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欧洲先天性感染倡议(ECCI)关于先天性巨细胞病毒感染产前、新生儿期和产后管理的共识建议。

Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI).

作者信息

Leruez-Ville Marianne, Chatzakis Christos, Lilleri Daniele, Blazquez-Gamero Daniel, Alarcon Ana, Bourgon Nicolas, Foulon Ina, Fourgeaud Jacques, Gonce Anna, Jones Christine E, Klapper Paul, Krom André, Lazzarotto Tiziana, Lyall Hermione, Paixao Paulo, Papaevangelou Vassiliki, Puchhammer Elisabeth, Sourvinos George, Vallely Pamela, Ville Yves, Vossen Ann

机构信息

Université Paris Cité, URP 7328 FETUS, F-75015, Paris, France.

Virology Laboratory, Reference Laboratory for Cytomegalovirus Infections, Hôpital Necker Enfants Malades, GHU Paris Centre, AP-HP, Paris, France.

出版信息

Lancet Reg Health Eur. 2024 Apr 1;40:100892. doi: 10.1016/j.lanepe.2024.100892. eCollection 2024 May.

Abstract

Congenital cytomegalovirus (cCMV) infection carries a significant burden with a 0.64% global prevalence and a 17-20% chance of serious long-term effects in children. Since the last guidelines, our understanding, particularly regarding primary maternal infections, has improved. A cCMV guidelines group was convened under the patronage of the European Society of Clinical Virology in April 2023 to refine these insights. The quality and validity of selected studies were assessed for potential biases and the GRADE framework was employed to evaluate quality of evidence across key domains. The resulting recommendations address managing cCMV, spanning prevention to postnatal care. Emphasizing early and accurate maternal diagnosis through serological tests enhances risk management and prevention strategies, including using valaciclovir to prevent vertical transmission. The guidelines also strive to refine personalized postnatal care based on risk assessments, ensuring targeted interventions for affected families.

摘要

先天性巨细胞病毒(cCMV)感染负担沉重,全球患病率为0.64%,儿童出现严重长期影响的几率为17%-20%。自上次发布指南以来,我们的认识,尤其是关于孕妇原发性感染的认识有所提高。2023年4月,在欧洲临床病毒学会的支持下召集了一个cCMV指南小组,以完善这些见解。对所选研究的质量和有效性进行了潜在偏倚评估,并采用GRADE框架评估关键领域的证据质量。由此产生的建议涉及cCMV的管理,涵盖从预防到产后护理的各个方面。强调通过血清学检测进行早期准确的孕妇诊断可加强风险管理和预防策略,包括使用伐昔洛韦预防垂直传播。这些指南还努力根据风险评估完善个性化的产后护理,确保对受影响家庭进行有针对性的干预。

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