Catamnesis of children with congenital cytomegalovirus infection depending on etiotropic therapy in the first year of life

About authors

1 Pediatric Research and Clinical Center of Infectious Diseases, Federal Medical Biological Agency, St. Petersburg, Russia

2 North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia, St. Petersburg, Russia

3 Pavlov First State Medical University of St. Petersburg, St. Petersburg, Russia

4 Almazov National Medical Research Center, Ministry of Health of Russia, St. Petersburg, Russia

Correspondence should be addressed: Valery V. Vasilyev
Mirgorodskaya, 3, korp. I, St. Petersburg, 191167, Russia; ur.ay@debucv

About paper

Funding: this study was performed under the research effort № 021-03 "Antenatal and early postnatal etiological diagnostics and etiotropic therapy of congenital infectious diseases of viral etiology" managed by the FMBA.

Author contribution: Vasilyev VV, Rogozina NV — study conceptualization and design; AA Grineva, Ivanova RA, Markin IV — collection and processing of the material, statistical data processing; Vasilyev VV, Rogozina NV — collection of literature data, article authoring, editing.

Received: 2023-08-12 Accepted: 2023-09-19 Published online: 2023-09-30

Cytomegalovirus infection (CMVI) continues to be a serious public health problem, being second to hypoxia and asphyxia in the list of reasons of morbidity and mortality of newborns. This study aimed to analyze therapeutic approaches to management of children with congenital cytomegalovirus with the regimens including an antiviral drug (direct action) and a specific anti-cytomegalovirus immunoglobulin (anti-CMV IG), depending on the clinical form of the disease. The total number of participants was 62, with the first group of children receiving the antiviral drug (n = 21), and the second group — an anti-CMV IG (n = 41). We analyzed the clinical, laboratory and instrumental research methods, and studied the catamnesis of children under 3 years of age. For statistical analysis, we used SPSS Statistics and StatTech v.3.1.6. In the first group, where the regimen included the direct action antiviral drug, the outcome was successful for 28.6% of the participants, and in the second group, which was treated with the anti-CMV immunoglobulin, this figure was 58.5%. Regardless of the regimen, by the age of 3, 50% of the children were practically healthy. Most of the participants tolerated the therapy satisfactorily. However, for 66% of the involved children, we had to shorten the direct action antiviral drug therapy to 14 days because of the problems with venous access, in 4.8% we registered thrombocytopenia, and in 9.5% — increased transaminase activity. Comparing the disease outcomes depending on the therapy initiation day, we established significant differences only for the specific antiviral therapy cases (p = 0.044).

Keywords: congenital cytomegalovirus infection, gancyclovir, anti-CMV immunoglobulin, outcomes