Human cytomegalovirus (CMV) infection can occur in pregnant women by primary infection or by non-primary infection, namely by either reactivation of the latent virus or reinfection with a different strain(1). In all cases the mother can transmit the virus to the fetus through the placenta(2,3). In the diagnosis of primary CMV infection, the gold standard is maternal seroconversion to CMV-specific antibodies. Currently, women are not routinely screened for CMV before conception or during pregnancy, thus CMV seroconversion is infrequently documented(1). Lastly, serological diagnosis of non-primary CMV infection is very difficult and very often unreliable since no optimal diagnostic methods are currently available. Today, the fetal compartment can be only studied by amniocentesis and ultrasound examination for the diagnosis and prognosis of CMV infection and generally, invasive diagnostic protocol can be only suggested to pregnant women with evidence of primary CMV infection acquired early in gestation and in case of abnormal findings suggestive of congenital infection(1). Therefore, a correct maternal diagnosis makes so that invasive prenatal diagnosis is only offered in selected cases. This report points out how a CMV-screening program combined with an advanced diagnostic protocol performed on pregnant women could identify those at high risk of transmitting the virus to their fetus. Furthermore, we evaluated the possible role of soluble HLA-G (sHLA-G) molecules detected in maternal and fetal samples in order to more accurately assess a greater risk of CMV-transmission and fetal/neonatal injury.
New diagnostics and methods of assessing pregnant women at risk of cytomegalovirus
RIZZO, Roberta
2015
Abstract
Human cytomegalovirus (CMV) infection can occur in pregnant women by primary infection or by non-primary infection, namely by either reactivation of the latent virus or reinfection with a different strain(1). In all cases the mother can transmit the virus to the fetus through the placenta(2,3). In the diagnosis of primary CMV infection, the gold standard is maternal seroconversion to CMV-specific antibodies. Currently, women are not routinely screened for CMV before conception or during pregnancy, thus CMV seroconversion is infrequently documented(1). Lastly, serological diagnosis of non-primary CMV infection is very difficult and very often unreliable since no optimal diagnostic methods are currently available. Today, the fetal compartment can be only studied by amniocentesis and ultrasound examination for the diagnosis and prognosis of CMV infection and generally, invasive diagnostic protocol can be only suggested to pregnant women with evidence of primary CMV infection acquired early in gestation and in case of abnormal findings suggestive of congenital infection(1). Therefore, a correct maternal diagnosis makes so that invasive prenatal diagnosis is only offered in selected cases. This report points out how a CMV-screening program combined with an advanced diagnostic protocol performed on pregnant women could identify those at high risk of transmitting the virus to their fetus. Furthermore, we evaluated the possible role of soluble HLA-G (sHLA-G) molecules detected in maternal and fetal samples in order to more accurately assess a greater risk of CMV-transmission and fetal/neonatal injury.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
