TY - JOUR 
A1 - Goycochea Valdivia, Walter Alfredo
AU - Baquero Artigao, Fernando
AU - Rosal, Teresa del
AU - Frick, Marie Antoinette
AU - Rojo, Pablo
AU - Echeverría, María Juncal
AU - Noguera Julián, Antoni
AU - Bringué, Xavier
AU - Saavedra Lozano, Jesús
AU - Vives Oñós, Isabel
AU - Moliner Calderón, Elisenda
AU - Cilleruelo Ortega, María José
AU - Cuadrado, Irene
AU - Colino, Elena
AU - Castells, Laura
AU - Tagarro García, Alfredo
AU - Vilas, Javier
AU - Soler Palacín, Pere
AU - Blázquez Gamero, Daniel
T1 - 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
Y1 - 2017
SN - 1058-4838
UR - http://hdl.handle.net/11268/7180
AB - 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.
KW - ADN
KW - Líquido cefalorraquídeo
KW - Lactantes
KW - Gen
KW - Primera infancia
KW - Enfermedad del sistema nervioso
LA - eng
ER -