Congenital human cytomegalovirus (CMV) infection is the most common congenital infection, affecting around 1 in 200 infants in high-income settings. It can have life-long consequences for up to one in four children, including sensorineural hearing loss and neurodisability. Despite the frequency of congenital CMV and the severity for some children, it is a little-known condition by pregnant women, families and healthcare providers. Timely diagnosis of CMV infection in pregnancy is important to facilitate consideration of treatment with valaciclovir, which may reduce the risk of transmission to the fetus or reduce the severity of the outcomes for infected infants. Recognition of features of congenital CMV is important for neonatologists, paediatricians and audiologists to prompt testing for congenital CMV within the first 21 days of life. Early diagnosis gives the opportunity for valganciclovir treatment, where appropriate, to improve outcomes for affected infants. Further research is urgently needed to inform decisions about antenatal and neonatal screening, long-term outcomes for asymptomatic and symptomatic infants, predictors of these outcomes and optimal treatment for women and infants.
- Infectious Disease Medicine
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Collaborators UK Congenital CMV Infection Collaboration (UKCCIC):Claire Atkinson.
Contributors CEJ drafted the manuscript. All other authors provided intellectual contributions and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests Provided consultancy and /or investigator roles in relation to product development for MSD (AK, CEJ, PTH, SBD), Sanofi Pasteur (AK, CEJ, PTH, SBD), Gilead (AB), Janssen (PTH), AstraZeneca (PTH), Moderna (CEJ, PTH, SBD) Pfizer (CEJ, PTH), Valneva (PTH) on behalf of their institutions. Chair of CCMVNet (provider of European Registry for Congenital CMV infection) (HL). Co-chair of the European Congenital CMV Initiative (ECCI) (CEJ).
Provenance and peer review Commissioned; externally peer reviewed.