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1.
Clin Infect Dis ; 68(8): 1420-1426, 2019 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-30137245

RESUMEN

Despite advances in preventive strategies, cytomegalovirus (CMV) infection remains a major complication in solid organ and hematopoietic cell transplant recipients. CMV infection may fail to respond to commercially available antiviral therapies, with or without demonstrating genotypic mutation(s) known to be associated with resistance to these therapies. This lack of response has been termed "resistant/refractory CMV" and is a key focus of clinical trials of some investigational antiviral agents. To provide consistent criteria for future clinical trials and outcomes research, the CMV Resistance Working Group of the CMV Drug Development Forum (consisting of scientists, clinicians, regulatory officials, and industry representatives from the United States, Canada, and Europe) has undertaken establishing standardized consensus definitions of "resistant" and "refractory" CMV. These definitions have emerged from the Working Group's review of the available virologic and clinical literature and will be subject to reassessment and modification based on results of future studies.


Asunto(s)
Infecciones por Citomegalovirus/clasificación , Trasplante de Células Madre Hematopoyéticas , Trasplante de Órganos , Receptores de Trasplantes , Farmacorresistencia Viral , Humanos , Huésped Inmunocomprometido , Factores de Riesgo , Terminología como Asunto , Insuficiencia del Tratamiento
2.
Medicina (Kaunas) ; 55(10)2019 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-31590269

RESUMEN

The incidence of infectious complications, compared with the general population and the pre-transplant status of the recipient, increases substantially following kidney transplantation, causing significant morbidity and mortality. The potent immunosuppressive therapy given to prevent graft rejection in kidney transplant recipients results in an increased susceptibility to a wide range of opportunistic infections including bacterial, viral and fungal infections. Over the last five years, several advances have occurred that may have changed the burden of infectious complications in kidney transplant recipients. Due to the availability of direct-acting antivirals to manage donor-derived hepatitis C infection, this has opened the way for donors with hepatitis C infection to be considered in the donation process. In addition, there have been the development of medications targeting the growing burden of resistant cytomegalovirus, as well as the discovery of the potentially important role of the gastrointestinal microbiota in the pathogenesis of post-transplant infection. In this narrative review, we will discuss these three advances and their potential implications for clinical practice.


Asunto(s)
Infecciones por Citomegalovirus/clasificación , Hepatitis C/complicaciones , Trasplante de Riñón/efectos adversos , Adulto , Citomegalovirus/patogenicidad , Infecciones por Citomegalovirus/fisiopatología , Femenino , Microbioma Gastrointestinal , Hepacivirus/patogenicidad , Hepatitis C/fisiopatología , Humanos , Incidencia , Trasplante de Riñón/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología
4.
Am J Ophthalmol ; 228: 89-95, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33845019

RESUMEN

PURPOSE: To determine classification criteria for cytomegalovirus (CMV) anterior uveitis. DESIGN: Machine learning of cases with CMV anterior uveitis and 8 other anterior uveitides. METHODS: Cases of anterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the anterior uveitides. The resulting criteria were evaluated on the validation set. RESULTS: One thousand eighty-three cases of anterior uveitides, including 89 cases of CMV anterior uveitis, were evaluated by machine learning. The overall accuracy for anterior uveitides was 97.5% in the training set and 96.7% in the validation set (95% confidence interval 92.4, 98.6). Key criteria for CMV anterior uveitis included unilateral anterior uveitis with a positive aqueous humor polymerase chain reaction assay for CMV. No clinical features reliably diagnosed CMV anterior uveitis. The misclassification rates for CMV anterior uveitis were 1.3% in the training set and 0% in the validation set. CONCLUSIONS: The criteria for CMV anterior uveitis had a low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.


Asunto(s)
Consenso , Infecciones por Citomegalovirus/clasificación , Infecciones Virales del Ojo/clasificación , Aprendizaje Automático , Uveítis Anterior/clasificación , Adolescente , Adulto , Anciano , Humor Acuoso/virología , Citomegalovirus/genética , Infecciones por Citomegalovirus/virología , ADN Viral/análisis , Infecciones Virales del Ojo/diagnóstico , Infecciones Virales del Ojo/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Uveítis Anterior/diagnóstico , Uveítis Anterior/etiología , Adulto Joven
6.
Pathologe ; 29 Suppl 2: 286-9, 2008 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-18820914

RESUMEN

New findings have been made in recent years on the various forms of the hepatitis virus in terms of disease course, its etiopathogenetic link with comorbidities and the definition of new forms in Central Europe. Epstein-Barr virus (EBV)- and cytomegalovirus (CMV)-induced hepatitis may occur in the so-called sero-negative group of hepatitis and direct demonstration of the viral genome in paraffin liver tissues is required to confirm the diagnosis. Since diagnosis of autoimmune hepatitis in daily practice may be difficult, a scoring system with simplified criteria has recently been developed.


Asunto(s)
Hepatitis Autoinmune/patología , Hepatitis Viral Humana/patología , Carcinoma Hepatocelular/clasificación , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patología , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/patología , Diagnóstico Diferencial , Progresión de la Enfermedad , Infecciones por Virus de Epstein-Barr/clasificación , Infecciones por Virus de Epstein-Barr/diagnóstico , Infecciones por Virus de Epstein-Barr/patología , Hepatitis B Crónica/clasificación , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/patología , Hepatitis C Crónica/clasificación , Hepatitis C Crónica/diagnóstico , Hepatitis C Crónica/patología , Hepatitis D/clasificación , Hepatitis D/diagnóstico , Hepatitis D/patología , Hepatitis E/clasificación , Hepatitis E/diagnóstico , Hepatitis E/patología , Hepatitis Autoinmune/clasificación , Hepatitis Autoinmune/diagnóstico , Hepatitis Viral Humana/clasificación , Hepatitis Viral Humana/diagnóstico , Humanos , Hígado/patología , Neoplasias Hepáticas/patología
7.
Acta Biochim Pol ; 53(3): 457-61, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-17019440

RESUMEN

In situ PCR and in situ reverse transcription PCR (RT-PCR) were applied to discriminate between latent and productive infection of human cytomegalovirus (HCMV) in leukocytes. We investigated 28 samples, in which viral pp65 antigen was detected only in the cytoplasm of leukocytes. Additionally we assayed 12 specimens lacking pp65 antigen. Using nested PCR (nPCR), viral DNA was detected in 27 samples. In six samples the results of nPCR were unreadable due to the presence of polymerase inhibitors. By application of in situ PCR, we were able to confirm the presence of viral DNA in the nucleus and/or cytoplasm. Productive infection was recognized in 20 samples in which transcripts for late viral genes were detected. Among the 20 samples negative by in situ RT-PCR, we recognized phagocytosis of viral particles in eight and the latent form of HCMV infection in five.


Asunto(s)
Infecciones por Citomegalovirus/diagnóstico , Citomegalovirus/aislamiento & purificación , ADN Viral/sangre , Leucocitos/virología , Fosfoproteínas/sangre , ARN Viral/sangre , Proteínas de la Matriz Viral/sangre , Antígenos Virales/sangre , Núcleo Celular/virología , Citomegalovirus/química , Citomegalovirus/genética , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/virología , Citoplasma/virología , Humanos , Leucocitos/patología , ARN Mensajero/sangre , Latencia del Virus
8.
World J Gastroenterol ; 22(3): 1321-30, 2016 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-26811669

RESUMEN

AIM: To identify definitions of cytomegalovirus (CMV) infection and intestinal disease, in inflammatory bowel disease (IBD), to determine the prevalence associated with these definitions. METHODS: We conducted a systematic review and interrogated PubMed, EMBASE and Cochrane for literature on prevalence and diagnostics of CMV infection and intestinal disease in IBD patients. As medical headings we used "cytomegalovirus" OR "CMV" OR "cytomegalo virus" AND "inflammatory bowel disease" OR "IBD" OR "ulcerative colitis" OR "colitis ulcerosa" OR "Crohn's disease". Both MeSH-terms and free searches were performed. We included all types of English-language (clinical) trials concerning diagnostics and prevalence of CMV in IBD. RESULTS: The search strategy identified 924 citations, and 52 articles were eligible for inclusion. We identified 21 different definitions for CMV infection, 8 definitions for CMV intestinal disease and 3 definitions for CMV reactivation. Prevalence numbers depend on used definition, studied population and region. The highest prevalence for CMV infection was found when using positive serum PCR as a definition, whereas for CMV intestinal disease this applies to the use of tissue PCR > 10 copies/mg tissue. Most patients with CMV infection and intestinal disease had steroid refractory disease and came from East Asia. CONCLUSION: We detected multiple different definitions used for CMV infection and intestinal disease in IBD patients, which has an effect on prevalence numbers and eventually on outcome in different trials.


Asunto(s)
Colitis Ulcerosa/epidemiología , Enfermedad de Crohn/epidemiología , Infecciones por Citomegalovirus/epidemiología , Citomegalovirus/patogenicidad , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/virología , Enfermedad de Crohn/diagnóstico , Enfermedad de Crohn/virología , Citomegalovirus/genética , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/virología , ADN Viral/sangre , ADN Viral/genética , Humanos , Inmunohistoquímica , Reacción en Cadena de la Polimerasa , Valor Predictivo de las Pruebas , Prevalencia , Reproducibilidad de los Resultados
9.
Transplant Proc ; 47(6): 1772-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26293049

RESUMEN

BACKGROUND: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding for cytomegalovirus (CMV) has been used as a proxy for active CMV infection or disease occurring in the inpatient setting in retrospective studies of kidney transplant recipients using large amounts of administrative data. However, the accuracy of inpatient CMV coding has not been determined. METHODS: We identified 393 kidney transplant recipients who were readmitted to Barnes-Jewish Hospital in St. Louis, Missouri from January 1, 2007 to December 31, 2011 to determine the accuracy of the ICD-9-CM diagnosis code for CMV (078.5) in identifying active CMV infection or disease (asymptomatic viremia, CMV syndrome, or tissue-invasive CMV disease) in the inpatient setting, using microbiological, histopathologic, or ophthalmologic evidence for CMV as the gold standard. RESULTS: The sensitivity and positive predictive value of CMV coding in identifying active CMV infection or disease were 0.77 and 0.71, respectively. The specificity and negative predictive value were both 0.98. The sensitivity of CMV coding in identifying CMV syndrome or tissue-invasive CMV disease was 0.93. CONCLUSIONS: CMV coding had good accuracy in identifying active CMV infection or disease among readmitted kidney transplant recipients in our hospital. Further validation studies of CMV coding in other hospitals are needed to obtain more generalizable estimates of the accuracy of CMV coding.


Asunto(s)
Infecciones por Citomegalovirus/clasificación , Rechazo de Injerto/clasificación , Pacientes Internos , Trasplante de Riñón/efectos adversos , Adulto , Humanos , Persona de Mediana Edad , Estudios Retrospectivos
10.
Am J Ophthalmol ; 108(6): 691-8, 1989 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-2556923

RESUMEN

We examined ten patients from a consecutive series of 73 patients with either isolated cytomegalovirus papillitis or limited cytomegalovirus retinitis contiguous with the optic disk. Patients with peripheral retinitis and other areas of retinitis were excluded. All patients were treated with ganciclovir. Two distinct types of cytomegalovirus infection of the peripapillary area were identified. Type I was characterized by spread of limited retinitis to the optic disk margin, good central visual acuity, and permanent arcuate and altitudinal visual field defects that enlarged and became more complete as the retinitis progressed toward the disk. Type II appeared to be a true cytomegalovirus infection of the optic nerve characterized by primary, isolated papillitis with peripapillary retinitis, an early afferent pupillary defect, and good initial visual acuity, which rapidly deteriorated despite prompt antiviral therapy. Peripapillary cytomegalovirus retinitis appears to be an important and underreported cause of visual morbidity in patients with AIDS.


Asunto(s)
Infecciones por Citomegalovirus/complicaciones , Infecciones Virales del Ojo/complicaciones , Neuritis Óptica/etiología , Retinitis/etiología , Trastornos de la Visión/etiología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/tratamiento farmacológico , Infecciones Virales del Ojo/clasificación , Infecciones Virales del Ojo/tratamiento farmacológico , Angiografía con Fluoresceína , Ganciclovir/uso terapéutico , Humanos , Oftalmoscopía , Disco Óptico/fisiopatología , Neuritis Óptica/clasificación , Neuritis Óptica/tratamiento farmacológico , Trastornos de la Pupila/etiología , Retinitis/clasificación , Retinitis/tratamiento farmacológico , Agudeza Visual , Pruebas del Campo Visual , Campos Visuales
11.
J Dev Behav Pediatr ; 19(4): 254-9, 1998 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9717134

RESUMEN

The findings of previous studies examining the neurocognitive development of children with clinically inapparent (asymptomatic) cytomegalovirus (CMV) infection have demonstrated mixed results. These studies have generally depended on small sample sizes (i.e., < 50). We examined the intellectual development of children with asymptomatic congenital CMV infection using a sample larger than previous studies. Two hundred and four cases aged 5 to 200 months were compared with 177 uninfected siblings ranging in age from 6 to 203 months. Parents were administered the Developmental Profile, a measure of developmental achievement. Children who were older than 30 months were administered an objective intelligence measure. Results of this study showed that children with asymptomatic congenital CMV infection do not demonstrate intellectual impairment, and that they perform similarly to uninfected siblings. Parents tended to overestimate their child's level of functioning regardless of whether the child had CMV infection.


Asunto(s)
Desarrollo Infantil , Infecciones por Citomegalovirus/congénito , Inteligencia , Factores de Edad , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/complicaciones , Femenino , Humanos , Lactante , Pruebas de Inteligencia/normas , Pruebas de Inteligencia/estadística & datos numéricos , Masculino , Núcleo Familiar , Reproducibilidad de los Resultados
12.
J Pediatr Endocrinol Metab ; 16(9): 1233-8, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14714744

RESUMEN

Birth characteristics and growth pattern in 76 children with congenital cytomegalovirus (CMV) infection were compared to Swedish reference data. Infection classification was based on maternal sera during pregnancy. In 31 children the infection was primary and 31 children had reactivated (recurrent or secondary) congenital CMV infection. Infection type could not be determined in 14 children. Transient neonatal symptoms were apparent in 22 children and eight children had classical neurological CMV sequelae. Heterogeneous neurological disorders were found in 13 children. No significant differences in height, weight, and growth were found. The median follow-up time was 10 years. From 4 years old children with congenital CMV infection were taller than the reference standard. At 1 and 2 years, those children with primary congenital CMV infection were borderline shorter than reference standard, and from 4 years children with reactivated CMV infection were taller than the reference standard. In conclusion, no evidence was found verifying that congenital CMV infection causes short stature.


Asunto(s)
Estatura/fisiología , Infecciones por Citomegalovirus/congénito , Tamizaje Neonatal/métodos , Peso al Nacer , Niño , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/epidemiología , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Recién Nacido , Estudios Prospectivos , Suecia , Factores de Tiempo
13.
Arkh Patol ; 46(9): 69-75, 1984.
Artículo en Ruso | MEDLINE | ID: mdl-6095797

RESUMEN

Two varieties of nodular sialadenitis, acute nodular (15%) and chronic with exacerbation of the nodular type (19%), were distinguished basing on analysis of the material from 880 children dead from cytomegaly. Parotid glands were examined electron-microscopically in 2 cass of generalized and 6 cases of localized cytomegaloviral infection. Basing on the histoenzymochemical data published earlier, the etiological role of cytomegalovirus in the development of nodular infiltrates was substantiated and the functional activity of cytomegalic cells in virus reproduction and isolation shown. Diagnostic importance of nodular infiltrates was stressed. Morphological manifestations of cytomegalovirus reproduction were described.


Asunto(s)
Infecciones por Citomegalovirus/patología , Enfermedades de las Glándulas Salivales/patología , Sialadenitis/patología , Transformación Celular Viral , Infecciones por Citomegalovirus/clasificación , Citoplasma/ultraestructura , Humanos , Cuerpos de Inclusión Viral/ultraestructura , Lactante , Microscopía Electrónica , Morfogénesis , Glándula Parótida/ultraestructura , Sialadenitis/clasificación
18.
Klin Monbl Augenheilkd ; 182(3): 237-40, 1983 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-6304395

RESUMEN

Case report on a premature male infant, born in the 34th week of pregnancy with bronchopulmonary dysplasia, bronchitis, hepatitis, marked cortical and subcortical atrophy of the brain with enlargement of the inner and outer subarachnoid space, with severe cerebral motility disorders and convulsions. Blood serology showed rapidly increasing cytomegaly titers, which were also elevated in the serum of the mother. The ophthalmological examination revealed a hypoplastic, white papilla in both eyes. Neither retinal arteries nor veins were seen. The macula and retinal periphery were normal. There were no signs of acute or passed retinochorioiditis. Temporary opacification of the cornea was observed. In connection with the pediatric findings the authors interpret the aplasia of the retinal vessels and the hypoplasia of the optic nerve as a result of a cytomegaly infection prior to the 4th month of pregnancy, which prevented normal development of the vessels. The temporary opacity of the cornea could be a reaction of the corneal endothelium against the virus.


Asunto(s)
Infecciones por Citomegalovirus/congénito , Enfermedades del Prematuro , Arteria Retiniana/anomalías , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/complicaciones , Humanos , Recién Nacido , Masculino
19.
Transpl Int ; 5 Suppl 1: S26-9, 1992.
Artículo en Inglés | MEDLINE | ID: mdl-14621724

RESUMEN

The aim of the study was to evaluate the virological parameters associated with the severity of cytomegalovirus (CMV) disease in renal and simultaneous renal and pancreatic transplantation. The association of the viral profile and the severity of the viral disease was analysed taking into account different confounding variables susceptible to linkage with the severity of the CMV infection and the viral parameters. All the patients transplanted between 1 January 1989 and 31 December 1990, a total of 242, were prospectively followed by viral cultures in blood and urine and by serological methods using the detection of CMV-specific IgM and the complement fixation (CF) test. The samples were taken systematically each week for the first month and then at day 90, 180 and every 6 months and also in cases of clinical manifestations related to viral disease. CMV infection was diagnosed virologically by the presence of viraemia, viruria, IgM, or a significant rise in CMV antibody titre in CF. CMV disease was classified as asymptomatic, mild (fever and/or leukopenia), moderate (fever, leukopenia and liver abnormalities), severe (CMV pneumopathy and/or gastrointestinal disease) or fatal. The incidence of CMV infection was 65% (157/242): 32% asymptomatic, 36% mild, 30% moderate and 2% severe. The presence of IgM was associated with the severity of CMV disease: 51.4% of moderate and severe CMV infections in the group with IgM versus only 16% in the group without IgM (P < 0.0001). The risk of having severe or moderate CMV disease was 3.28 times higher in patients with positive IgM. However the serological changes in CF were not significantly associated with the severity of the viral disease since 34.6% of the patients with CF changes had a severe form versus 20.8% in the group without CF modification. Viruria was significantly associated with moderate or severe infection: 43.6% of the patients with viruria had severe infection versus only 12.5% in the patients without viruria (P < 0.0002). The risk of having moderate or severe CMV disease was 3.48 times higher in the patients with viruria. Viraemia was also associated with more severe CMV infection: 48.6% of moderate or severe CMV infection in the group of patients with viraemia versus 19% in the group without viraemia (P < 0.0001). The risk of having severe or moderate CMV infection was 2.58 times higher in the patients with viraemia. Viraemia was not more associated with severe CMV infection than viruria. Using the maximum likelihood ratio method and the logistic regression model, CMV-specific IgM, viruria and viraemia were each shown to be associated with the severity of CMV disease and the addition of one parameter to the other(s), whatever the type (except the CF changes) and whatever the order of this addition, did not remove the link between the severity and IgM, viruria and viremia. The incidence of severe and moderate CMV disease increased with the number of positive viral parameters (PVP) from 2% of moderate and severe infections in the group with one PVP, to 28% in the group with two PVP, to 39% in the group with three PVP and 68% in the group with four PVP (trend, 35.95; P < 0.0001). Taking the absolute risk of the group of patients without IgM, viruria or viraemia as the basal level, the observed relative risk of severe CMV infection varied from 6.45 in the group with positive IgM without viruria or viraemia, to 10.74 in the group with positive IgM and viruria without viraemia and to 22.5 in the group with the three positive parameters IgM, viruria and viraemia. The different potential confounding factors (recipient and donor serology, renal or renal and pancreatic transplantation, DR compatibility, rejection before CMV infection) did not modify the link between the viral profile and the severity of CMV disease. This study suggests that the severity of CMV disease might be linked to the overspread of the virus as well as to the consequences of a CMV-specific humoral immune response.


Asunto(s)
Infecciones por Citomegalovirus/fisiopatología , Citomegalovirus/aislamiento & purificación , Trasplante de Riñón/efectos adversos , Trasplante de Páncreas/efectos adversos , Factores de Edad , Anticuerpos Antivirales/sangre , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/epidemiología , Humanos , Inmunoglobulina M/sangre , Incidencia , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/virología , Estudios Retrospectivos , Donantes de Tejidos , Viremia/epidemiología
20.
Scand J Infect Dis ; 31(5): 443-57, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10576123

RESUMEN

This report summarizes knowledge accumulated in a long-term study of congenital and maternal cytomegalovirus (CMV) infection in Sweden. Some new findings are included. We considered diagnostic methods, sources of maternal infection (including occupational risks), roles of primary and secondary maternal infections, transmission to foetuses, incidence, symptoms and prognosis of established congenital infection and relative importance of such infection in infantile sensorineural deafness, microcephaly and type 1 diabetes mellitus. Virus isolation testing was done 1977-1985 on 16,474 newborns. 76 (0.5%) congenitally infected infants were found, 22/76 (29%) with transient neonatal symptoms and 11/60 (18%) with neurological symptoms by the age of 7 y. Type of maternal CMV infection was serologically determined in 62/76 cases (30 primary, 32 secondary). CNS disturbances in the infants occurred after both primary (all trimesters) and secondary maternal infections. The negative potential of secondary maternal infections might be an obstacle to preventive vaccination.


Asunto(s)
Infecciones por Citomegalovirus , Citomegalovirus/aislamiento & purificación , Transmisión Vertical de Enfermedad Infecciosa , Adolescente , Adulto , Peso al Nacer , Infecciones por Citomegalovirus/clasificación , Infecciones por Citomegalovirus/congénito , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/transmisión , Inglaterra/epidemiología , Femenino , Edad Gestacional , Humanos , Incidencia , Recién Nacido , Masculino , Edad Materna , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Suecia/epidemiología , Estados Unidos/epidemiología
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