Treatment prevents defects from CMV infection
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An expensive but widely established treatment for cytomegalovirus, a common and usually benign virus, can reverse potentially dangerous complications of the disease in the fetus, a study showed on Wednesday.
The study by doctors in the United States and Italy, published in The New England Journal of Medicine, also suggests that ultrasound may be an easy way to screen unborn children for the infection.
Cytomegalovirus, or CMV, is best known for occasionally causing mononucleosis. The virus is very common, but most people don’t realize they’ve been infected by it.
About 40,000 babies are born with the infection in the United States each year, but only 10 percent have symptoms, and the virus is believed responsible for serious handicaps, such as mental retardation, hearing or vision problems, in 7,000 to 9,000 children annually.
In the new study, mothers with the infection who were treated with hyperimmune globulin were far less likely to give birth to an underweight child or a baby with other problems.
“The gamma globulin appeared to be effective in reversing the severe effects of the infection,” said Stuart Adler of Virginia Commonwealth University, one of the authors.
Hyperimmune globulin, which contains virus-fighting antibodies, has been used for years to treat CMV infections, particularly among transplant patients.
It is made in the United States by MedImmune Inc. and in Europe by Biotest.
PREVENTING MENTAL RETARDATION
“It is relatively expensive - hundreds if not thousands of dollars, depending on how much you give and how often,” Adler said. “But it’s a minimal cost if you’re preventing a baby from becoming mentally retarded.”
He told Reuters that further tests were needed to confirm that the treatment really works as well as the new study suggests.
The study was done in Italy because many doctors there already screen for CMV in pregnant women.
The United States does not screen for CMV because, until recently, the test was difficult and it can be hard to tell if the baby is infected and if the fetus is being harmed by the virus. Also, up to now, there has been no effective treatment.
Many women who discover that their child is infected choose an abortion.
But Adler and his colleagues found that ultrasound testing comparable to what most pregnant women now receive offers “a potent predictor” of whether a newborn will have problems from a CMV infection. In the new study, no fetus with an abnormal ultrasound was born with symptoms of CMV.
In one group of patients, among the 31 pregnant women who received the treatment after amniocentesis confirmed a CMV infection, only one gave birth to an infant with the disease, compared to 7 of the 14 women who declined the hyperimmune globulin.
Adler said the therapy probably works by treating the infection in the placenta, which shuttles nutrients and oxygen between the mother and the child.
If CMV cripples the placenta, “the baby gets starved for both oxygen and nutrition, so often these babies are small,” he said. “We think, at least in part, we’re reversing the effect on the placenta.”
In one sense, the finding is not surprising, he said, because many babies born small because of CMV infection often improve quickly with improved nutrition and oxygenation.
Several vaccines against CMV are currently in development.
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