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孕期巨细胞病毒非原发性感染。血清学检查有助于诊断吗？

Cytomegalovirus non-primary infection during pregnancy. Can serology help with diagnosis?

作者信息

Picone O, Grangeot-Keros L, Senat Mv, Fuchs F, Bouthry E, Ayoubi Jm, Benachi A, Vauloup-Fellous C

机构信息

a Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Foch , Suresnes , France.

b Collège Français d'échographie Foetale (CFEF) , Chateaubriant, France.

出版信息

J Matern Fetal Neonatal Med. 2017 Jan;30(2):224-227. doi: 10.3109/14767058.2016.1169521. Epub 2016 May 5.

DOI:10.3109/14767058.2016.1169521
PMID:27147102
Abstract

Diagnosis of cytomegalovirus (CMV) primary infection is reliable, but diagnosis of CMV non-primary infection (NPI) is questionable. Our aim is to highlight the difficulties met in diagnosis of CMV NPI. We illustrate that in proven cases of CMV NPI, very different serologic and molecular patterns may be observed and that routine serologic testing may fail to help with diagnosis. These results point out that many data available in literature concerning the prevalence of NPI, materno-fetal transmission rates and consequences of NPI may be wrong. We need to know how frequently they occur, are transmitted and cause fetal damages. Diagnosis of NPI must be improved, along with our understanding of the mechanisms leading to intrauterine CMV transmission and congenital infection in babies born to women with preexisting immunity.

摘要

巨细胞病毒（CMV）原发性感染的诊断是可靠的，但CMV非原发性感染（NPI）的诊断存在疑问。我们的目的是强调CMV NPI诊断中遇到的困难。我们举例说明，在已证实的CMV NPI病例中，可能观察到非常不同的血清学和分子模式，并且常规血清学检测可能无助于诊断。这些结果指出，文献中许多关于NPI患病率、母婴传播率和NPI后果的数据可能是错误的。我们需要了解它们发生的频率、传播情况以及对胎儿造成损害的情况。必须改进NPI的诊断，同时加深我们对导致有既往免疫力的女性所生婴儿发生宫内CMV传播和先天性感染机制的理解。

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