Department of Gynaecology & Obstetrics, Prenatal Diagnostic Centre, Tianjin Medical University General Hospital, Tianjin, China.
Department of Occupational & Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China.
Epidemiol Infect. 2020 Feb 19;148:e34. doi: 10.1017/S0950268820000217.
Cytomegalovirus (CMV) enters latency after primary infection and can reactivate periodically with virus excreted in body fluids which can be called shedding. CMV shedding during the early stage of pregnancy is associated with adverse pregnancy outcome. The shedding pattern in healthy seropositive women who plan to have babies has not been well characterised. Vaginal swabs, urine and blood were collected from 1262 CMV IgG-positive women who intended to have babies and tested for CMV DNA by fluorogenic quantitative PCR method. Serum IgM was also detected. The association between sociodemographic characteristics and CMV shedding prevalence was analysed. Among 1262 seropositive women, 12.8% (161/1262) were detected CMV DNA positive in at least one body fluid. CMV DNA was more frequently detected in vaginal secretion (10.5%) than in urine (3.2%) and blood (0.6%) also with higher viral loads (P < 0.00). CMV shedding was more likely detected in IgM-positive women than IgM-negative women (29.5% (13/44) vs. 12.2% (148/1218); OR 3.03, 95% CI 1.55-5.93; P = 0.001). CMV shedding in vaginal secretion was highly correlated with shedding in urine, the immune state of IgM, the adverse pregnant history and younger age. CMV shedding was more commonly detected in vaginal secretion than in urine or blood with higher viral loads among healthy seropositive women of reproductive age. Further studies are needed to figure out whether the shedding is occasional or continuous and whether it is associated with adverse pregnancy outcomes.
巨细胞病毒(CMV)在初次感染后进入潜伏期,并可定期通过体液排出病毒而重新激活,这种病毒排出的现象可称为脱落。妊娠早期 CMV 脱落与不良妊娠结局相关。计划妊娠的健康 CMV 抗体阳性妇女的脱落模式尚未得到充分描述。本研究收集了 1262 例计划妊娠的 CMV IgG 阳性妇女的阴道拭子、尿液和血液标本,采用荧光定量 PCR 法检测 CMV DNA,并检测血清 IgM。分析社会人口特征与 CMV 脱落率的相关性。在 1262 例血清阳性妇女中,12.8%(161/1262)在至少一种体液中检测到 CMV DNA 阳性。阴道分泌物中 CMV DNA (10.5%)比尿液(3.2%)和血液(0.6%)更常被检测到,且病毒载量更高(P < 0.00)。IgM 阳性妇女比 IgM 阴性妇女更易检测到 CMV 脱落(29.5%(13/44)vs. 12.2%(148/1218);OR 3.03,95%CI 1.55-5.93;P = 0.001)。阴道分泌物 CMV 脱落与尿液脱落、IgM 免疫状态、不良妊娠史和年龄较小密切相关。在生育年龄的健康 CMV 抗体阳性妇女中,阴道分泌物中的 CMV 脱落比尿液或血液更常见,病毒载量更高。需要进一步研究来确定脱落是偶发还是连续的,以及是否与不良妊娠结局相关。