BACKGROUND Dating of primary human cytomegalovirus (HCMV) infection in pregnancy is crucial to define whether infection occurred before or during pregnancy and at which gestational age. OBJECTIVE The aim of this study was to identify a diagnostic strategy for determination of early, intermediate and late phase of HCMV primary infection during pregnancy. STUDY DESIGN Sequential serum samples from 40 pregnant women with defined onset of HCMV primary infection were tested retrospectively for IgM, IgG and IgG avidity against whole HCMV lysate, along with anti-p52 IgM and anti-gB IgG (Euroimmun AG). RESULTS Anti-HCMV IgM were positive in all samples collected within the first 2 months, then decreased remaining weakly positive in about 40% of samples collected within 6-12 months after infection. Anti-p52 IgM followed similar kinetics but decreased earlier, remaining weakly positive only in 20% of late samples. Anti-HCMV IgG were positive in all samples and showed variable kinetics. Their avidity increased from low levels, observed within 2 months, to intermediate/high levels from 4 months onwards. Anti-gB IgG increased over time following kinetics similar to anti-HCMV IgG avidity. By combining results of anti-HCMV IgM plus IgG avidity, and confirming them with anti-p52 IgM plus anti-gB IgG as second-line assays, the early (within 2-3 months) and late (after 3 months) phases of HCMV infection were satisfactorily defined, whereas the intermediate phase overlapped with the beginning of the late phase. CONCLUSION Anti-p52 IgM and anti-gB IgG provide additional tools besides classical anti-HCMV IgM, IgG and IgG avidity in dating HCMV primary infections.

中文翻译：

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通过ELISA测定抗p52 IgM和抗gB IgG，作为检测妊娠期间原发性人类巨细胞病毒感染的早期和晚期的新型诊断工具。

背景技术妊娠中原发性人类巨细胞病毒（HCMV）感染的约会对于确定感染是在妊娠之前还是期间以及在哪个胎龄中至关重要。目的本研究的目的是确定一种诊断策略，以确定怀孕期间HCMV原发性感染的早期，中期和晚期。研究设计回顾性分析了40例HCMV原发性感染的孕妇的顺序血清样品的抗全HCMV裂解物的IgM，IgG和IgG亲和力，以及抗p52 IgM和抗gB IgG（Euroimmun AG）。结果在感染后的头两个月内，所有样本中的抗HCMV IgM均呈阳性，然后在感染后6至12个月内约40％的样本中呈弱阳性。抗p52 IgM遵循相似的动力学，但下降较早，仅在20％的晚期样品中保持弱阳性。所有样品中的抗HCMV IgG均为阳性，并显示出可变的动力学。它们的亲和力从2个月内观察到的低水平增加到4个月以后的中等/高水平。类似于抗HCMV IgG亲和力的动力学后，抗gB IgG随时间增加。通过结合抗HCMV IgM和IgG亲和力的结果，并用抗p52 IgM加上抗gB IgG作为二线检测方法进行确认，HCMV的早期阶段（2-3个月内）和晚期阶段（3个月后）感染的定义令人满意，而中间阶段与晚期阶段开始重叠。结论除了经典的抗HCMV IgM，抗p52 IgM和抗gB IgG还提供了其他工具，