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Am J Perinatol 2021; 38(13): 1403-1411
DOI: 10.1055/s-0040-1713001
Original Article

Clinical Features, Treatment Courses, and Distribution of Cytomegalovirus Genotypes among Thrombocytopenia Patients Aged Younger than 12 Months

Hongbo Hu
1   Department of Laboratory, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
,
Ying Cheng
2   Department of Pediatrics, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
,
Qiaoying Peng
3   Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
,
Kun Chen
4   Department of Laboratory, Wuhan Ninth Hospital, Wuhan, China
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Abstract

Objective The aims of this study were to evaluate the clinical characteristics, laboratory data, and treatment of the cytomegalovirus (CMV)-associated thrombocytopenia in infants aged younger than 12 months and to investigate the possible relationship between genotypes of glycoprotein B (gB) and glycoprotein H (gH) and CMV-associated thrombocytopenia.

Study Design Infants with positive identification of cytomegalovirus (CMV) and thrombocytopenia, being treated at Hubei Maternal and Child Health Hospital from January 2015 to June 2019 were included. Genotype of gB and gH analysis were done by nested polymerase chain reaction (nPCR) and restrictions length polymorphism.

Results The prevalence of CMV congenital, perinatal, and postnatal infection were 1.4% (76/5428), 29.1% (378/1301), and 41.8% (243/581), respectively. A total of 29 immunocompetent patients with CMV-associated thrombocytopenia were analyzed, including 7 (9.2%, 7/76) congenital infections, 14 (3.7%, 14/378) perinatal infections, and 8 (3.3%, 8/243) postnatal infections. Platelet count at diagnosis <20 × 109/L was the common hematologic finding of CMV-associated thrombocytopenia in perinatal infection (1/7 congenital infection vs. 10/14 perinatal infection vs. 3/8 postnatal infection, Chi-square (χ2) = 6.616, p = 0.037). Notably, significantly higher frequency of hepatobiliary symptoms was found in congenital and perinatal infections groups (4/7 congenital infection vs. 10/14 perinatal infection vs. 1/8 postnatal infection, χ2 = 7.188, p = 0.027). Intravenous immunoglobulin was prescribed for 24 (82.8%, 24/29) patients, and antiviral agents were prescribed for 9 (31.0%, 9/29) patients. The most prevalent genotypes of CMV in the study were gB1 (60.7%, 17/28) and gH2 (57.1%, 16/28).

Conclusion There was a substantial percentage of symptomatic CMV infection in patients aged younger than 12 months. Thrombocytopenia is one of the common clinical manifestations in congenital CMV infection. The gB1 genotype had more virulence in infants with acquired CMV infection. There might be an association between gH2 genotype of CMV and CMV-associated thrombocytopenia.

Keywords

cytomegalovirus - cytomegalovirus-associated thrombocytopenia - glycoprotein B - glycoprotein H


Publication History

Received: 11 December 2019

Accepted: 04 May 2020

Article published online:
11 June 2020

© 2020. Thieme. All rights reserved.

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