Adler Stuart P, Nigro Giovanni
Department of Pediatrics, Virginia Commonwealth University, Richmond, VA 23298, USA.
Herpes. 2008 Nov;15(2):24-7.
Primary maternal infection with cytomegalovirus (CMV) during or just before pregnancy is responsible for nearly all congenital infections where the baby is symptomatic at birth. If primary maternal CMV infection occurs during the first or second trimester, between one-third and one-half of fetuses become infected, and between one-half and one-third of infected fetuses go on to have symptoms at birth. Experiments using a guinea-pig model of CMV infection in pregnant dames (and subsequent observational studies in humans) indicate a beneficial effect is associated with administering high-titre CMV hyperimmunoglobulin (HIg) to pregnant women with primary CMV infection. HIg appears to be effective for treating and preventing fetal CMV infection; its mechanism of action probably includes reduced placental inflammation, viral neutralization associated with high-avidity antibodies and, possibly, downregulation of cytokine-mediated cellular immune responses.
孕期或临产前孕妇初次感染巨细胞病毒（CMV）几乎是导致所有出生时出现症状的先天性感染的原因。如果孕妇初次感染CMV发生在孕早期或孕中期，三分之一至二分之一的胎儿会受到感染，而受感染胎儿中有二分之一至三分之一会在出生时出现症状。在怀孕母豚鼠身上进行的CMV感染豚鼠模型实验（以及随后在人类中的观察性研究）表明，对初次感染CMV的孕妇给予高滴度CMV高效价免疫球蛋白（HIg）具有有益效果。HIg似乎对治疗和预防胎儿CMV感染有效；其作用机制可能包括减轻胎盘炎症、与高亲和力抗体相关的病毒中和作用，以及可能下调细胞因子介导的细胞免疫反应。
