Relevance of CMV DNA Detection in Symptomatic Children up to 3 Months of Age

Abstract

Cytomegalovirus (CMV) is the most frequent cause of congenital infection worldwide. The burden of disease related to congenital CMV (cCMV) is substantial, as it is the leading cause of sensorineural hearing loss and an important cause of neurodevelopmental disabilities in children. Despite its clinical significance, cCMV infection often goes undetected because the majority of infected infants are asymptomatic at birth and screening programmes have not been implemented in any country.

The aim of this study is to define the role of CMV in congenital and early postnatal morbidity in clinically relevant symptomatic children up to 3 months of age in Varna region, comparatively in ELISA (anti CMV IgM/IgG) and PCR.

We found CMV DNA in 12 out of 50 tested children (24%, 95% CI: 12.16–35.84%). The viral load ranged in 65–1 628 879 IU/ml, average viral load 144 707.2 IU/ml.

It is important to note that only half of the PCR positive children 6/12 (50%) had an anti CMV IgM positive result.

Our data demonstrate that serological tests defining active CMV infection with CMV IgM detection are not sufficiently indicative in all newborns, and it is therefore mandatory to conduct modern PCR for all relevant infants after birth.