Blood Viral Load in Symptomatic Congenital Cytomegalovirus Infection.

Autor:	Marsico C; Neonatology Unit, Department of Medical and Surgical Sciences, University of Bologna, Italy., Aban I; Department of Biostatistics, Division of Infectious Diseases, University of Alabama at Birmingham., Kuo H; Department of Biostatistics, Division of Infectious Diseases, University of Alabama at Birmingham., James SH; Department of Pediatrics, Division of Infectious Diseases, University of Alabama at Birmingham., Sanchez PJ; Department of Pediatrics, Divisions of Pediatric Infectious Diseases and Neonatology, Nationwide Children's Hospital - Ohio State University College of Medicine, Columbus., Ahmed A; Department of Pediatrics, Carolinas Medical Center, Charlotte, North Carolina., Arav-Boger R; Medical College of Wisconsin, Milwaukee., Michaels MG; Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pennsylvania., Ashouri N; Infectious Diseases, CHOC Children's Hospital, Orange, California., Englund JA; University of Washington/Seattle Children's Hospital., Estrada B; University of South Alabama, Mobile., Jacobs RF; University of Arkansas, Little Rock., Romero JR; University of Arkansas, Little Rock., Sood SK; Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, New York., Whitworth S; Cook Children's Medical Center, Fort Worth, Texas., Jester PM; Department of Pediatrics, Division of Infectious Diseases, University of Alabama at Birmingham., Whitley RJ; Department of Pediatrics, Division of Infectious Diseases, University of Alabama at Birmingham., Kimberlin DW; Department of Pediatrics, Division of Infectious Diseases, University of Alabama at Birmingham.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2019 Apr 16; Vol. 219 (9), pp. 1398-1406.
DOI:	10.1093/infdis/jiy695
Abstrakt:	Background: Viral loads (VLs) frequently are followed during treatment of symptomatic congenital cytomegalovirus disease, but their predictive value is unclear. Methods: Post hoc analysis of 2 antiviral studies was performed. Seventy-three subjects were treated for 6 weeks and 47 subjects were treated for 6 months. Whole blood VL was determined by real-time polymerase chain reaction before and during therapy. Results: Higher baseline VL was associated with central nervous system involvement (3.82 log, range 1-5.65 vs 3.32 log, range 1-5.36; P = .001), thrombocytopenia (3.68 log, range 1-5.65 vs 3.43 log, range 1-5.36; P = .03), and transaminitis at presentation (3.73 log, range 1-5.60 vs 3.39 log, range 1-5.65; P = .009), but with overlap in the amount of virus detected between groups. In subjects treated for 6 months, lower VL at presentation correlated with better hearing outcomes at 12 months, but VL breakpoints predictive of hearing loss were not identified. Sustained viral suppression during 6 months of therapy correlated with better hearing outcomes at 6, 12, and 24 months (P = .01, P = .0007, P = .04), but a majority without viral suppression still had improved hearing. Conclusions: In infants with symptomatic congenital cytomegalovirus disease, higher whole blood VL before initiation of antiviral therapy has no clinically meaningful predictive value for long-term outcomes. (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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