CYTOMEGALOVIRAL INFECTION AND DISEASE
CYTOMEGALOVIRAL INFECTION AND DISEASE
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DOI：
10.1093/infdis/151.5.772
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发表时间：
1985-01-01
影响因子：
6.4
通讯作者：
SCHONBERGER, LB
中科院分区：
文献类型：
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作者：
KINNEY, JS;ONORATO, IM;SCHONBERGER, LB
新生儿巨细胞病毒（CMV）和巨细胞包涵体病（CID）的发病率已引起医学界和公众的高度重视。这种认识导致了对CMV感染和疾病风险的信息要求，以及预防或限制其传播的建议，特别是在育龄妇女可能受到影响的环境中。CMV是一种普遍存在的病毒，在大多数人一生中的某个时候感染他们。CMV在人与人之间的传播方式尚不完全清楚。获得似乎需要密切或亲密接触的人谁是排泄CMV在他们的尿液，唾液或其他分泌物。性接触可能引起CMV传播的频率尚不清楚，但性病传播似乎是某些成年人群（即同性恋男性）的主要感染源。婴儿和儿童在子宫内、出生时或围产期从其他感染儿童或其母亲获得CMV感染[1-3]。CMV也可以通过输血、母乳和移植器官传播[4-7]。正常儿童和成人的感染通常无症状，但在免疫功能低下的宿主中，CMV可能是一种机会性病原体，并导致严重的疾病，发病率和死亡率很高。CMV宫内感染是所有宫内感染中最常见的，估计发生在所有活产的0.4%-2.3%中。它可能具有可变的结果，并且可能由妊娠期间获得的原发感染或血清阳性女性的复发性母体感染（再激活或再感染）引起[8]。目前认为，大多数但不是所有的有症状的先天性CMV感染都是由原发感染引起的，在美国，10%-65%的进入育龄期的妇女（取决于她们的种族和社会经济地位）是血清阴性的，易受原发CMV感染[8]。妊娠期间的血清转化率估计在1%至2%之间0 [9-11]。只有40%-50%的孕妇发生原发性CMV感染后会将感染传给胎儿。一项研究[9]发现，在受感染的婴儿中，5%-10%会在出生时出现症状。受影响最严重的是CID患者，表现为肝脾肿大、黄疸、点状皮疹、脉络膜视网膜炎、脑钙化和小头畸形。这些CID儿童是与CMV相关的主要长期公共卫生问题。在先天性感染的婴儿中，90%-95%在出生时有症状：其中10%将在儿童期后期出现感染表现，通常是听力损失（有时是进行性的）或智力低下[12，13]。先天性或围产期感染的性质是慢性的，与病毒排泄
The medical community and general public are be-coming increasingly aware of cytomegalovirus (CMV) and cytomegalic inclusion disease (CID) of newborns. This awareness has led to requests for in-formation about the risks of infection and disease due to CMV and suggestions to prevent or limit their spread, particularly in settings where women of childbearing age may be affected. CMV is an ubiquitous virus that infects most persons at some time during their lives. The modes of transmission of CMV from person to person are incompletely un-derstood. Acquisition appears to require close or intimate contact with persons who are excreting CMV in their urine, saliva, or other secretions. The frequency with which sexual contact may cause transmission of CMV is not clear, but venereal transmis-sion appears to be a major source of infection in some adult populations (ie, homosexual men). Infants and children acquire CMV infection either from other infected children or from their mothers either in utero, at birth, or during the perinatal period [1-3]. CMV can also be transmitted via blood transfusions, breastmilk, and transplanted organs [4-7]. Infection in normal children and adults is usually asymptomatic, although in immunocompromised hosts CMV may be an opportunistic pathogen and cause serious illness with high morbidity and mortality. Intrauterine infection with CMV is the most common of all the intrauterine infections and occurs in an estimated 0.4%-2.3% of all live births. It can have a variable outcome and may result from either primary infection acquired during gestation or a recurrent maternal infection (reactivation or reinfection) in a seropositive woman [8]. It is currently believed that most, but not all, symptomatic congenital CMV infections result from primary in-fection.In the United States, 10%-65% of women (de-pending on their race and socioeconomic status) entering their childbearing years are seronegative and susceptible to primary CMV infection [8]. The rate of seroconversion during pregnancy is estimated to be between 1% and 2% 0 [9-11]. Only 40%-50% of pregnant women who develop primary CMV infec-tion will transmit that infection to their fetuses. Of those infants infected, one study [9] has found that 5%-10% will show symptoms at birth. The most se-verely affected are those with CID manifested by hepatosplenomegaly, jaundice, petechial rash, chorioretinitis, cerebral calcifications, and microcephaly. These children with CID are the major long-term public health problem associated with CMV. Of con-genitally infected infants, 90%-95% are sympto-matic at birth: 10% of these will develop manifestations of infection later in childhood, usually hearing loss (which is sometimes progressive) or poor intellec-tual performance [12, 13]. Congenital or perinatal infections are chronic in nature, with viral excretion