Exciting Times for Cytomegalovirus (CMV) Vaccine Development: Navigating the Pathways toward the Goal of Protecting Infants against Congenital CMV Infection

摘要

The congenital transmission of cytomegalovirus (cCMV) is the most common infectious cause of disability in children in the developed world, and probably globally [1,2]. Remarkably, in spite of the impact of cCMV on child health, overall awareness is low, particularly among women of child-bearing age [3]. Congenital infection can occur either in the context of primary maternal infection or re-infection of seropositive women with new strains of the virus that have polymorphisms in coding sequences in viral envelope glycoproteins (important targets of neutralizing antibody responses). The occurrence of such re-infections can be confirmed by the demonstration of the emergence of new antibody specificities in seropositive women [4]. Although the most severe disabilities associated with cCMV probably occur in the setting of a primary CMV infection that occurs in pregnancy (particularly early in pregnancy [5,6]), disabling congenital transmission can occur with a strain acquired during pregnancy through this re-infection phenomenon [7].