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Difficulties in diagnosing congenital CMV: how accurate is detection using dried blood spot?

Journal of Perinatology volume 33, page 495 (2013)Cite this article

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Piersigilli et al.1 report a case of active retinitis in an infant with cytomegalovirus (CMV) infection. The authors acknowledge that it is difficult to distinguish between congenital or postnatally acquired CMV but exclude congenital infection due to the timing of the samples (virus isolation in urine before 28 days of life and positive CMV DNA in saliva, plasma and whole blood on day 34 of life), maternal serology and a negative CMV result from the dried blood spot (DBS).

Our data in the United Kingdom have shown that a negative DBS does not exclude congenital CMV (cCMV) infection. We have shown the sensitivity of DBS for retrospective diagnosis of cCMV in two well-defined laboratory confirmed groups to be 72% and 74%, respectively.2 A large prospective study in the USA assessed the diagnostic accuracy of DBS PCR as a universal screening tool for cCMV.3 This study showed that DBS PCR has low sensitivity for accurate diagnosis of cCMV as two-thirds of infections were missed. Moreover, our data as part of the Viral Load and Immunity in congenital cytomegalovirus study along with that published elsewhere shows that up to 25% of congenitally infected babies are not viraemic at birth using standard diagnostic CMV PCR techniques (Kimberlin et al.4 and unpublished data).

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References

  1. Piersgilli F, Catena G, De Gasperis MR, Lozzi S, Auriti C et al. Active retinitis in an infant with postnatally acquired cytomegalovirus infection. J Perinatol 2012; 32 (7): 559–562.

    Article  Google Scholar 

  2. Atkinson C, Walter S, Sharland M, Tookey P, Luck S, Peckham C . Use of dried blood spots for retrospective diagnosis of congenital CMV. J Med Virol 2009; 81 (8): 1394–1398.

    Article  Google Scholar 

  3. Boppana S, Ross S, Novak Z, Shimamura M, Tolan RW, Palmer AL . Dried blood spot real-time polymerase chain reaction assays to screen newborns for congenital cytomegalovirus infection. JAMA 2010; 303 (14): 1375–1382.

    Article  CAS  Google Scholar 

  4. Kimberlin DW, Acosta EP, Sanchez PJ, Sood S, Agrawal V, Homans J . Pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease. J Infect Dis 2008; 197: 836–845.

    Article  CAS  Google Scholar 

  5. Yamamoto AY, Mussi-Pinhata MM, Boppana SB, Novak Z, Wagatsuma VM, Oliveira Pde F . Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population. Am J Obstet Gynaecol 2010; 202: e1–e8.

    Article  Google Scholar 

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Authors and Affiliations

  1. Centre for Virology, University College London Medical School, London, UK

    C Atkinson, S Luck & P Griffiths

  2. Paediatric Infectious Diseases Research Group, St George's University of London, London, UK

    S Kadambari

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  1. C Atkinson
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  2. S Luck
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  3. S Kadambari
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  4. P Griffiths
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Correspondence to C Atkinson.

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Atkinson, C., Luck, S., Kadambari, S. et al. Difficulties in diagnosing congenital CMV: how accurate is detection using dried blood spot?. J Perinatol 33, 495 (2013). https://doi.org/10.1038/jp.2012.150

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