Congenital Heart Disease: Assessing Viral Etiology in infants attending at a tertiary care hospital

ABSTRACT Background Congenital heart disease (CHD) is the commonest birth defect worldwide, affecting millions of newborns every year. Limited information is available regarding risk factors for its causation. Objectives This study was planned with an aim to determine the viral etiology in infants with congenital heart disease. Although a number of viruses diseases have been etiologically linked to congenital defects, only two viruses namely rubella virus and cytomegalovirus are definitely proved to be associated with anomalies in infants. Materials and Methods This Prospective study was conducted at a paediatric tertiary care hospital for a period of 6 months. Hundred (100) Infants with structural Congenital heart defects (CHD) based on Echocardiography findings were included in the study after taking informed consent from their mothers. Serum samples were collected and sent to Virology lab. The samples were tested for Rubella and Cytomegalovirus IgM antibodies using Enzyme Linked Immunosorbent Assay (ELISA). Results Out of 100 infants with congenital heart defects, (M: F:56:44) 4% were seropositive for rubella IgM antibodies whereas 20% showed seropositivity of Cytomegalovirus IgM antibodies. Median age of infants was 25 days. The most common congenital heart defect in Rubella positive infants was Patent ductus arteriosus followed by Atrial septal defect whereas it was Patent ductus arteriosus only in CMV positive infants followed by Patent Foramen ovale. 6% of infants died and among them 50% had infection with CMV while 11% showed infection with Rubella. Conclusion Regular screening by TORCH (Toxoplasmosis, Rubella, Cytomegalovirus, HSV) panel testing of mothers in first trimester is necessary for early detection. Early vaccination strategies should be implemented. Rapid and correct diagnosis of congenital CMV and Rubella infections in infants is very important for the correct therapy selection and proper management of the cases.