Fetal Infections: Cytomegalovirus, Herpes Simplex, and Varicella
This chapter reviews three herpesviruses that cause infections of the fetus and/or newborn: cytomegalovirus (CMV), herpesvirus (HSV) 1 and 2, and varicella-zoster virus (VZV). CMV and VZV can cause severe fetal disease following a primary maternal infection and subsequent placentitis by viremia. Persistent infection with CMV can cause progressive disease with significant developmental abnormalities which become apparent over the first years of life. Preconceptional immunity generally protects the fetus either from infection or from the severe disease both in utero and after birth for a few months, although symptomatic congenital CMV infection may rarely occur after recurrent maternal infection. The second important factor, which affects both the frequency of transplacental transmission and the severity of disease, is the gestational age when the fetus is infected: the severity is high in the first months; the frequency prevails in the last months of pregnancy. The third factor influencing the severity and the manifestations of an intrauterine infection is the tissue tropism of each virus: many manifestations of intrauterine VZV infection arise from effects upon the developing nervous system.
- Chiuppesi F, Wussow F, Johnson E et al (2015) Vaccine-derived neutralizing antibodies to the human cytomegalovirus gH/gL pentamer potently block primary cytotrophoblast infection. J Virol. pii: JVI.01701-15Google Scholar
- Leruez-Ville M, Ghout I, Bussières L, et al (2016) In utero treatment of congenital cytomegalovirus infection with valacyclovir in a multicenter, open-label, phase II study. Am J Obstet Gynecol Apr 13. pii: S0002-9378(16)30044-8. https://doi.org/10.1016/j.ajog.2016.04.003. [Epub ahead of print]CrossRefGoogle Scholar
- Mocarski ES Jr, Courcelle CT (2002) Cytomegaloviruses and their replication. In: Knipe DM, Howley PM, Griffin DE, Lamb RA, Martin MA, Roizman B, Straus SE (eds) Fields virology. Lippincott Williams & Wilkins, Philadelphia, pp 2629–2673Google Scholar
- Nigro G (2009) Maternal-fetal cytomegalovirus infection: from diagnosis to therapy. J Mat Fet Neon Med 22:169–174Google Scholar