Immunization to prevent congenital cytomegalovirus infection.

INTRODUCTION

A primary maternal cytomegalovirus (CMV) during pregnancy causes newborn disease that includes hearing deficit and/or mental retardation.

SOURCES OF DATA

Relevant published literature.

AREAS OF AGREEMENT

There are no biologic obstacles to immunization against fetal/placental infection with CMV.

AREAS OF UNCERTAINTY

CMV vaccine trials may be difficult due to a lack of public awareness of CMV. Vaccine trials that use fetal infection as an endpoint will be prolonged, since vaccination will need to occur preconception.

AREAS TIMELY FOR DEVELOPING RESEARCH

Vaccines in preclinical development include antigens of the CMV gB glycoprotein and the gH/gL UL128, 130 and 131 pentameric complex. These antigens induce antibodies that block viral entry into fibroblasts and endothelial/epithelial cells. Vaccines immunogenic in animals include an inactivated virus with a wild-type UL131 gene, a DNA vaccine using a wild-type UL130 gene and peptide vaccines using peptides from UL130 and 131.

CONCLUSIONS

In spite of these potential obstacles, successful evaluation of CMV vaccines is possible.