CYTOMEGALOVIRUS INFECTION IN PRETERM INFANTS

早产儿巨细胞病毒感染

• 批准号: 6265631
• 负责人: SANDRA BURCHETT
• 金额: $ 0.07万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6265631
• 关键词: Herpesviridae disease; clinical research; congenital infection; cytomegalovirus; hearing disorders; hepatitis; human data; human milk; longitudinal human study; passive immunization; perinatal; pneumonia; pregnancy infection; premature infant human; vertical transmission; women's health

Approximately 1% of all infants have congenital cytomegalovirus (CMV) infection. In symptomatically infected infants, some may have manifestations of central nervous system disease (including deafness, partial blindness, microcephaly, intracerebral calcifications) or of disseminated disease (hematologic abnormality, hepatitis, gastroenteritis) which can also be life threatening or result in serious morbidity. There are no approved therapies for either group of symptomatic infants, although those with CNS disease may be offered a trial of ganciclovir, but even this therapy is not yet approved and can have consequences in itself. Symptomatic infection usually occurs in infants born to women who have primary CMV infection. Reasoning that the lack of passively acquired maternal antibody in these infected infants of women with primary infection is at least in part permissive for symptomatic infection, the scenario in which an infant is born pre-term and therefore prior to receipt of high levels of passive maternal antibody, may be analogous. Hence if the pre-term infant is infected by exposure to CMV in the birth canal or by breastmilk, disease manifestations may be present in the first few weeks of life. The project will enroll 500 pre-term infants, identify congenitally infected infants, follow CMV exposed infants for acquisition of CMV and assess infected infants for clinical abnormalies (including hearing loss, pneumonitis) and laboratory abnormalities (hepatitis, hematologic manifestions). Correlation of congenital infection and peripartum attack rate and level of passively acquired maternal antibody will be assessed as well as semiquantitative assessment of CMV and antibody to CMV in breastmilk and postnatal attack rate in breastfed infants will be assessed.

大约1%的婴儿患有先天性巨细胞病毒（CMV）感染。在有症状的感染婴儿中，有些可能表现为中枢神经系统疾病（包括耳聋、部分失明、小头畸形、脑内钙化）或播散性疾病（血液学异常、肝炎、肠胃炎），这些疾病也可能危及生命或导致严重发病率。对于这两组有症状的婴儿，目前还没有批准的治疗方法，尽管那些患有中枢神经系统疾病的婴儿可能会接受更昔洛韦的试验，但即使是这种治疗方法也尚未获得批准，并且可能会产生后果。有症状的感染通常发生在原发巨细胞病毒感染妇女所生的婴儿中。由于原发感染妇女的这些受感染婴儿缺乏被动获得性母体抗体，至少在一定程度上允许出现症状性感染，因此，在接受高水平的被动母体抗体之前，婴儿早产的情况可能是类似的。因此，如果早产婴儿通过产道或母乳接触巨细胞病毒而感染，则可能在生命的最初几周出现疾病表现。该项目将招募500名早产儿，识别先天感染的婴儿，跟踪巨细胞病毒暴露的婴儿是否获得巨细胞病毒，并评估感染婴儿的临床异常（包括听力损失、肺炎）和实验室异常（肝炎、血液学表现）。评估先天性感染与围生期发作率及母体被动获得性抗体水平的相关性，评估母乳中巨细胞病毒及巨细胞病毒抗体半定量评估及母乳喂养婴儿产后发作率。