Congenital Cytomegalovirus Conference - Congenital CMV ...

Epidemiology
P-01 Congenital Cytomegalovirus infection surveillance in a cohort of newborns from Apulia Region (7 yrs).
Calvario Agata, Nicola Laforgia, Maria Scarasciulli, Lucrezia de Cosmo, Anna Bozzi, Francesco Schettini. Microbiology
and Virology Unit, Laboratory of Molecular and Cellular Virology, Policlinico of Bari, Bari, Italy.
Background: The risk of congenital Cytomegalovirus (CMV) infection is related to maternal antibodies status. In
absence of systematic studies on CMV seroprevalence in fertile females in Apulia region, the Neonatology Unit in
collaboration with the Virology Laboratory (Bari, Policlinico Hospital) started a surveillance program of congenital
CMV infection.
Methods: From 2000 to 2007, 170 newborns admitted in the Neonatology and NICU of Bari University (1900 births/
year) have been included in this study, according to the following inclusion criteria: undefined maternal CMV
serostatus or possible seroconversion/reactivation in pregnancy; presence of signs suggestive of congenital CMV
infection. Cultural and molecular test on urine within the second week of life were carried out to assess congenital
CMV infection. In case of positivity, blood samples and/or neonatal Guthrie Cards (DBS) were also tested by Real
Time PCR (Q-CMV Real Time; Nanogen Advanced Diagnostics Srl). All newborns CMV infected were included in a
follow up program until to 6 years of age.
Results: Seventeen newborns (12 F;5 M) resulted congenital CMV infected. According to maternal serologic status,
7 were born from mothers with seroconversion in pregnancy, ascertained (AS) in 5 cases and presumed (PS) in 2
cases; 7 from mothers with undefined serology (US) and 3 from mother with possible reactivation (PR). 10 were CMV
symptomatic; of these, 5 developed neurologic sequelae (2 cases from US mothers, 1 PS and 2 AS), 3 had normal
neurosensorial development (all AS) and 2 were missed to follow up (1 PS, 1US). 7 congenital infected children were
asymptomatic at birth; of these, 2 developed neurosensorial impairment (1PS, 1PR), 2 had normal follow up, the
remaining 3 cases were missed to follow up (2 ND, 1PR). None of the newborns received antiviral treatment.
Conclusions: In a recent report we have found that in Apulia region the seroprevalence among fertile women was
74,5% whereas the amount of undefined maternal serological patterns with risk of CMV transmission was 22%. In
our study in 42,2% of CMV congenital infected babies, maternal CMV serostatus was incomplete or not ascertained;
36,3% of this group showed cognitive/motor deficit or exitus related to CMV infection.
P-02 Cytomegalovirus Seroprevalence in the U.S. from 1999 to 2004.
Michael J. Cannon, Sheri Lewis Bate, Sheila C. Dollard, Deanna Kruszon-Moran. National Center for Immunization
and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Background: Congenital cytomegalovirus (CMV) is the most common congenital infection in the U.S., resulting in
permanent disabilities such as mental retardation, vision loss, and hearing impairment for more than 5,500 children
per year. Seroprevalence studies of CMV-specific-IgG provide important data to monitor trends in CMV prevalence,
identify risk groups, and assess the potential burden of CMV infection.
Objectives: The purpose of this study is to provide a current and robust estimate of the seroprevalence of CMV in the
U.S. by using National Health and Nutrition Examination Survey (NHANES) seroprevalence data from 1999-2004.
Methods: 15,310 stored serum specimens from individuals 6 to 49 years who participated in NHANES 1999-2004
were tested for CMV-specific IgG antibody. To account for the complex survey design of the NHANES dataset, all
prevalence estimates were weighted to represent the U.S. population. CMV seroprevalences by demographic and
sexual risk factors were assessed. Logistic models were created for each race/ethnic (non-Hispanic White, non-
Hispanic Black, and Mexican-American) and gender subgroup due to interactions between age and gender and
between age and race/ethnicity.
Results: The overall age-adjusted seroprevalence of CMV infection for individuals 6 to 49 years was 50.4% (95%
Confidence Interval [CI], 48.0%-52.7%). Seroprevalence varied by gender (55.5% [95% CI, 53.3%-57.7%] for females
and 45.2% [95% CI, 42.4%-48.0%] for males) and race-ethnicity (39.5% [95% CI, 36.9%-42.2%] for non-Hispanic
Whites, 70.6% [95% CI, 68.5%-72.8%] for non-Hispanic Blacks, and 76.9% [95% CI, 74.1%-79.6%] for Mexican-
Americans). Seroprevalence steadily increased with age (from 37.5% [95% CI, 34.2-40.8%] for 6-11 years to 58.0% [95%
CI, 54.8%-61.1%] for 40-49 years). CMV seropositivity was strongly associated with low socioeconomic status (SES)
(ORs ranged from 1.9 to 3.9 for low vs. high SES [poverty index < 1.3 versus > 3.5]) and birthplace outside the U.S.
(ORs from 2.8 to 6.3 for birth outside vs. within the U.S.) in all race/gender specific logistic models also adjusted for
age and health insurance status (p H.S.,
adjusting for age, sex, birthplace, insurance, number of lifetime sex partners, and age of sex initiation, p