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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
The "Silent" global burden of congenital cytomegalovirus
Clinical Microbiology Reviews, Volume 26, No. 1, Year 2013
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Description
Human cytomegalovirus (CMV) is a leading cause of congenital infections worldwide. In the developed world, following the virtual elimination of circulating rubella, it is the commonest nongenetic cause of childhood hearing loss and an important cause of neurodevelopmental delay. The seroprevalence of CMV in adults and the incidence of congenital CMV infection are highest in developing countries (1 to 5% of births) and are most likely driven by nonprimary maternal infections. However, reliable estimates of prevalence and outcome from developing countries are not available. This is largely due to the dogma that maternal preexisting seroimmunity virtually eliminates the risk for sequelae. However, recent data demonstrating similar rates of sequelae, especially hearing loss, following primary and nonprimary maternal infection have underscored the importance of congenital CMV infection in resource-poor settings. Although a significant proportion of congenital CMV infections are attributable to maternal primary infection in well-resourced settings, the absence of specific interventions for seronegative mothers and uncertainty about fetal prognosis have discouraged routine maternal antibody screening. Despite these challenges, encouraging results from prototype vaccines have been reported, and the first randomized phase III trials of prenatal interventions and prolonged postnatal antiviral therapy are under way. Successful implementation of strategies to prevent or reduce the burden of congenital CMV infection will require heightened global awareness among clinicians and the general population. In this review, we highlight the global epidemiology of congenital CMV and the implications of growing knowledge in areas of prevention, diagnosis, prognosis, and management for both low (50 to 70%)- and high (>70%)-seroprevalence settings. © 2013, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Manicklal, S.
South Africa, Cape Town
University of Cape Town
Emery, Vince
United Kingdom, London
University College London
Lazzarotto, Tiziana
Italy, Bologna
Irccs Azienda Ospedaliero-universitaria Di Bologna
Boppana, S. B.
United States, Birmingham
Heersink School of Medicine
Gupta, Ravindra K.
United Kingdom, London
University College London
Statistics
Citations: 808
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1128/CMR.00062-12
ISSN:
08938512
e-ISSN:
10986618
Research Areas
Disability
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study