Human cytomegalovirus (HCMV) infection remains an important cause of neurodevelopmental sequelae in infants infected in utero. Unique to the natural history of perinatal HCMV infections is the occurrence of congenital HCMV infections (cCMV) in women with existing immunity to HCMV, infections that have been designated as nonprimary maternal infection. In maternal populations with a high HCMV seroprevalence, cCMV that follows nonprimary maternal infections accounts for 75%–90% of all cases of cCMV infections as well as a large proportion of infected infants with neurodevelopmental sequelae. Although considerable effort has been directed toward understanding immune correlates that can modify maternal infections and intrauterine transmission, the source of virus leading to nonprimary maternal infections and intrauterine transmission is not well defined. Previous paradigms that included reactivation of latent virus as the source of infection in immune women have been challenged by studies demonstrating acquisition and transmission of antigenically distinct viruses, a finding suggesting that reinfection through exposure to an exogenous virus is responsible for some cases of nonprimary maternal infection. Additional understanding of the source(s) of virus that leads to nonprimary maternal infection will be of considerable value in the development and testing of interventions such as vaccines designed to limit the incidence of cCMV in populations with high HCMV seroprevalence.

中文翻译：

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已有免疫力的女性中的人类巨细胞病毒感染：存在抗病毒免疫力时的感染来源和感染机制


人类巨细胞病毒（HCMV）感染仍然是子宫内感染婴儿神经发育后遗症的重要原因。围产期 HCMV 感染自然史的独特之处在于，对 HCMV 已有免疫力的女性会发生先天性 HCMV 感染 (cCMV)，这种感染被指定为非原发性孕产妇感染。在HCMV血清阳性率较高的孕产妇人群中，非原发性孕产妇感染后的cCMV占所有cCMV感染病例的75%~90%，并且大部分感染婴儿出现神经发育后遗症。尽管人们付出了大量努力来了解可以改变母体感染和宫内传播的免疫相关因素，但导致非原发性母体感染和宫内传播的病毒来源尚不清楚。先前将潜伏病毒重新激活作为免疫妇女感染源的范式受到了研究的挑战，这些研究证明了抗原性不同病毒的获得和传播，这一发现表明，通过暴露于外源病毒而导致的再感染是一些非原发性母体感染病例的原因。对导致非原发性孕产妇感染的病毒来源的进一步了解对于开发和测试干预措施具有相当大的价值，例如旨在限制高 HCMV 血清流行率人群中 cCMV 发病率的疫苗。