5 th <strong>European</strong> <strong>Congress</strong> <strong>of</strong> <strong>Virology</strong>inaudible fetal heartbeat. The ultrasound revealed a single fetus with noactive movements, little or absente amniotic fluid and placenta with reduceddimensions. The fetus was 32/33 weeks presenting placental abruptionwith apparently early detachment. During the caesarean there was largeextravasation <strong>of</strong> blood in cavity, deterioration <strong>of</strong> clinical picture, hypothermia,anuria, hemodynamic instability, mydriasis, absent reflexes anddeath. Tissues <strong>of</strong> spleen, placenta and umbilical cord were paraffin embeddedto investigate dengue virus. The RNA was extracted from sections <strong>of</strong>3 m and RNA extraction was performed using the kit Purelink FFPERNA Isolation Invitrogen. Real time PCR and RT PCR was performedand DENV 2 detected by both methods in the umbilical cord.Considering that dengue infection during pregnancy may represent a risk tomother and concept, measures to strengthen epidemiological surveillanceand virological diagnosis should be implemented to this specific groupespecially in dengue endemic areas.REF 488Prognostic significance <strong>of</strong> intra-uterine detection <strong>of</strong> infectious agentsOlga OSTROVSKAYA, Nataliya IVAKHNISHINA, ElenaNAGOVITSYNA, Marina VLASOVAResearch Institute <strong>of</strong> Mother and Child Health Care, Khabarovsk, RUSSIADNA <strong>of</strong> infectious agents was analyzed by a PCR method in placentalsamples <strong>of</strong> 66 pregnant women who had placental insufficiency and ahigh risk <strong>of</strong> intrauterine infection development. Infectious agents werefound in 72.7% cases <strong>of</strong> placental analysis. Ur.urealyticum (51.5%) andM. hominis (24.2%) were most frequent foiund, followed by type 4, 5 and6 herpesviruses. Enteroviruses, C. trachomatis, S. pneumoniae were foundin single cases. No other pathogens were detected.Infected placentas were significantly more frequently associated withabnormal peri-natal features such as untimely discharge <strong>of</strong> amnioticfluid, decompensation <strong>of</strong> chronic placental insufficiency, delivery <strong>of</strong>premature newborns with very to extremely low body weight, withdevelopmental delay and clinical signs <strong>of</strong> neonatal infection (pneumonia,hepatosplenomegaly,necrotizing enterocolitis, retinopathy, etc.)Detection <strong>of</strong> intrauterine infectious agents in placenta may be used forprediction <strong>of</strong> the newborn’s condition and early administration <strong>of</strong> adequatetherapy.REF 489Case report <strong>of</strong> a congenital Echovirus 11 infection acquired early inpregnancyChristelle VAULOUP FELLOUS 5 , Mikael TASSIN 1 , JelenaMARTINOVIC 2 , Audrey MIRAND 3 , Hélène PEIGUE LAFEUILLE 3 ,Olivier PICONE 4 , Alexandra BENACHI 11 AP HP, Department <strong>of</strong> Gynecology and Obstetrics, Antoine BéclèreHospital, Clamart, FRANCE; 2 AP HP, Unit <strong>of</strong> Fetal Pathology, AntoineBéclère Hospital, Clamart, FRANCE; 3 Laboratory <strong>of</strong> <strong>Virology</strong>, EnterovirusNational Reference Centre, Clermont Ferrand Hospital, ClermontFerrand, FRANCE; 4 Department <strong>of</strong> Gynecology and Obstetrics, FochHospital, Suresnes, FRANCE; 5 AP HP, Laboratory <strong>of</strong> <strong>Virology</strong>, RubellaMaterno foetal infection National Reference Center, Paul Brousse Hospital,Villejuif, FRANCEEnterovirus (EV) maternal infection during pregnancy and its relation t<strong>of</strong>etal pathology are not well described. When reported, the main manifestations<strong>of</strong> EV congenital infections are intra uterine fetal death ormyocarditis. No information on intrauterine Echovirus 11 infection or theeffect <strong>of</strong> transplacental Echovirus 11 infection on development <strong>of</strong> the fetushas been described in literature up to date (excluding late pregnancy infections).We report here a case <strong>of</strong> an extreme form <strong>of</strong> pulmonary hypoplasiain a neonate, characterized by total failure <strong>of</strong> development <strong>of</strong> terminal respiratoryunits. This bichorial biamniotic twin pregnancy, was marked byspontaneous demise <strong>of</strong> the co twin at 14 weeks <strong>of</strong> gestation (WG), as wellas by positive PCR for EV (Echovirus 11 serotype) in the amniotic fluid,performed for moderate pericardial effusion at 22 WG. No sign <strong>of</strong> cardiacdisease were further observed, but at 32 WG an ultrasound examinationrevealed bilateral abnormal lung development, and pulmonary hypoplasiawas confirmed by MRI. After spontaneous delivery at 38 WG, and despitepediatric reanimation, the child died one hour after birth. The coexistence<strong>of</strong> a congenital EV infection and a severe primary pulmonary hypoplasia,in this case, challenges our understanding <strong>of</strong> the pathogenesis <strong>of</strong> thissevere pulmonary growth arrest. The study <strong>of</strong> more cases <strong>of</strong> congenitalEV infections acquired early in pregnancy is needed to better understandthis puzzling lethal condition.REF 490Infants born to HBsAg(+) Mothers Are they fully protected afteractive passive vaccination?Radka KOMITOVA 1 , Maria NESHEROVA 2 , Maria ATANASOVA 31 Infectious Diseases Dept, University Hospital, Plovdiv, BULGARIA;2 Neonatology Unit, Selena Hospital, Plovdiv, BULGARIA; 3 Microbiologyand Immunology Laboratory, Medical University, Plovdiv, BULGARIAIntroduction: Infants born to HBsAg(+) mothers are at ongoing risk <strong>of</strong>hepatitis B virus (HBV) infection. Despite the timely active-passive vaccination,newborns may still become HBV infected because <strong>of</strong> nonresponseto vaccination.Aims: to confirm that the child born to an HBsAg(+) mother is fullyprotected by active-passive immunization.Case presentation: A girl was born on 07.04.2012 by cesarean sectionto a mother with chronic HBV infection [(HBsAg(+), antiBHctotal(+),HBeAg(-), antiHBe(+)]. The infant received the 1-st shot hepatitis B vaccineas well as hepatitis B immunoglobulin (HBIG) within 6 hours afterbirth. The test conducted on 07.01.2013 (3 months after administration <strong>of</strong>the third vaccine shot) revealed an HBsAg(-) result and antiHBs level 1225IU/ml, i. e. she is thoroughly protected and does not need further management.A second study is underway with a girl born to an HBsAg(+)mother on 30.11.2012. She also received the 1-st shot hepatitis B vaccineas well as HIBG within 6 hours after birth. At the age <strong>of</strong> 9 months shewill be tested for HBsAg and antiHBs level to make sure protection ispresent. In case <strong>of</strong> HbsAg(-) and antiHBs level
5 th <strong>European</strong> <strong>Congress</strong> <strong>of</strong> <strong>Virology</strong>injecting drug users and individuals from countries with HIV epidemics.In accordance with the ‘2008 <strong>European</strong> Guideline on HIV testing’ fourthgeneration screening assays are recommended for simultaneously detection<strong>of</strong> anti-HIV-1 antibodies and HIV-1 p24 antigen as well as HIV-2antibodies. The guideline requests confirmation <strong>of</strong> any reactive or indeterminatescreening test result, using a line-immunoassay or western blotthat distinguish between the different individual HIV-1 and HIV-2 antibodies.This study evaluated two immunoblot line assays to be used as HIVconfirmation assays.REF 590Studies <strong>of</strong> human cytomegalovirus (HCMV) maternal fetal transmissionand pathogenesis in ex vivo infected human decidual organculturesDana WOLF 1 , Yiska WEISBLUM 1,2 , Zichria ZAKAY RONES 2 , RonitHAIMOV KOCHMAN 3 , Debra GOLDMAN WOHL 3 , SimchaYAGEL 3 , Amos PANET 21 Clinical <strong>Virology</strong> Unit, Hadassah Hebrew University Medical Center,Jerusalem, ISRAEL; 2 Department <strong>of</strong> Biochemistry and the Chanock centerfor <strong>Virology</strong>, IMRIC, Jerusalem, ISRAEL; 3 Department <strong>of</strong> Obstetrics andGynecology, Hadassah Hebrew University Medical Center, Jerusalem,ISRAELHuman cytomegalovirus (HCMV) is the leading cause <strong>of</strong> congenitalinfection, associated with severe birth defects, placental damage, andintrauterine growth retardation. The mechanism <strong>of</strong> transmission via thematernal fetal interface is largely unknown, and there are no animal modelsfor congenital HCMV infection. The initial stages <strong>of</strong> infection are believedto occur in the maternal decidua representing the maternal aspect<strong>of</strong> the chimeric human placenta. To gain insight into these critical earlyevents <strong>of</strong> transmission and pathogenesis, we have recently establishedan ex vivo model <strong>of</strong> HCMV infection in first trimester decidual organcultures. Using both laboratory derived and clinical HCMV strains, wedemonstrated the broad viral target cell range, with consistent cell to cellmode <strong>of</strong> spread in the decidual tissue. Antiviral drugs as well as neutralizingHCMV antibodies exhibited inhibitory activity on viral spread inthe decidua. We have further employed the decidual infection model tostudy the tissue innate immune response to HCMV infection, revealing apr<strong>of</strong>ound effect <strong>of</strong> the virus on decidual innate immune and angiogeniccytokine/chemokine expression pr<strong>of</strong>ile. Significantly, a unique virus inducedstimulation <strong>of</strong> a decidual innate immune response, with formation<strong>of</strong> proinflammatory environment was demonstrated. The ex vivo infecteddecidual cultures can serve as a surrogate human model that couldpotentially address viral and tissue determinants <strong>of</strong> HCMV maternal fetaltransmission, damage, and immunopathogenesis, and could facilitate evaluation<strong>of</strong> the effects <strong>of</strong> new antiviral interventions in the maternal fetalinterface.S256 Vi<strong>rologie</strong>, Vol 17, supplément 2, septembre 2013
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