieri TM, Dollard SC, Bialek SR, Grosse SD. Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries. Int J Infect Dis 2014; 22:44-8.
  42. Lunardi S, Lorenzoni F, Ghirri P. Universal Screening for Congenital CMV Infection. Common Newborn and Infant Health Problems: Intech Open; 2019. p.15.
  43. Aljumaili ZK, Alsamarai AM, Najem WS. Cytomegalovirus seroprevalence in women with bad obstetric history in Kirkuk, Iraq. J Infect Public Health 2014; 7(4):277-88.
  44. Mujtaba G, Shaukat S, Angez M, Alam MM, Hasan F, Zahoor Zaidi SS, et al. Seroprevalence of Human Cytomegalovirus (HCMV) infection in pregnant women and outcomes of pregnancies with active infection. J Pak Med Assoc 2016; 66(8):1009-14.
  45. Siddiqui AR, Ibrahim S, Siddiqui AA, Moss P, Lalani EN. Human Cytomegalovirus: a neglected public health area of significant relevance to women, the foetus and new born. Time for action!. J Pak Med Assoc 2017; 67(6):827-829.
  46. Husseini AA, Fidan I, Saeed KMI, Bozdayi AM. Seroprevalence of Cytomegaloviruses in Afghanistan. Journal of Microbiology and Infectious Diseases 2019; 9(02):78-82.
  47. Jahan M, Sultana N, Asma R, Tabassum S, Islam MN. Birth Prevalence of Congenital Cytomegalovirus (CMV) infection in a cohort of pregnant women in Bangladesh. Bangladesh Medical Research Council Bulletin 2017; 43(2):77-81.
  48. Sahiner F, Cekmez F, Cetinkaya M, Kaya G, Kalayci T, Gunes O, et al. Congenital cytomegalovirus infections and glycoprotein B genotypes in live-born infants: a prevalence study in Turkey. Infect Dis (Lond) 2015; 47(7):465-71.
  49. Gandhoke I, Aggarwal R, Lal S, Khare S. Congenital CMV infection in symptomatic infants in Delhi and surrounding areas. Indian J Pediatr 2006; 73(12):1095-7.
  50. Arabpour M, Kaviyanee K, Jankhah A, Yaghobi R. Human cytomegalovirus infection in women of childbearing age throughout Fars Province-Iran: a population-based cohort study. Malaysian Journal of Microbiology 2007; 3(2):23-28.
  51. Bagheri L, Mokhtarian H, Sarshar N, Ghahramani M. Seroprevalence of cytomegalovirus infection among pregnant women in Eastern Iran. Braz J of Infect Dis 2012; 16(4):402-3.
  52. Janan A, Honarmand H, Amirmozafari N, Asgharnia M, Janan A. Distribution of Cytomegalovirus Infection in Spontaneous Abortion. Iran J Obstet Gynecol Infertil 2014; 17(102):12-19. (Persian).
  53. Delfan Beiranvand M, Sheikhian A, Birjandi M, Fazeli M. Seroprevalence of Cytomegalovirus Infection in Pregnant Women Referred to Health Care Center of Khorramabad. Iranian Journal of Virology 2011; 5(4):11-6.
  54. Rajaii M, Pourhassan A. Evaluation of immunity against CMV in Azarbaijan female population. Iran J Clin Infect Dis 2008; 3(3):143-148.
  55. Hamkar R, Azarian B, Saadatmand Z, Babaei Z, Farrokh Eslamlo HR, Mokhtari-Azad T. Seroprevalence of Cytomegalovirus in the
  56. Sharghi M, Musavi H, Malekpour SM, Kooti W, Behzadifar M, Ashrafi-Zadeh H, et al. Seroprevalence of cytomegalovirus among women of reproductive age in iran: A systematic review and meta-analysis. Iran J Public Health 2019; 48(2):206-216.
  57. Noorbakhsh S, Farhadi M, Tabatabaei A. Cytomegalovirus, a Common Cause of Intrauterine Infection: A Case-Control Study in Tehran, Iran. Iranian Journal of Clinical Infectious Diseases 2010; 5(1):9-13.
  58. Karimian P, Yaghini O, Nasr Azadani H, Mohammadizadeh M, Arabzadeh SA, Adibi A, et al. Prevalence, characteristics, and one-year follow-up of congenital cytomegalovirus infection in Isfahan City, Iran. Interdiscip Perspect Infect Dis 2016; 2016:7812106.
  59. Marashi SM, Tabatabaei H, Mahmoodi M, Nategh R, Mokhtari-Azad T. Prevalence of rubella and HCMV antibodies among neonates with congenital defects in four provinces of Iran. Iran J Virol 2011; 5(3):34-39.
  60. Farshidi F, Abedi Gh, Moosazadeh M, Afshari M. Seroprevalence of cytomegalovirus antibodies and primary infection among women and infants in Iran: A meta-analysis. Iranian Journal of Cancer Prevention 2017; 10(1):e3704.
  61. Mirsalehi N. Frequency of congenital cytomegalovirus infection in newborns suspected of congenital rubella syndrome in Iran in 2016-2017.[Master of science thesis].Iran.Virology Department, School of Public Health, Tehran University of Medical Sciences; 2019. (persian)
  62. Nijman J, Mandemaker FS, Verboon-Maciolek MA, Aitken SC, van Loon AM, de Vries LS, et al. Genotype distribution, viral load and clinical characteristics of infants with postnatal or congenital cytomegalovirus infection. PLoS One 2014; 9(9):e108018.
  63. Brañas P, Blázquez-Gamero D, Galindo A, Prieto C, Olabarrieta I, Cuadrado I, et al. Cytomegalovirus genotype distribution among congenitally and postnatally infected patients: Association of particular glycoprotein (g) B and gN types with symptomatic disease. Open Forum Infect Dis 2015; 2(4):ofv151.
  64. Pignatelli S, Lazzarotto T, Gatto MR, Dal Monte P, Landini MP, Faldella G, et al. Cytomegalovirus gN genotypes distribution among congenitally infected newborns and their relationship with symptoms at birth and sequelae. Clin Infect Dis 2010; 51(1):33-41.
  65. Sarkar A, Das D, Ansari S, Chatterjee RP, Mishra L, Basu B, et al. Genotypes of glycoprotein B gene among the Indian symptomatic neonates with congenital CMV infection. BMC Pediatr 2019; 19(1):291.
  66. Mujtaba G, Khurshid A, Sharif S, Alam MM, Aamir UB, Shaukat S, et al. Distribution of cytomegalovirus genotypes among neonates born to infected mothers in Islamabad, Pakistan. PloS One 2016; 11(7):e0156049.
  67. Ciotti M, Cella E, Rittà M, Ciccozzi M, Cavallo R, Perno CF, et al. Cytomegalovirus Glycoprotein B Genotype Distribution in Italian Transplant Patients. Intervirology 2017; 60(4):165-70.
  68. Soleimani AR, Jafari M, Piroozmand A, Nikoueinejad H, Akbari H, Einollahi B. The incidence of cytomegalovirus glycoprotein B genotypes in kidney transplant recipients in Iran. Int J Organ Transplant Med 2018; 9(4):173-177.
  69. Taherkhani R, Farshadpour F, Makvandi M, Hamidifard M, Esmailizadeh M, Ahmadi B, et al. Determination of cytomegalovirus prevalence and glycoprotein B genotypes among ulcerative colitis patients in Ahvaz, Iran. Jundishapur J Microbiol 2015; 8(2):e17458.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 7
September 2020
Pages 97-108

Files

Share

How to cite

Statistics