Cytomegalovirus urinary excretion and long term outcome in children with congenital cytomegalovirus infection
Cytomegalovirus urinary excretion and long term outcome in children with congenital cytomegalovirus infection
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DOI：
10.1097/00006454-200006000-00003
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发表时间：
2000-06-01
影响因子：
3.6
通讯作者：
Yow, MD
中科院分区：
文献类型：
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作者：
Noyola, DE;Demmler, GJ;Yow, MD
背景巨细胞病毒（CMV）是先天性感染的最常见原因，有症状和无症状的婴儿都可能有长期后遗症。患有先天性CMV感染的儿童是慢性感染，并在尿液中长时间排出CMV。然而，长期病毒复制对这些儿童的长期结果的影响尚不清楚。确定CMV排泄持续时间是否与有症状和无症状先天性感染儿童6岁时的结局相关。纵向队列研究。先天性CMV感染的儿童在出生时就被确定，并在先天性CMV感染的长期影响研究中进行前瞻性随访。CMV尿排泄的持续时间与生长、神经发育和6岁时感音神经性听力损失（SNHL）的存在和进展之间的关系被确定。结果：无症状（中位数4.55年）和有症状（中位数2.97年）先天性CMV感染患儿的病毒尿排泄持续时间无显著差异（P = 0.11）。此外，长期生长或认知结果与病毒排泄持续时间之间没有相关性。然而，有更大比例的儿童排泄CMV 4年（P = 0.019，P = 0.009）。先天性CMV感染的儿童会慢性感染数年，但CMV尿排泄的持续时间与生长异常或神经发育缺陷无关。然而，SNHL和进行性SNHL与CMV排泄持续时间较短相关。
Background. Cytomegalovirus (CMV) is the most frequent cause of congenital infection, and both symptomatic and asymptomatic infants may have long term sequelae. Children with congenital CMV infection are chronically infected and excrete CMV in the urine for prolonged periods. However, the effect of prolonged viral replication on the long term outcome of these children is unknown.Objective. To determine whether duration of CMV excretion is associated with outcome at 6 years of life in symptomatic and asymptomatic congenitally infected children.Methods. Longitudinal cohort study. Children congenitally infected with CMV were identified at birth and followed prospectively in a study of long term effects of congenital CMV infection. The relationship between duration of CMV urinary excretion and growth, neurodevelopment and presence and progression of sensorineural hearing loss (SNHL) at 6 years of age was determined.Results, There was no significant difference in the duration of viral urinary excretion between children born with asymptomatic (median, 4.55 years) and symptomatic (median, 2.97 years) congenital CMV infection (P = 0.11). Furthermore there was no association between long term growth or cognitive outcome and duration of viral excretion. However, a significantly greater proportion of children who excreted CMV for 4 years (P = 0.019, P = 0.009, respectively).Conclusions. Children congenitally infected with CMV are chronically infected for years, but the duration of CMV urinary excretion is not associated with abnormalities of growth, or neurodevelopmental deficits. However, SNHL and progressive SNHL were associated with a shorter duration of CMV excretion.