Immunization to prevent congenital cytomegalovirus infection.

INTRODUCTION: A primary maternal cytomegalovirus (CMV) during pregnancy causes newborn disease that includes hearing deficit and/or mental retardation. SOURCES OF DATA: Relevant published literature. AREAS OF AGREEMENT: There are no biologic obstacles to immunization against fetal/placental infection with CMV. AREAS OF UNCERTAINTY: CMV vaccine trials may be difficult due to a lack of public awareness of CMV. Vaccine trials that use fetal infection as an endpoint will be prolonged, since vaccination will need to occur preconception. AREAS TIMELY FOR DEVELOPING RESEARCH: Vaccines in preclinical development include antigens of the CMV gB glycoprotein and the gH/gL UL128, 130 and 131 pentameric complex. These antigens induce antibodies that block viral entry into fibroblasts and endothelial/epithelial cells. Vaccines immunogenic in animals include an inactivated virus with a wild-type UL131 gene, a DNA vaccine using a wild-type UL130 gene and peptide vaccines using peptides from UL130 and 131. CONCLUSIONS: In spite of these potential obstacles, successful evaluation of CMV vaccines is possible.