Seroepidemiological Survey Of Cytomegalovirus Infection In Children And Clinical Analysis Of Cytomegalovirus Hepatitis In Chongqing In 2008

ObjectiveTo investigate the prevalence and infective characteristics of children with cytomegalovirus (CMV) in Chongqing and the clinical characteristics of CMV hepatitis in infants through retrospective analysis in Chongqing and to provide information for prevention and treatment of CMV infection .MethodsCMV serology markers detected by ELISA in Children's Hospital of Chongqing Medical University in 2008 were taken using an overall survey, and the data was counted using statistical analysis of Chi-Square Test by gender and age groups. The clinical data of 87 infants with CMV hepatitis diagnosed in our hospital was also retrospectively analyzed.Results1. The overall infection rate of children with CMV was 40.9% in Chongqing in 2008. The positive rate of CMV-IgG which suggested past infection was 33.1%.2. The overall distribution of gender with CMV was different in children in Chongqing (P<0.05), but CMV active infection between different age groups had no difference in the gender (P>0.05). The recent infection rate with CMV among 1~14d, 15~28d, 29d~3m, 4~6m, 7~12m, 1~3y, 4~6y, 7~10y, 11~18y groups was 1.7%, 2.5%, 29.0%, 33.8%, 5.3%, 2.2%, 1.0%, 1.3% and 1.8%, respectively. And the cumulative infection rate was 37.6%, 1.7%, 44.7%, 55.4%, 49.4%, 36.6%, 29.7%, 23.4% and 23.4%, respectively. There was significantly difference between any two group for the recent infection rate or the cumulative infection rate (P<0.05). There were 1368 children admitted to hospital with CMV active infection, in which 804/1368 (58.8%) were from rural areas, and 564/1368 (41.2%) were from urban areas. Ratio of CMV active infection in rural areas was higher than urban areas.3. Jaundice was the first clinical symptom in most infants with CMV hepatitis. Clinical manifestations also included hepatosplenomegaly and abnormal liver function; and combined with pneumonia 47/87 (54.0%), biliary atresia 23/87 (26.4%), congenital heart disease 14/24 (58.3%), inguinal hernia 9 / 87 (10.3%) and BAEP abnormality 8 / 28 (28.6%).Conclusions1. The overall infection rate of children with CMV is 40.9% in Chongqing in 2008. This seroprevalence is higher than that of the population below 20-year-old in Jinan of Shandong in China. Compared with data of other countries, it is significantly lower than that of the population below 10-year-old in some areas of Africa, but higher than that of the population below 15-year-old in developed countries such as Britain and the U.S. And 33.1% has serological evidence of past infection, which is lower than the adult seropositive rate of past infection in developed countries such as Britain and the U.S.2. The overall distribution of gender with CMV is different in children in Chongqing, but CMV active infection between different age groups has no difference in the gender. CMV recent infection is mostly concentrated in infants under 6 month old, especially in 29d~6m group. The ratio of CMV active infection in rural areas is higher than urban areas.3. Clinical manifestations of CMV hepatitis in infants are diverse. Jaundice is the first clinical symptom in most infants with CMV hepatitis. Clinical manifestations also include hepatosplenomegaly and abnormal liver function, and may also involve other systems or congenital malformations.