The role of IgG avidity in diagnosis of cytomegalovirus infection in newborns and infants [Uloga IgG aviditeta u dijagnostici infekcije citomegalovirusom u novorođenčadi i dojenčadi]

Vilibić-Čavlek, Tatjana and Ljubin-Sternak, Sunčanica and Vojnović, Gordana and Sviben, Mario and Mlinarić-Galinović, Gordana (2012) The role of IgG avidity in diagnosis of cytomegalovirus infection in newborns and infants [Uloga IgG aviditeta u dijagnostici infekcije citomegalovirusom u novorođenčadi i dojenčadi]. Collegium Antropologicum, 36 (1). pp. 297-300. ISSN 0350-6134

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Abstract

To evaluate the value of IgG avidity in diagnosis of congenital cytomegalovirus (CMV) infection in newborns and infants we collected serum samples from 40 infants under 12 months of age with suspected congenital CMV infection. Sera were tested for IgM, IgG and IgG avidity. For 25 of them, virus isolation and/or polymerase chain reaction (PCR) on urine specimens were performed. Thirteen (32.5%) patients showed the presence of CMV IgM antibodies, 3 (7.5%) had equivocal IgM result, and 24 (60.0%) patients had IgG antibodies only. Using IgG avidity, CMV infection (low avidity index-AI) was documented in 61.5% IgM positive and 54.2% IgM negative patients. Eight of nine (88.8%) IgM positive patients were positive either on virus isolation or PCR. In IgM negative patients, 46.6% urine cultures were positive for CMV and 66.6% were PCR positive. According to age, IgG avidity demonstrated acute/recent primary CMV infection in 58.8% patients younger than three months compared with 91.7% and 81.8% in 3-6 and 6-12 months old babies, respectively. In conclusion, IgG avidity is useful in diagnosis of CMV infection either in IgM positive or IgM negative children older than 3 months of age. In infants less than 3 months, transplacentally derived maternal IgG antibodies of high avidity influence on the IgG avidity result. In these children, CMV infection should be confirmed by direct virologic methods such as virus isolation or PCR.

Abstract in Croatian

ULOGA IgG AVIDITETA U DIJAGNOSTICI INFEKCIJE CITOMEGALOVIRUSOM U NOVOROĐENČADI I DOJENČADI ----- Cilj rada bio je odrediti ulogu testa IgG aviditeta u u dijagnostici kongenitalne infekcije citomegalovirusom (CMV) u novorođenčadi i dojenčadi. Prikupljeni su uzorci seruma 40 djece mlađe od godinu dana sa suspektom CMV infekcijom i testirani na prisustvo CMV IgM i IgG protutijela te aviditet IgG protutijela. U 25 djece također je učinjena izolacija virusa i/ili lančana reakcija polimeraze (PCR) iz urina. Trinaest (32,5%) bolesnika imalo je prisutna CMV IgM protutijela, 3 (7,5%) bolesnika imalo je graničan IgM nalaz, dok je 24 (60,0%) bolesnika imalo samo CMV IgG protutijela. Pomoću IgG aviditeta, akutna CMV infekcija (nizak indeks aviditeta-AI) dokazana je u 61,5% bolesnika s pozitivnim IgM protutijelima te 54,2% bolesnika s negativnim IgM protutijelima. Osam od 9 (88,8%) IgM pozitivnih bolesnika imalo je pozitivan nalaz izolacije i/ili PCR. U IgM negativnih bolesnika, virus je izoliran u njih 46,6% dok je 66,6% bilo PCR pozitivno. S obzirom na dob, testom IgG aviditeta dokazana je primarna CMV infekcija u 58,8% djece mlađe od tri mjeseca, 91,7% djece u dobi od 3–6 mjeseca te 81,8% djece u dobi od 6–12 mjeseci. U zaključku, test IgG aviditeta može pomoći u dijagnostici CMV infekcije u djece starije od 3 mjeseca s pozitivnim kao i negativnim IgM protutijelima. U djece mlađe od 3 mjeseca, transplacentarno prenesena majčina protutijela visokog IgG aviditeta utječu na rezultat AI. Stoga u toj dobnoj skupini CMV infekciju treba potvrditi izravnim virološkim metodama kao što je izolacija virusa ili PCR.

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