Avarello I, Cancemi A, D'Ambra A
Dipartimento Materno Infantile e Scienze Radiologiche, Università degli Studi di Catania, Catania, Italia -
Minerva Pediatr. 2013 Oct;65(5):541-63.
In recent years, infection with cytomegalovirus (CMV) was the subject of numerous studies, one side being the most frequent congenital infection in newborns and one that determines the increased incidence of sequelae distance (about one third of childhood deafness is due to CMV), and the other one of the most frequent and serious opportunistic infections in immunocompromised individuals. Of newborns with congenital infection, approximately 10% are symptomatic at birth. Of the remaining 90%, asymptomatic at birth, 10-15% will develop sequelae from a distance. Regarding the possibility of vertical transmission of the disease from mother to fetus, the debate is still open on the usefulness or not to set a screening during pregnancy in order to prevent or limit the damage caused fetal infection. Despite detailed knowledge about the epidemiology and pathogenesis of CMV disease in pregnant women, this infection remains largely unknown to most women. The opportunity of a serological screening is important, however, since more than 90% of primary CMV infection in pregnancy are asymptomatic and may remain asymptomatic in the fetus. The education on methods to prevent transmission of CMV, particularly among young women of childbearing age, must continue until an effective vaccine becomes available. In this article we summarize the current concepts regarding the epidemiology, pathogenesis, symptoms and prevention of CMV disease, with particular focus on strategies to improve awareness of the risk of CMV infection in women of childbearing age.
近年来,巨细胞病毒(CMV)感染成为众多研究的主题,一方面它是新生儿中最常见的先天性感染,也是导致远期后遗症发病率增加的原因之一(约三分之一的儿童期耳聋归因于CMV),另一方面它是免疫功能低下个体中最常见且严重的机会性感染之一。在先天性感染的新生儿中,约10%在出生时出现症状。其余90%出生时无症状的新生儿中,10 - 15%会在远期出现后遗症。关于该疾病从母亲垂直传播给胎儿的可能性,对于孕期是否进行筛查以预防或限制胎儿感染所造成的损害,目前仍存在争议。尽管对孕妇CMV疾病的流行病学和发病机制已有详细了解,但大多数女性对这种感染仍知之甚少。然而,血清学筛查很重要,因为孕期超过90%的原发性CMV感染是无症状的,且在胎儿中可能也保持无症状。在有效疫苗问世之前,必须持续开展关于预防CMV传播方法的教育,尤其是在育龄年轻女性中。在本文中,我们总结了关于CMV疾病的流行病学、发病机制、症状和预防的当前概念,特别关注提高育龄女性对CMV感染风险认识的策略。