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

Goycochea Valdivia, Walter AlfredoBaquero Artigao, FernandoRosal, Teresa delFrick, Marie AntoinetteRojo, PabloEcheverría, María JuncalNoguera Julián, AntoniBringué, XavierSaavedra Lozano, JesúsVives Oñós, IsabelMoliner Calderón, ElisendaCilleruelo Ortega, María JoséCuadrado, IreneColino, ElenaCastells, LauraTagarro García, AlfredoVilas, JavierSoler Palacín, PereBlázquez Gamero, Daniel2018-04-052018-04-052017Goycochea-Valdivia, W. A., Baquero-Artigao, F., del Rosal, T., Frick, M. A., Rojo, P., Echeverría, M. J., ... & Moliner, E. (2017). 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. Clinical Infectious Diseases, 64(10), 1335-1342. DOI:10.1093/cid/cix1051058-4838http://hdl.handle.net/11268/7180BACKGROUND: 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.engCytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-upjournal article1537-659110.1093/cid/cix105restricted accessADNLíquido cefalorraquídeoLactantesGenPrimera infanciaEnfermedad del sistema nervioso