Kongenitale Zytomegalie-Virus-Infektionen

Cytomegalovirus (CIVIV) belongs to the family of herpesviruses. Within 24 hours of inoculation of clinical specimens early-antigens can be detected with CMV-specific monoclonal antibodies. After primary infection recurrent infection or infection with another viral strain is common. The majority of humans will be infected with CMV during their life. CMV-infection is endemic and without seasonal variation. The level of immunity among women of childbearing age is 50 to 85% in Europe and more than 90% in most of the developing countries. The rate of CMV acquisition during pregnancy depends on socio-economic background, age and parity of the mother. Congenital infection is assumed to be the result of transplacental transmission. It occurs in 0.3% of all newborns in Germany. Clinical findings of congenital CMV-infection are prematurity, small for gestational age, microcephaly with or without cerebral calcifications, chorioretinitis, petechiae, jaundice, and hepatosplenomegaly. 10% of the infected infants have symptoms, their mortality is 12 to 30%. Sequelae occur in 90% of infants with symptomatic congenital infection, but also in 10% of asymptomatic infants. Diagnosis of congenital CMV infection is performed by virus isolation in tissue cultures, determination of CMV early-antigen, or CMV genetic material by polymerase chain reaction. In case of severe congenital CMV-disease gancyclovir can be administered. CMV hyperimmunoglobulin in pregnant women led to a reduction of symptomatic congenital CMV infection in newborn.