先天性感染新生儿各种体液中的人巨细胞病毒载量。

Human cytomegalovirus load in various body fluids of congenitally infected newborns.

作者信息

Halwachs-Baumann Gabriele, Genser Bernd, Pailer Sabine, Engele Heidi, Rosegger Hellfried, Schalk Andreas, Kessler Harald H, Truschnig-Wilders Martie

机构信息

Department of Clinical Chemistry and Laboratory Medicine, University Hospital Graz, Auenbruggerplatz 29, A-8036 Graz, Austria.

出版信息

J Clin Virol. 2002 Dec;25 Suppl 3:S81-7. doi: 10.1016/s1386-6532(02)00188-9.

DOI:10.1016/s1386-6532(02)00188-9

PMID:12467781

Abstract

BACKGROUND

Congenital human cytomegalovirus (hCMV) infection is the most common intrauterine viral disease in western countries. Little is known about hCMV virus load in various body fluids of congenitally infected children.

OBJECTIVES

To determine virus load in various body fluids. To assess the impact of hCMV virus load to predict the outcome of congenitally infected newborns and efficacy of antiviral therapy.

STUDY DESIGN

Cord vein blood, urine, and cerebrospinal fluid (CSF) of congenitally hCMV-infected children were investigated and hCMV load was determined by quantitative polymerase chain reaction (PCR). Fourteen of 30 children had clinical symptoms and/or pathological laboratory results and 16 had none of them at birth. Ganciclovir was given to 21 children (10 of them with symptoms, 11 of them without symptoms). Viral load before and after therapy was measured.

RESULTS

There was a significant difference between median virus load in cord vein blood (2.3 x 10(3) copies per ml) and in urine (4.2 x 10(5) copies per ml; P<0.001) at diagnosis of congenital hCMV infection. At that time, no significant difference of virus load was found between the various groups (symptomatic vs. asymptomatic; with therapy vs. without therapy), neither in serum nor in urine. Comparing median virus load in urine before (3.0 x 10(5) copies per ml) and after therapy (2.0 x 10(3) copies per ml), a significant decrease was observed (P<0.001). Virus load in CSF was always found to be less than 400 copies per ml, and only those children with symptoms showed a positive result.

CONCLUSION

At birth, virus load in urine seems to be superior to that in cord vein blood to reflect the situation in the organs precisely. As predicting factor for the risk of developing symptoms, only hCMV detection in the CSF appears to be promising. The significant decrease of virus load in children with therapy may reflect the efficacy of therapy. Studies including a greater number of children are needed.

摘要

背景

先天性人巨细胞病毒（hCMV）感染是西方国家最常见的宫内病毒疾病。对于先天性感染儿童各种体液中的hCMV病毒载量了解甚少。

目的

确定各种体液中的病毒载量。评估hCMV病毒载量对预测先天性感染新生儿结局及抗病毒治疗疗效的影响。

研究设计

对先天性hCMV感染儿童的脐静脉血、尿液和脑脊液（CSF）进行研究，并通过定量聚合酶链反应（PCR）测定hCMV载量。30名儿童中有14名出生时有临床症状和/或病理实验室结果，16名出生时无上述情况。21名儿童接受了更昔洛韦治疗（其中10名有症状，11名无症状）。测量治疗前后的病毒载量。

结果

先天性hCMV感染诊断时，脐静脉血中的病毒载量中位数（每毫升2.3×10³拷贝）与尿液中的病毒载量中位数（每毫升4.2×10⁵拷贝；P<0.001）之间存在显著差异。此时，各亚组（有症状与无症状；接受治疗与未接受治疗）之间的病毒载量在血清和尿液中均无显著差异。比较治疗前尿液中的病毒载量中位数（每毫升3.0×10⁵拷贝）和治疗后的病毒载量中位数（每毫升2.0×10³拷贝），观察到显著下降（P<0.001）。脑脊液中的病毒载量始终低于每毫升400拷贝，只有那些有症状的儿童检测结果呈阳性。