Hantz Sébastien, Alain Sophie
CNR des Herpesvirus, laboratoire de bactériologievirologie-hygiène, CHU de Limoges, université de Limoges, Inserm, RESINFIT, U1092, Limoges, France.
Rev Prat. 2019 Mar;69(3):301-306.
Cytomegalovirus infections. Cytomegalovirus (CMV) infections, which are common in children and adolescents, are often asymptomatic or with little specific signs. When they occur in adults, clinical forms may be more severe even in the immunocompetent. CMV is responsible for significant morbidity and mortality in transplant patients. In pregnant women, congenital CMV infection can lead to neurosensory damages requiring diagnosis and early management. The diagnosis of primary infection is based on serology, whereas the monitoring of infection in immunocompromised patients requires the use of polymerase chain reaction. As screening for congenital infection by serology is not recommended so far, it will be realized in an evocative context. Therapeutic options are still limited and expose to haematological or renal toxicity, but new antivirals (maribavir, letermovir) should be available soon to optimize therapeutic management.
巨细胞病毒感染。巨细胞病毒(CMV)感染在儿童和青少年中很常见,通常无症状或只有很少的特异性体征。当发生在成人身上时,即使免疫功能正常,临床症状也可能更严重。CMV是移植患者发病和死亡的重要原因。在孕妇中,先天性CMV感染可导致神经感觉损伤,需要进行诊断和早期处理。原发性感染的诊断基于血清学,而免疫功能低下患者感染的监测需要使用聚合酶链反应。由于目前不建议通过血清学筛查先天性感染,因此将在有提示性的情况下进行。治疗选择仍然有限,且存在血液学或肾毒性,但新型抗病毒药物(马瑞巴韦、来特莫韦)很快就会上市,以优化治疗管理。