This project studies the outcome of congenital cytomegalovirus (CMV) infection in relation to clinical, immunologic and virologic variables in mother and newborn. Newborns with congenital CMV infection are identified by virologic screening in the hospital nursery at UAB Hospital; during the past year, screening at Cooper Green Hospital was added to the program. Infants with congenital CMV infection are followed up to school age (age 7) in order to define outcome of the congenital infection; these follow-up visits take place on the GCRC. Outcomes of interest include neurologic abnormality, cognitive deficits (defined by a series of neuropsychologic tests), hearing and ophthalmologic or vision abnormality. Siblings (free of congenital CMV infection) serve as controls. Infected patients are tested for virus shredding (urine and saliva), viremia (by PCR), viral load (quantitation of virus in urine or blood) and immune response to the virus. This study has been underway for over 20 years. Results to date have (to sum it up briefly) provided a fairly detailed picture of the outcome of congenital CMV infection which makes it possible to provide prognosis to families of infected infants and estimate the risk of damage when infection occurs in a pregnant woman. In addition, results have established the public health importance of congenital CMV infection, identified sources of maternal infection, identified newborn risk factors for CNS sequelae, linked newborn findings with adverse outcome, demonstrated that hearing loss is commonly progressive in these children, and shown that congenital CMV infection can result in CNS damage in some patients even if the mother was immune prior to conception.
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