BACKGROUND There is limited data on the role of cytomegalovirus (CMV) blood quantitative polymerase chain reaction (qPCR) in the diagnostic workup of congenital CMV (cCMV) infection. OBJECTIVES The objective of this study was to determine if CMV blood qPCR at the time diagnosis could differentiate between symptomatic and asymptomatic infants according to the recent consensus classification. STUDY DESIGN Retrospective study of children diagnosed with cCMV infection at CHU Sainte-Justine, Montreal, Canada, between 2008 and 2016. Cases for whom qPCR was done at baseline (<4 weeks of age) alongside a complete diagnostic workup were included. The association between CMV blood viral load (VL) and clinical severity group was determined. The probability of having moderate to severe symptoms was assessed using univariate logistic regression analysis. RESULTS Forty-seven patients were included in the analysis. Median VL was significantly higher among infants with moderate to severely symptomatic disease vs. those asymptomatic or asymptomatic with isolated sensorineural hearing loss (SNHL) (13 736 vs. 1876 copies/ml, p = 0.004), infants with moderate to severe disease or asymptomatic with isolated SNHL vs. asymptomatic (17 736 vs. 1496 copies/ml, p < 0.001), and in infants with baseline neurological involvement vs. those without (17 317 vs. 2641 copies/ml, p = 0.03). Using logistic regression, an infant would have a >75 % probability of being moderate to severely symptomatic above 18 770 copies/ml, with a threshold of 100 000 copies/ml approaching a 100 % probability. CONCLUSIONS Our baseline assessment of CMV blood VL suggests that that the level of CMV viremia correlates with symptom severity.

中文翻译：

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血液病毒载量在诊断先天性巨细胞病毒感染中的作用。

背景技术关于巨细胞病毒（CMV）血液定量聚合酶链反应（qPCR）在先天性CMV（cCMV）感染的诊断检查中的作用的数据有限。目的本研究的目的是根据最近的共识分类，确定诊断时的CMV血液qPCR是否可以区分有症状婴儿和无症状婴儿。研究设计回顾性研究于2008年至2016年之间在加拿大蒙特利尔的CHU Sainte-Justine诊断为cCMV感染的儿童。该研究包括在基线（<4周龄）进行qPCR并进行完整诊断检查的病例。确定了CMV血液病毒载量（VL）与临床严重程度组之间的关联。使用单因素逻辑回归分析评估出现中度至重度症状的可能性。结果分析中纳入了47例患者。中度至重度症状性疾病婴儿与无症状或无症状性单纯感音神经性听力损失（SNHL）的婴儿相比，中位VL明显更高（13 736比1876拷贝/ ml，p = 0.004），中度至重度疾病或无症状的婴儿分离的SNHL与无症状（17 736 vs. 1496拷贝/ ml，p <0.001），基线神经系统受累婴儿与无基线神经病变的婴儿（17 317 vs. 2641拷贝/ ml，p = 0.03）。使用逻辑回归，婴儿在18 770拷贝/ ml以上时有中等至严重症状的可能性为> 75％，而100000拷贝/ ml的阈值接近100％的可能性。