Congenital cytomegalovirus infection (cCMV) is the leading infectious cause of sensorineural hearing loss and lifelong neurodevelopmental disabilities. Studies suggest antiviral therapy can prevent fetal infection after maternal primary infection, as well as halt the progression of hearing loss and neurodevelopmental disabilities in newborns with symptomatic cCMV. With growing worldwide momentum on early detection and diagnosis of cCMV, this review describes the exciting recent advances in antiviral therapies in CMV infected pregnant mothers and babies, as well as emerging evidence on anti-CMV vaccines.

Recent findings:

New opportunities for prenatal and neonatal interventions have driven a rising interest in screening and identification of asymptomatic CMV infection. Routine screening of pregnant women to identify primary infection in first trimester is now advocated in Western Europe but has yet to be examined from a public health perspective in other regions. Evidence is emerging for maternal valaciclovir therapy to prevent fetal infection after a maternal primary CMV infection in the first trimester of pregnancy. For those infants who are born with symptomatic cCMV, a 6-month course of valganciclovir, started within the first 4 weeks of life, and possibly up to 13 weeks of life, is the current recommended therapy. However, there is unclear evidence for the benefit of treatment for asymptomatic cCMV and cCMV with isolated hearing loss. Research to identify more effective antivirals and an effective CMV vaccine continues.

Summary:

More research is needed to determine the region-specific applicability of the new European recommendations for routine CMV screening in pregnancy. Areas of uncertainty in postnatal management include timing of initiation, duration of treatment and identifying pediatric subgroups that benefit from modification of the standard treatment recommendations.

1990-05-01·STRAHLENTHERAPIE UND ONKOLOGIE

Difference in onset between cytomegalovirus and idiopathic interstitial pneumonitis following allogeneic bone marrow transplantation for leukemia.

Article

作者: Shibata, H ; Masaoka, T ; Inoue, T

Interstitial pneumonitis is one of the major causes of morbidity and mortality following bone marrow transplantation (BMT). Based on the Japanese BMT Registry, however, since 1983 the incidence of interstitial pneumonitis at one year has decreased to 32% by means of several efforts, such as fractionated low-dose rate total body irradiation, selection of platelet donor from cytomegalovirus (CMV) seronegative donor, and prophylactic administration of anti-CMV high titer globulin. Cytomegalovirus (58%) was the most frequently causative organism within 100 days after bone marrow transplantation. On the other hand, idiopathic interstitial pneumonitis (44%) was the leading cause more than 100 days after bone marrow transplantation. There was a significant difference in onset after bone marrow transplantation against leukemia between cytomegalovirus (mean: 90 +/- 15 days) and idiopathic interstitial pneumonitis (mean: 186 +/- 32 days) (p less than 0.01).

1989-03-01·Nihon Kyobu Shikkan Gakkai zasshi

[Prevention and treatment of respiratory infections in leukemia patients].

Article

作者: Masaoka, T

Among infections in leukemia patients during their first induction treatment pneumonia was the third most frequent infection (11.4%) following fever of unknown origin and sepsis. Granulocytopenia was suggested to be very closely related to the onset of pneumonia. Laminar air flow rooms seemed very effective for preventing exogenous infections including pneumonia. They reduced pneumonia from 30 to 0 in 106 patients with acute leukemia during their first induction treatment. Bone marrow transplantation (BMT) is one of the most intensive immunosuppressive treatments. Major causes of failure were interstitial pneumonitis (IP) due to cytomegalovirus (CMV), relapse of leukemia and bacterial and fungal infections. The incidence of IP was reduced by fractionation of total body irradiation and selection of CMV antibody negative donor for platelet transfusion. Administration of anti CMV immunoglobulin has also reduced the incidence of IP significantly from 37.5% to 11.5%. Colony stimulating factor appeared to stimulate the recovery of leukocytes after BMT. By several modifications of BMT techniques, mainly for the prevention of infection and IP, the survival of patients after BMT has improved significantly from 20% to 85%. In conclusion, prevention and treatment of respiratory infections are important in the treatment of leukemia, both for chemotherapy and BMT.

100 项与 CMV (Memo Therapeutics) 相关的药物交易

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