Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir
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Caroline F. Meine Jansen
Abstract
Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. Some congenitally infected infants will develop sequelae later in life, especially sensorineural hearing loss (SNHL) and mental retardation. There is no generally accepted antiviral therapy for the treatment of symptomatic congenital CMV infections yet. We present a neonate with symptomatic congenital CMV infection, who was treated with intravenous (iv) ganciclovir (GCV) during 18 days and subsequently with oral valganciclovir (VGCV) for 5.5 months, in an attempt to prevent development of SNHL. GCV was given intravenously 10 mg/kg/day in two doses and VGCV doses ranged from 280–850 mg/m2 bidaily (bid). Our experience shows that it is not possible to give a fixed dosing regime for VGCV in neonates and that continuous adaptation of dose is necessary to achieve stable target levels of GCV and to keep the viral load in urine at undetectable level. At 18 months of age no hearing deterioration has occurred. While the current findings are encouraging, the limitations of a single case report with a relatively short follow-up emphasizes the need for further prospective randomized studies to evaluate pharmacokinetics, efficacy and safety of VGCV therapy in neonates with congenital CMV infection.
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© Walter de Gruyter
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Articles in the same Issue
- The epidemiology of preterm labor – a global perspective
- Erythropoietin and prematurity – where do we stand?
- The quality of nifedipine studies used to assess tocolytic efficacy: a systematic review
- Unexplained intrauterine fetal death is accompanied by activation of complement
- Anaphylatoxins in preterm and term labor
- The transcription factor Ets-1 is expressed in human amniochorionic membranes and is up-regulated in term and preterm premature rupture of membranes
- Recombinant human lactoferrin has preventive effects on lipopolysaccharide-induced preterm delivery and production of inflammatory cytokines in mice
- Laparoscopic and vaginal repair of uterine scar dehiscence following cesarean section as detected by ultrasound
- Cerebral ventricular volume assessment by three-dimensional ultrasonography
- Nomogram of the fetal gastric size development in normal pregnancy
- Therapeutic hypothermia: from lab to NICU
- Alveolar capillary dysplasia: a six-year single center experience
- Spina bifida – a follow-up study of neonates born from 1991 to 2001
- Concordant occipital encephalocele in monoamniotic twins
- Changes of lactate, glucose, ionized calcium and glutamate concentrations in cephalic vein blood during brain hypothermia using extracorporeal membrane oxygenation (ECMO) in a newborn infant with hypoxic-ischemic encephalopathy
- Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir
- A coiled nasogastric tube in a newborn
