Bradford Russell D, Cloud Gretchen, Lakeman Alfred D, Boppana Suresh, Kimberlin David W, Jacobs Richard, Demmler Gail, Sanchez Pablo, Britt William, Soong Seng-jaw, Whitley Richard J
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
J Infect Dis. 2005 Jan 15;191(2):227-33. doi: 10.1086/426456. Epub 2004 Dec 16.
The study sought to determine the relationship between cytomegalovirus (CMV) viremia during early infancy and clinical and laboratory outcome events, particularly hearing loss in infants with symptomatic congenital CMV infection involving the central nervous system (CNS).
A total of 147 infant patients were enrolled prospectively in 2 clinical trials evaluating ganciclovir for the treatment of symptomatic congenital CMV infection involving the CNS. Aliquots of serum collected at enrollment in either of the 2 trials were available from 50 of the infants, and the degree of viremia was determined by real-time quantitative polymerase chain reaction.
Of the 50 infants from whom serum samples were available, 37 had detectable CMV DNA in the serum sample collected at enrollment and were classified as viremic. Viremic infants were more likely to have (1) hearing loss both at enrollment (P = .045) and at the 6-month follow-up testing (P = .035) and (2) other indicators of active CMV disease, including elevated levels of alanine aminotransferase, petechial rash, and organomegaly.
In children with symptomatic congenital CMV infection involving the CNS, viremia during early infancy is associated with hearing loss and systemic CMV disease.
本研究旨在确定婴儿早期巨细胞病毒(CMV)病毒血症与临床及实验室转归事件之间的关系,尤其是涉及中枢神经系统(CNS)的有症状先天性CMV感染婴儿的听力损失情况。
共有147例婴儿患者前瞻性纳入两项评估更昔洛韦治疗涉及CNS的有症状先天性CMV感染的临床试验。两项试验中任何一项入组时采集的血清标本可从50例婴儿中获得,病毒血症程度通过实时定量聚合酶链反应确定。
在可获得血清样本的50例婴儿中,37例在入组时采集的血清样本中检测到CMV DNA,被归类为病毒血症患者。病毒血症婴儿更有可能出现以下情况:(1)入组时(P = 0.045)和6个月随访检测时(P = 0.035)均出现听力损失;(2)出现其他活动性CMV疾病指标,包括丙氨酸转氨酶水平升高、瘀点疹和器官肿大。
在涉及CNS的有症状先天性CMV感染儿童中,婴儿早期的病毒血症与听力损失和全身性CMV疾病相关。