Virus-host interaction, antiviral treatment, disease burden and prevention
Description of research
After having optimised postnatal diagnosis of congenital CMV (cCMV) by performing PCR on neonatal dried blood spots, we have shown that cCMV has a birth prevalence of 0.5 % in the Netherlands. This means that in the Netherlands every year about 1000 children are born with cCMV of whom about 170 will develop long-term sequelae, such as hearing loss and motor and cognitive developmental delay. Our current research focuses on finding virus-host factors that predict the development of disease associated with cCMV. These predictive markers could contribute to implementation of universal neonatal screening for cCMV and to development of CMV vaccines (VACTRAIN). In children that fail neonatal hearing screening and have cCMV, we study the efficacy of antiviral treatment in preventing the deterioration of the hearing loss (CONCERT). In order to gain insight into the disease burden of cCMV in the Netherlands, a large cohort of children of 5-6 years of age with cCMV and a matched control group has been studied for their psycho-motor development and hearing (CROCUS).This has been done in collaboration with the National Institute of Public Health and the Environment (RIVM). Also the effect of cCMV on the quality of life of children and parents was assessed. These data will serve to estimate the cost-effectiveness of primary and secondary preventive measures.
Nowadays, the second most prevalent viral congenital infection in the Netherlands is probably congenital parvovirus B19 infection (cB19V). When infection during pregnancy is diagnosed and fetal infection has led to fetal anaemia and hydrops, intrauterine transfusion is an effective measure to reduce mortality. The true birth prevalence of cB19V is not known, nor is the burden of disease. The possibility to diagnose cB19V postnatally by testing neonatal dried blood spots is now being explored.
- Virus-host interaction in congenital CMV infection
- Predictive markers for long-term outcome of congenital CMV infection
- Antiviral treatment of congenital CMV infection of children with hearing loss
- Disease burden of congenital CMV infection in the Netherlands
- Diagnosis of congenital parvovirus B19 infection
- Long-term impairment attributable to congenital cytomegalovirus infection: a retrospective cohort study. Korndewal MJ, Oudesluys-Murphy AM, Kroes ACM, van der Sande MAB, de Melker HE, Vossen ACTM. Dev Med Child Neurol. 2017;59(12):1261-1268
- Congenital Cytomegalovirus Infection: Child Development, Quality of Life and Impact on Daily Life. Korndewal MJ, Oudesluys-Murphy AM, Kroes ACM, Vossen ACTM, de Melker HE. Pediatr Infect Dis J. 2017;36(12):1141-1147
- T and B Cell Markers in Dried Blood Spots of Neonates with Congenital Cytomegalovirus Infection: B Cell Numbers at Birth Are Associated with Long-Term Outcomes. Rovito R, Korndewal MJ, van Zelm MC, Ziagkos D, Wessels E, van der Burg M, Kroes AC, Langerak AW, Vossen AC. J Immunol. 2017;198(1):102-109
- Valganciclovir for Congenital Cytomegalovirus. Schornagel FA, Oudesluys-Murphy AM, Vossen AC. N Engl J Med. 2015; 372:2462 .
- Cytomegalovirus infection in the Netherlands: seroprevalence, risk factors, and implications. Korndewal MJ, Mollema L, Tcherniaeva I, van der Klis F, Kroes AC, Oudesluys-Murphy AM, Vossen AC, de Melker HE. J Clin Virol. 2015; 63:53-8 .
- The apparent paradox of maternal seropositivity as a risk factor for congenital cytomegalovirus infection: a population-based prediction model. de Vries JJ, van Zwet EW, Dekker FW, Kroes AC, Verkerk PH, Vossen AC. Rev Med Virol. 2013; 23:241-9