Prenatal Diagnosis, Prognostic Indicators, Correlates of Immunity, and Treatment O-27 The current state of H<strong>CMV</strong> prenatal diagnosis Maria Grazia Revello, Servizio di Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Prenatal diagnosis represents a key option in the management of pregnancy complicated by primary human cytomegalovirus (H<strong>CMV</strong>) infection in those countries where H<strong>CMV</strong> testing is performed. Over the years, major factors affecting the reliability of prenatal diagnosis results (including type of specimens, time of gestation at prenatal diagnosis with respect to maternal infection, techniques employed for detection of the virus and /or viral components) have been investigated. As a result, negative and positive predictive values of different techniques are now well defined and, consequently, counseling of pregnant women has greatly improved. Still unaccomplished, however, is the definition of a single, reliable prenatal prognostic marker to be used prospectively on an individual basis. Indeed, only the simultaneous determination of multiple specific and non-specific parameters together with ultrasound examination may help in the identification of infected fetuses at increased risk of congenital disease. Recently, administration of H<strong>CMV</strong>-specific immunoglobulin has been reported to spectacularly reverse the prognosis in severely affected fetuses (Nigro et al, NEJM 2005). In addition, virological parameters in symptomatic infected fetuses have been shown to possibly improve following valaciclovir administration (Jacquemard et al, BMJ 2007). Should those data be confirmed in controlled studies, voluntary termination of pregnancy would no longer be the only option for mothers of H<strong>CMV</strong>-infected fetuses. It must be stressed, however, that in the meantime and in the absence of an effective H<strong>CMV</strong> vaccine, all efforts should de directed to the prevention of maternal primary H<strong>CMV</strong> infection by means of the identification of seronegative women prior to conception and by providing appropriate information about hygienic measures. O-28 Findings from <strong>CMV</strong> hyperimmune globulin treatment trials. Stuart Adler, Medical College of Virginia, Campus of Virginia Commonwealth University Richmond, VA. Several options may be available to prevent or treat maternal <strong>CMV</strong> infection during pregnancy. The first is to enhance public awareness of <strong>CMV</strong> which would lead to women knowing their risk factors such as serologic status, age of their child, and day care attendance. A second option is for obstetricians to identify high risk women at the first obstetrical visit post-conception. If seronegative, instructing women how to avoid acquiring <strong>CMV</strong> during pregnancy by hygienic practices should be effective. A third option is for serologic monitoring during pregnancy which would allow the option to terminate the pregnancy or if infected during the first 20 weeks of pregnancy to receive <strong>CMV</strong> hyperimmune globulin to prevent maternal-to-fetal transmission of <strong>CMV</strong>. If the fetus is infected the viral load in the amniotic fluid and serial sonograms of the foetus and placenta may predict which foetuses will have a poor outcome. Finally, <strong>CMV</strong> hyperimmune globulin in an initial study appeared safe and effective for the in utero treatment of babies with poor prognostic ultrasound findings. O-29 Modeling efficacy of a mAb targeting <strong>CMV</strong> UL128/130/131: prediction of viral load and mAb affinity. Jing Yu, Brian R. Stoll, Thomas G. Evans, Teresa Compton, Adam Feire. Novartis Institutes for Biomedical Research, Cambridge, MA. The UL128/130/131 glycoprotein complex of H<strong>CMV</strong> was identified as a promising target for the treatment of <strong>CMV</strong> and the development of a monoclonal antibody (mAb) therapeutic was proposed. We developed a mathematical model to guide the identification of a mAb likely to satisfy the clinical criteria for therapeutic efficacy. The model consists of a standard viral load component combined with a PK/ PD component to describe the mAb distribution and binding. The unknown model parameters, such as infection rate and the number of target cells, were determined using in vitro neutralization data and published infection curves for <strong>CMV</strong> in humans. The model was used to predict the viral load for various mAb affinities, doses, and dosing frequencies. The cases of prophylactic treatment, treatment initiated 47
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Congenital Cytomegalovirus Conferen
- Page 3 and 4: Welcome to the CDC in Atlanta, Geor
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- Page 9 and 10: Conference Venue All Conference pro
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- Page 13 and 14: Registration Information Gala Event
- Page 15 and 16: MARTA The Metropolitan Atlanta Rapi
- Page 17 and 18: Reception at Global Health Odyssey
- Page 19 and 20: Conference Agenda Daily Programming
- Page 21 and 22: Thursday, November 6 7:00-8:00am Br
- Page 23 and 24: 11:30 Roundtable presentation and d
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- Page 28 and 29: Epidemiology O-01 Recent epidemiolo
- Page 30 and 31: O-04 Neuroimaging Abnormalities in
- Page 32 and 33: Conclusions: A high birth prevalenc
- Page 34 and 35: Results: We were able to classify t
- Page 36 and 37: ceutical-grade valganciclovir which
- Page 38 and 39: O-12 CMV genotyping in a peri- and
- Page 40 and 41: es, probably related to the longer
- Page 42 and 43: Results: CMV pp65-specific CD4+ or
- Page 44 and 45: human embryonic fibroblasts (HCMV),
- Page 46 and 47: O-19 Histological and virological d
- Page 48 and 49: culture. A subsequent study is unde
- Page 50 and 51: Methods: Twenty Japanese children w
- Page 52 and 53: O-24 A two-year study on Cytomegalo
- Page 56 and 57: at the viral load detection limit,
- Page 58 and 59: Methods: We performed a prospective
- Page 60 and 61: Vaccines O-33 Update on CMV gB Vacc
- Page 62 and 63: O-35 A Live, Attenuated CMV Vaccine
- Page 64 and 65: Newborn Screening O-37 Current Scre
- Page 66 and 67: Objectives: 1)Determine the prevale
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- Page 71 and 72: for males and 2.1 for females for >
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- Page 75 and 76: associated with such outcomes in ea
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- Page 79 and 80: P-19 Standardization of Neonatal CM
- Page 81 and 82: Conclusion: This is the first long
- Page 83 and 84: Conclusions: The results suggest th
- Page 85 and 86: Postnatal Diagnosis, Treatment, and
- Page 87 and 88: Background: Cytomegalovirus (CMV),
- Page 89 and 90: P-40 Evaluation of the Abbott ARCHI
- Page 91 and 92: Vaccines P-44 BAC cloning and cell
- Page 93 and 94: Notes 86
- Page 95 and 96: Abstract Author Index 88
- Page 97 and 98: Guibert, Gaelle....................
- Page 99 and 100: Planning Begins now! September 23-2