Congenital and Other Related Infectious Diseases of the Newborn (Perspectives in Medical Virology)

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If this infection results in HCMV transmission to the unborn child in utero during the first trimester, it may lead to birth defects. The most common consequence is HCMV chronic infection. This translates into approximately 8, children a year. In extreme cases, congenital HCMV may result in death of the neonate.

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At this time, no tracking exists for the correlation of heart disease development with congential HCMV infection. HCMV treatment and prevention. There is currently no vaccine available to prevent HCMV. Because the HCMV virus has evolved to possess an elaborate system of immune evasion strategies [ 15 ], current efforts to develop HCMV vaccines must focus on stimulating both the innate and adaptive immune system in order to be successful.

The antiviral treatment of choice for HCMV is the nucleoside analog ganciclovir and it is given to all transplant patients.

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While ganciclovir may prevent hearing loss in children, it may have side effects. Another nucleoside drug, cidofovir, is also available but is less prominent in use. Both of these drugs have been associated with the emergence to resistant viral strains.

A new anti-HCMV drug, maribavir, is currently in clinical trials. Of interest are findings that an oral ganciclovir regime reduces myocarditis in immune competent adults in certain cases [ 16 ].

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The best way to prevent HCMV transmission is through behavior modification which emphasizes hygiene. Accordingly, women who are pregnant or who may become pregnant are recommended by the CDC to take the following precautions [ 13 ]; i wash hands often, especially after contact with saliva or diapers of young children, ii never kiss children below the age of six years of age on the mouth or cheek, and ii do not share food, drinks, or utensils with young children.

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HCMV pathogenesis in adults. Primary HCMV infection in an immunocompetent individual is usually subclinical, rarely causing illness.

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However, large scale infection can cause an HCMV infectious mononucleosis that has a clinical presentation very similar to that caused by Epstein Barr virus. Other rare symptoms of HCMV include tonsillopharyngitis, pneumonitis , myocarditis, arthritis, ulcerative colitis, and meningitis. Transplant patients may also present with retinitis, esophagitis, and gastritis. HCMV infection in transplant patients also predisposes them to infection by other opportunistic pathogens. As noted above, recent evidence indicates that HCMV infection is also a likely risk factor for heart disease in transplant patients.

HCMV infection in immunocompromised individuals.

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While neonates and newborns may be considered immunocompromised individuals, HCMV remains the major pathogen of risk for solid organ transplant patients. More than half of all transplant cases show evidence of HCMV infection. The associated morbidity of these infections is a major cause of rejection. For this reason, anti-HCMV drugs must be administered throughout solid organ transplants.

While HCMV infection of solid organ transplant recipients are usually acute primary infections, CMV infection following stem cell transplants are frequently due to reactivation of latent virus. HCMV is a high risk pathogen for individuals who have an impaired adaptive immune response, which is why neonates and newborns are at such high risk.

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  5. Today, patients with chronic HIV infection may develop pulmonary arterial hypertension [ 18 ], though the impact of HAART on its incidence remains controversial. The role that HCMV might play in this process is unknown at this time. HCMV is a major human pathogen which places both the mother and child at risk. Once infected, the individual remains infected for life and may spread the virus to others. Although effective antiviral drugs exist for HCMV, the problem is that most infections are asymptomatic.

    Existing research efforts are focusing on the development of an HCMV vaccine. Currently, the best way to prevent HCMV infection is to limit exposure to bodily fluids. Importantly, HCMV is associated with congenital birth defects. Recent evidence supports a molecular basis for the role of HCMV in vascular cell proliferation and arterial hypertension. It may now be the time to consider coronary heart disease as another potential congenital consequence of neonatal HCMV infection. All Published work is licensed under a Creative Commons Attribution 4. Human cytomegalovirus infection in pregnant women and neonates: A new risk factor for cardiovascular disease?

    John A. Visit for more related articles at Archives of Clinical Microbiology. Lancet Am J Pathol Circulation Cardiology J Infect Dis J Virol J Exp Med Pediatrics E Pediatrics Annu Rev Immunol If you decide to participate, a new browser tab will open so you can complete the survey after you have completed your visit to this website.

    Thanks in advance for your time. Skip to content. Search for books, journals or webpages All Pages Books Journals. The continuing rapid progress in medical virology is the result to a large extent of rapid advances in recombinant DNA techniques, in molecular and cell biology, in protein and nucleic acid chemistry, the use of monoclonal antibodies, progress in antiviral research and the application of modern technology to fundamental biological processes.

    These advances in knowledge of structural and biochemical components of viruses and mode of viral replication, understanding of cell pathology and immunopathogenesis have many health implications which include rapid, precise and specific diagnosis, epidemiology of viral infections, and the development of new types of vaccines, and emerging new infections.

    Strengthening of the links between the laboratory, fieldwork and the clinician is essential for implementing the strategy of the World Health Organisation's programme of health for all. Infectious diseases -and viral infections- are still responsible for most of the problems encountered daily in many parts of the world. This book provides overviews and updates on basic research, diagnosis, epidemiology, and public health on enteric viruses, as well as on treatment and intervention to prevent their waterborne transmission.