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缬更昔洛韦治疗有症状和无症状先天性巨细胞病毒感染儿童的长期临床、听力、视觉、神经认知和行为结局

Long-Term Clinical, Audiological, Visual, Neurocognitive and Behavioral Outcome in Children With Symptomatic and Asymptomatic Congenital Cytomegalovirus Infection Treated With Valganciclovir.

作者信息

Turriziani Colonna Arianna, Buonsenso Danilo, Pata Davide, Salerno Gilda, Chieffo Daniela P R, Romeo Domenico M, Faccia Valerio, Conti Guido, Molle Fernando, Baldascino Antonio, De Waure Chiara, Acampora Anna, Luciano Rita, Santangelo Rosaria, Valentini Piero

机构信息

Istituto di Pediatria, Università Cattolica del Sacro Cuore, Rome, Italy.

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Front Med (Lausanne). 2020 Jul 24;7:268. doi: 10.3389/fmed.2020.00268. eCollection 2020.

Abstract

Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. There are no enough data on long-term outcome of newborns with congenital CMV (cCMV) infection, particularly for those asymptomatic at birth. For this reason, we performed this study to evaluate long-term audiological, visual, neurocognitive, and behavioral outcome in patients with symptomatic and asymptomatic cCMV infection treated with oral Valganciclovir (VGC). Thirty-six newborns with confirmed cCMV infection were evaluated: 12 (33.3%) symptomatic at birth and 24 asymptomatic (66.7%). No one had cognitive impairment. Cognitive assessment scales resulted abnormal in 4/35 patients (11.4%). 11/21 patients (52.4%) achieved abnormal scores in neuropsychological tests. The language evaluation gave pathological results in 6/21 (28.5%) patients. 6/35 patients (17.1%) developed SNHL, all symptomatic at birth except one. None of the 34 patients evaluated developed CMV retinopathy. Our study shows that both symptomatic and asymptomatic newborns with cCMV infection develop long-term sequelae, particularly in the behavioral and communicative areas, independently from the trimester of maternal infection.

摘要

巨细胞病毒(CMV)是人类先天性感染最常见的病因。关于先天性CMV(cCMV)感染新生儿的长期预后,尤其是出生时无症状者,目前尚无足够的数据。因此,我们开展了这项研究,以评估接受口服缬更昔洛韦(VGC)治疗的有症状和无症状cCMV感染患者的长期听力、视力、神经认知和行为预后。对36例确诊为cCMV感染的新生儿进行了评估:12例(33.3%)出生时有症状,24例无症状(66.7%)。无人有认知障碍。认知评估量表在4/35例患者(11.4%)中结果异常。11/21例患者(52.4%)在神经心理测试中得分异常。语言评估在6/21例(28.5%)患者中得出病理结果。6/35例患者(17.1%)发生感音神经性听力损失(SNHL),除1例外在出生时均有症状。在接受评估的34例患者中无人发生CMV视网膜病变。我们的研究表明,有症状和无症状的cCMV感染新生儿都会出现长期后遗症,尤其是在行为和交流领域,且与母亲感染的孕周无关。

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