Cross-sectional study of cytomegalovirus shedding and immunological markers among seropositive children and their mothers

BMC Infectious Diseases

Michael J Cannon³  Sheila C Dollard²  Tatiana M Lanzieri²  Will Hendley²  Denise Levis³  Rebekah Clark¹  Minal Amin²  Karen Mask³  Jennifer D Stowell³ 

[1] Emory University, Atlanta, GA, USA;National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS E-86, Atlanta 30333, GA, USA

关键词: Children;    Pregnancy;    Transmission;    Cytomegalovirus;    Congenital;   

Others  :  1122091
DOI  :  10.1186/s12879-014-0568-2

 received in 2014-05-12, accepted in 2014-10-16,  发布年份 2014

【 摘 要 】

Background

Congenital cytomegalovirus (CMV) is the leading infectious cause of birth defects in the United States. To better understand factors that may influence CMV transmission risk, we compared viral and immunological factors in healthy children and their mothers.

Methods

We screened for CMV IgG antibodies in a convenience sample of 161 children aged 0–47 months from the Atlanta, Georgia metropolitan area, along with 32 mothers of children who screened CMV-seropositive. We assessed CMV shedding via PCR using saliva collected with oral swabs (children and mothers) and urine collected from diapers using filter paper inserts (children only).

Results

CMV IgG was present in 31% (50/161) of the children. Half (25/50) of seropositive children were shedding in at least one fluid. The proportion of seropositive children who shed in saliva was 100% (8/8) among the 4–12 month-olds, 64% (9/14) among 13–24 month-olds, and 40% (6/15) among 25–47 month-olds (P for trend = 0.003). Seropositive mothers had a lower proportion of saliva shedding (21% [6/29]) than children (P < 0.001). Among children who were shedding CMV, viral loads in saliva were significantly higher in younger children (P <0.001); on average, the saliva viral load of infants (i.e., <12 months) was approximately 300 times that of two year-olds (i.e., 24–35 months). Median CMV viral loads were similar in children’s saliva and urine but were 10–50 times higher (P < 0.001) than the median viral load of the mothers’ saliva. However, very high viral loads (> one million copies/mL) were only found in children’s saliva (31% of those shedding); children’s urine and mothers’ saliva specimens all had fewer than 100,000 copies/mL. Low IgG avidity, a marker of primary infection, was associated with younger age (p = 0.03), higher viral loads in saliva (p = 0.02), and lower antibody titers (p = 0.005).

Conclusions

Young CMV seropositive children, especially those less than one year-old may present high-risk CMV exposures to pregnant women, especially via saliva, though further research is needed to see if this finding can be generalized across racial or other demographic strata.

【 授权许可】

   
2014 Stowell et al.; licensee BioMed Central Ltd.

【 图 表 】

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