Clinical Diagnostic Testing for Human Cytomegalovirus Infections

J Infect Dis. 2020 Mar 5;221(Suppl 1):S74-S85. doi: 10.1093/infdis/jiz601.

Abstract

Human cytomegalovirus (HCMV) infections are among the most common complications arising in transplant patients, elevating the risk of various complications including loss of graft and death. HCMV infections are also responsible for more congenital infections worldwide than any other agent. Congenital HCMV (cCMV) infections are the leading nongenetic cause of sensorineural hearing loss and a source of significant neurological disabilities in children. While there is overlap in the clinical and laboratory approaches to diagnosis of HCMV infections in these settings, the management, follow-up, treatment, and diagnostic strategies differ considerably. As yet, no country has implemented a universal screening program for cCMV. Here, we summarize the issues, limitations, and application of diagnostic strategies for transplant recipients and congenital infection, including examples of screening programs for congenital HCMV that have been implemented at several centers in Japan, Italy, and the United States.

Keywords: human cytomegalovirus; congenital infection; diagnosis; pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Algorithms
  • Clinical Decision-Making
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / transmission
  • Cytomegalovirus* / genetics
  • Cytomegalovirus* / immunology
  • Diagnostic Tests, Routine* / methods
  • Disease Management
  • Female
  • Host-Pathogen Interactions
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Molecular Diagnostic Techniques
  • Neonatal Screening
  • Organ Transplantation / adverse effects
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / etiology
  • Prenatal Diagnosis