Detecção de Citomegalovírus humano em recém-nascidos, São Paulo, 2010 a 2018

Figueiredo, Carla Grasso

O Citomegalovírus humano (HCMV) pertence à família Herpesviridae é a causa mais frequente de infecção congênita, ocorrendo em todas as regiões do mundo variando de 0,7% a 6,1%. Uma característica desse vírus é a sua capacidade de permanecer latente após uma infecção onde o vírus não é eliminado do organismo podendo ocorrer reativação a qualquer momento. A infecção pelo HCMV pode ser adquirida através de contaminação com diversos líquidos biológicos e a transmissão intrauterina pode ocorrer em mães sem imunidade preexistente que adquirem infecção por HCMV pela primeira vez na gravidez (infecção primária) ou em mulheres com anticorpos preexistentes ao HCMV por reativação de uma infecção anterior ou por aquisição de uma cepa viral diferente. Cerca de 10% a 15% dos lactentes com infecção congênita podem estar em risco de sequelas como problemas neurológicos, icterícia, hepatoesplenomegalia, microcefalia, deficiência auditiva e trombocitopenia. Este estudo teve como objetivo avaliar a frequência da infecção congênita pelo HCMV em crianças de até 1 mês de idade no estado de São Paulo de 2010 a 2018. Também foi realizada a caracterização molecular de amostras...(AU)

Human cytomegalovirus (HCMV) belongs to the Herpesviridae family and is the most frequent cause of congenital infection, occurring worldwide and ranging from 0.7% to 6.1%. One characteristic of this virus is its ability to remain latent after the infection where the virus is not eliminated from the body and reactivation can occur at any time. HCMV infection can be acquired through contamination with various biological fluids and intrauterine transmission can occur in mothers without pre-existing immunity who acquire HCMV infection for the first time during pregnancy (primary infection) or in women with pre-existing HCMV through reactivation of a previous infection or by acquiring a different viral strain. About 10% to 15% of infants with congenital infection may be at risk for sequel such as neurological problems, jaundice, hepatosplenomegaly, microcephaly, hearing loss and thrombocytopenia. The aim of the present study was to evaluate the frequency of HCMV congenital infections in newborns up to 1 month in the Sao Paulo State, from 2010 to 2018. The molecular characterization of HCMV-positive samples was also undertaken.

The study period was divided into two:

(i) from 2010 to 2016 where a retrospective survey was carried out involving the analysis of the database, and (ii) from 2017 to 2018. Urine samples from 275 potential congenital HCMVinfected patients were tested by real-time Polymerase Chain Reaction (qPCR). HCMV-positive samples were amplified by conventional PCR targeting gN and gB, and UL89 genes, sequenced and searched for genotypes and mutations, respectively.A total of 32 (11.6%) positive-HCMV cases were detected (mean Ct 30.59); mean and median age of 10.3 and 6 days old, respectively. Children aged between 0-3 weeks had higher HCMV detection rates (84.4%; 27/32). UL89 gene was successfully sequenced in two samples (IAL-230 and IAL259), both classified as the human betaherpesvirus 5. No described resistance- associated mutations were identified. PCRs for the gB and gN regions failed and no information about HCMV genotypes could be obtained. A routine screening in newborns coupled with the genetic characterization of key viral genes is vital to decrease sequels associated with congenital HCMV infections. ~(AU)