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. 2010 Mar;202(3):297.e1-8.
doi: 10.1016/j.ajog.2009.11.018. Epub 2010 Jan 13.

Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population

Aparecida Yulie Yamamoto  1 , Marisa Marcia Mussi-Pinhata, Suresh B Boppana, Zdenek Novak, Virginia M Wagatsuma, Patricia de Frizzo Oliveira, Geraldo Duarte, William J Britt
Affiliations

Human cytomegalovirus reinfection is associated with intrauterine transmission in a highly cytomegalovirus-immune maternal population

Aparecida Yulie Yamamoto et al. Am J Obstet Gynecol. 2010 Mar.

Abstract

Objective: To determine contribution of reinfection with new strains of cytomegalovirus in cytomegalovirus seromimmune women to incidence of congenital cytomegalovirus infection.

Study design: In 7848 women studied prospectively for congenital cytomegalovirus infection from a population with near universal cytomegalovirus seroimmunity, sera from 40 mothers of congenitally infected infants and 109 mothers of uninfected newborns were analyzed for strain-specific anticytomegalovirus antibodies.

Results: All women were cytomegalovirus seroimmune at first prenatal visit. Reactivity for 2 cytomegalovirus strains was found in 14 of 40 study mothers and in 17 of 109 control mothers at first prenatal visit (P = .009). Seven of 40 (17.5%) study women and 5 of 109 (4.6%) controls (P = .002) acquired antibodies reactive with new cytomegalovirus strains during pregnancy. Evidence of infection with more than 1 strain of cytomegalovirus before or during current pregnancy occurred in 21 of 40 study mothers and 22 of 109 controls (P < .0001).

Conclusion: Maternal reinfection by new strains of cytomegalovirus is a major source of congenital infection in this population.

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Figures

FIGURE
FIGURE. Patterns of reactivity for polymorphic linear epitopes on CMV glycoproteins gH and gB
Schematic representation of primary amino acid sequence of CMV strain-specific antibody-binding sites present on envelope gH and gB. Possible patterns of antibody reactivity shown on far left with the interpretation of reactivity for number of viral strains that have infected a single individual.
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