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Managing challenges in congenital CMV: current thinking
  1. Christine E Jones1,2,
  2. Heather Bailey3,
  3. Alasdair Bamford4,5,
  4. Anna Calvert6,
  5. Robert B Dorey7,
  6. Simon B Drysdale6,
  7. Asma Khalil8,9,
  8. Paul T Heath6,
  9. Hermione Lyall10,
  10. Kate Monica Isabel Ralph7,
  11. Shari Sapuan6,
  12. Tushna Vandrevala11,
  13. Simone Walter12,
  14. Elizabeth Whittaker10,
  15. Sharon Wood13
  16. for the UK Congenital CMV Infection Collaboration (UKCCIC)
  1. 1Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
  2. 2Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  3. 3Institute for Global Health, University College London, London, UK
  4. 4Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  5. 5Infection, Immunity and Inflammation Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
  6. 6Centre for Neonatal and Paediatric infection, St George's, University of London, London, UK
  7. 7Faculty of Medicine, University of Southampton, Southampton, UK
  8. 8Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK
  9. 9Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
  10. 10Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
  11. 11Centre for Applied Health and Social Care Research, Faculty of Health, Science, Social Care and Education, Kingston University, Kingston-Upon-Thames, UK
  12. 12Department of Audiovestibular Medicine, St George's University Hospitals NHS Foundation Trust, London, UK
  13. 13CMV Action, London, UK
  1. Correspondence to Dr Christine E Jones, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; c.e.jones{at}soton.ac.uk

Abstract

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
  • Neonatology

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Footnotes

  • Twitter @drchrissiejones, @profasmakhalil, @psych_tush

  • 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.