Nardiello S, Galanti B
Istituto di Clinica delle Malattie Infettive, I Facoltà di Medicina e Chirurgia dell'Università di Napoli.
Clin Ter. 1990 Sep 15;134(5):281-7.
Congenital CMV infection occurs frequently as a consequence of primary maternal CMV infection during pregnancy: clinical abnormalities are present at birth or may become apparent later in about 25% of infected infants. Transmission of CMV to the fetus occurs less frequently as a consequence of CMV reactivation in immune mothers, and is rarely associated with clinical manifestations at birth or long-term sequelae. The incidence of congenital CMV infection can be reduced by avoiding primary infection during pregnancy and knowledge of the epidemiology of CMV infection allows physicians to inform pregnant women on major risk factors. Since vaccination of nonimmune women could prevent congenital disease, the development of a suitable and safe CMV vaccine would be desirable. New anti-viral agents with anti-CMV activity are expected to be lifesaving in infants with disseminated visceral disease; moreover, if safe, they could be used to treat CMV disease prenatally. If effective anti-CMV drugs were available the development of simple, rapid and inexpensive methods for the early diagnosis of congenital CMV infection would become more urgent. Instruction of parents, family doctors and all those involved in child care can improve prevention of congenital CMV infection.
约25%的受感染婴儿在出生时即有临床异常表现,或在之后出现明显症状。免疫功能正常的母亲体内巨细胞病毒再激活导致胎儿感染的情况较少见,且很少与出生时的临床表现或长期后遗症相关。通过避免孕期原发性感染可降低先天性巨细胞病毒感染的发生率,了解巨细胞病毒感染的流行病学情况有助于医生告知孕妇主要危险因素。由于对非免疫女性进行疫苗接种可预防先天性疾病,因此研发合适且安全的巨细胞病毒疫苗很有必要。具有抗巨细胞病毒活性的新型抗病毒药物有望挽救患有播散性内脏疾病的婴儿生命;此外,如果安全,这些药物可用于产前治疗巨细胞病毒疾病。如果有有效的抗巨细胞病毒药物,那么开发简单、快速且廉价的先天性巨细胞病毒感染早期诊断方法将变得更加迫切。对父母、家庭医生及所有参与儿童护理的人员进行指导可改善先天性巨细胞病毒感染的预防工作。