Cytomegalovirus

Congenital infection with human cytomegalovirus (CMV) is the most common infectious cause of developmental disability in newborns. Congenital CMV is also a leading cause of hearing loss in infants. The overall birth prevalence of congenital CMV is 0.5–1%, varying among different populations. CMV infection may be symptomatic at birth or, more commonly, asymptomatic. Both groups are at risk for sequelae. Antiviral therapy with ganciclovir (or valganciclovir) in infants with symptomatic congenital CMV infection can result in improved neurodevelopmental and hearing outcomes. CMV infections in very low birthweight premature infants, typically acquired via breast milk, can also produce substantial short-term and possibility long-term morbidity. This chapter reviews current concepts regarding the biology of CMV as well as the epidemiology, clinical presentation, diagnosis, management, and outcome of congenital and perinatal CMV infections. High-priority areas for future research, including in the arena of newborn screening for congenital CMV, are discussed.