HEALTH IMPACT OF CONGENITAL C INFECTION

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。本提案的总体目标是通过对来自三个地区医院的20，000名新生儿进行为期两年的病毒学筛查，确定北方加州不同人群中人巨细胞病毒（HCMV）引起的先天性感染的流行病学和疾病负担。将使用荧光灶直接早期抗原检测（DEAFF）方法进行筛查，以识别新生儿唾液样本中的HCMV。为了评估疾病负担，我们将记录感染婴儿的临床表现，并使用特定病例定义和分类标准确定有症状与无症状表现的分布。 我们将描述参加前瞻性听力筛查计划的感染婴儿在3年内感音神经性听力损失（SNHL）的发病率、严重程度和发病时间，并确定是否或在何种程度上，新生儿听力筛查识别先天性HCMV感染引起的SNHL。此外，我们将描述在生命的前三年期间感染婴儿的HCMV特异性CD 4和CD 8 T细胞应答的发展，以评估无症状和无症状感染婴儿之间的免疫应答模式的差异。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall objective of this proposal is to define the epidemiology and disease burden of congenital infection caused by human cytomegalovirus (HCMV) in a diverse, Northern California population by virologically screening 20,000 newborns from three area hospitals over a two-yr period. Screening will be done using a direct early antigen detection of fluorescent foci (DEAFF) method to identify HCMV in saliva samples of newborns. To assess disease burden, we will document the clinical manifestations in infected infants and determine the distribution of symptomatic vs. asymptomatic presentation using specific case definitions and classification criteria. We will describe the incidence, severity and timing of onset of sensorineural hearing loss (SNHL) over three yrs in infected infants enrolled in a prospective hearing screening program and determine whether, or the extent to which, universal newborn hearing screening identifies SNHL caused by congenital HCMV infection. In addition, we will describe the development of HCMV-specific CD4 and CD8 T-cell responses of infected infants during the first three yrs of life to assess differences in immune response patterns between symptomatically and asymptomatically infected infants.