Search

Background: Congenital cytomegalovirus (cCMV) is the leading cause of nongenetic congenital hearing loss in much of theworld and a leading cause of neurodevelopmental disabilities. Infected babies can be born towomenwho are seropositive and seronegative prior to pregnancy, and the incidence is approximately 0.6%-0.7% in the United States. Symptoms vary from mild to severe, and hearing loss can be delayed in onset and progressive. Methods: We reviewed the literature to summarize the epidemiology, clinical manifestations, diagnosis, treatment, and future directions of cCMV. Results: The best way to diagnose the infection is with polymerase chain reaction of urine or saliva within 3 weeks after birth, followed by a repeat confirmatory test if positive. Moderately to severely symptomatic neonates should be treated for 6 months with valganciclovir, and some practitioners also choose to treat infants who have isolated hearing loss only. Treatment is not recommended for asymptomatic infants. All infected infants should be screened for hearing loss and neurodevelopmental sequelae. Universal and targeted screening may be cost effective. Currently, no vaccine is commercially available, although multiple candidates are under study. Conclusion: Congenitally acquired cytomegalovirus is found in all communities around the world with a disease burden that is greater thanmany other well-known diseases. Advances are beingmade in prevention and treatment; however, improved awareness of the disease among clinicians and patients is needed. [ABSTRACT FROM AUTHOR]

Background: Poor immune function is associated with increased risk for a number of age-related diseases, however, little is known about the impact of early life trauma on immune function in late-life., Methods: Using nationally representative data from the Health and Retirement Study (n = 5,823), we examined the association between experiencing parental/caregiver death or separation before age 16 and four indicators of immune function in late-life: C-reactive Protein (CRP), Interleukin-6 (IL-6), soluble Tumor Necrosis Factor (sTNFR), and Immunoglobulin G (IgG) response to cytomegalovirus (CMV). We also examined racial/ethnic differences., Findings: Individuals that identified as racial/ethnic minorities were more likely to experience parental/caregiver loss and parental separation in early life compared to Non-Hispanic Whites, and had poorer immune function in late-life. We found consistent associations between experiencing parental/caregiver loss and separation and poor immune function measured by CMV IgG levels and IL-6 across all racial/ethnic subgroups. For example, among Non-Hispanic Blacks, those that experienced parental/caregiver death before age 16 had a 26% increase in CMV IgG antibodies in late-life (β = 1.26; 95% CI: 1.17, 1.34) compared to a 3% increase in CMV antibodies among Non-Hispanic Whites (β = 1.03; 95% CI: 0.99, 1.07) controlling for age, gender, and parental education., Interpretation: Our results suggest a durable association between experiencing early life trauma and immune health in late-life, and that structural forces may shape the ways in which these relationships unfold over the life course., Competing Interests: This study was partially funded by multiple sources including the U.S. National Institutes of Health, National Institute on Aging R00AG062749 (GN), R01AG075719 (AA and GN), and K99AG066846-02 (KAD). Further, JBD acknowledges support from the Leverhulme Trust (Centre Grant). The funders have had no role in the design or conceptualization of the study, nor in the interpretation of the results. This study is not associated with any patents, products in development or marketed products. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Noppert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Over 6.5 million commercial vehicle drivers were operating a large truck or bus in the United States in 2020. This career often has high stress and long working hours, with few opportunities for physical activity. Previous research has linked these factors to adverse health conditions. Adverse health conditions affect not only the professional drivers' wellbeing but potentially also commercial motor vehicle (CMV) operators' safe driving ability and public safety for others sharing the roadway. The prevalence of health conditions with high impact on roadway safety in North American CMV drivers necessitates empirical epidemiological research to better understand and improve driver health. The paper presents four challenges in conducting epidemiological research with truck and bus drivers in North America and potential resolutions identified in past and current research. These challenges include (1) the correlation between driving performance, driving experience, and driver demographic factors; (2) the impact of medical treatment status on the relationship between health conditions and driver risk; (3) capturing accurate data in self-report data collection methods; and (4) reaching the CMV population for research. These challenges are common and influential in epidemiological research of this population, as drivers face severe health issues, health-related federal regulations, and the impact of vehicle operation on the safety of themselves and others using the roadways.

Background: Limited English proficiency (LEP) is associated with adverse clinical outcomes. The clinical impact of LEP in hematopoietic stem cell transplant (HSCT) has not been studied. The objectives of this study were to compare HSCT outcomes and health care utilization of Hispanic pediatric patients with and without parental LEP., Methods: We conducted a retrospective review of Hispanic/Latino pediatric patients receiving HSCT at a single institution. Families were identified as LEP or English proficient (EP) based on clinicians' notes, social work documentation, or the signature of a Spanish interpreter on treatment consents., Results: A total of 83 Hispanic/Latino patients were identified with 53 (65.1%) having parental LEP. More patients in the LEP group had a documented financial burden at pretransplant psychosocial evaluation (72.2% vs. 41.4%, p = .009). LEP patients were more likely to have health insurance coverage through government-sponsored Medicaid (76.9% vs. 27.6%, p < .001). LEP patients were hospitalized on average 13 days longer than EP patients, and LEP patients were more likely to have pretransplant cytomegalovirus (CMV) reactivity (67.3%) than EP patients (p = .001). Overall survival was lower in LEP than EP, but was not statistically significant (p = .193). Multivariable Cox modeling suggested a potentially higher risk of death in LEP versus EP (hazard ratio = 1.56, 95% CI: 0.38, 6.23)., Conclusions: Parental LEP in HSCT is associated with prolonged hospitalization and pretransplant CMV reactivity. These factors are associated with posttransplant complications and death. Our results suggest parental LEP is a risk factor for poor HSCT outcomes. Further study is warranted in a larger cohort., (© 2021 Wiley Periodicals LLC.)

Background: Hematopoietic stem cell transplantation (HSCT) is an effective method for the treatment of hematological malignancies, severe aplastic anemia, and myelodysplastic syndromes. The most common infectious complication after HSCT is cytomegalovirus (CMV) infection. The purpose of this study was to analyze the status of research related to CMV infection after HSCT by conducting a literature search for CMV, hematopoietic, and stem cell transplantation., Methods: The Science Citation Index Expanded (SCI-E) database in the Web of Science Core Collection (WOSCC) was used as the target database for our literature search. The subject search terms were CMV, hematopoietic, and stem cell transplantation, with the logical operation 'AND'. The search date range was from 1900 to June 15, 2021. We used CiteSpace software to analyze the literature. The analysis included: the annual change in the number of publications, the annual change in the number of references cited, the distribution of countries, the distribution of institutions, the distribution of journals, the distribution of authors, and the use of keywords., Results: A total of 1,476 relevant documents were retrieved. The top 5 countries for number of publications were the United States, Germany, Japan, China, and Italy, while the top 5 countries for centrality scores were the United States, Australia, Germany, France, and Italy. The top 5 institutions for the number of publications were: Fred Hutchinson Cancer Research Center, the University of Washington, the University of Minnesota, Karolinska Institute, and Peking University. The top 4 institutions for centrality scores were: Fred Hutchinson Cancer Research Center, Henri-Mondor Hospital, the National Cancer Center, Karolinska University Hospital, and the University of Pavia. There were only 4 authors with a centrality score of 0.01. The literature was mainly published in top hematology journals and journals for immunization and transplantation. The top 5 keywords used were: cytomegalovirus, bone marrow transplantation, recipient, infection, and versus host disease., Conclusions: We found that CMV infection after HSCT has been attracting more and more attention by researchers, and that treatment has been the focus of current research.

Objectives: To evaluate clinical conditions associated with mortality in HIV-infected children with CD4+ counts <100 cells/microl., Methods: The Pediatric Spectrum of HIV Disease Project is a longitudinal medical record review study with eight study sites in the United States, which have been enrolling children since 1989. Survival time from baseline very low CD4 count (<100 cells/microl) to death was estimated using the Kaplan-Meier method. Cox proportional hazards models were used to evaluate the effect of clinical variables on mortality., Results: Of 522 children (>/=1 year of age) with serial CD4+ T-lymphocyte measurements, the median age at the first very low CD4 count was 4.8 years. The estimated median survival following the first very low CD4 count was 36 months. The following factors present at the first very low CD4 count were independently associated with a higher risk of death: younger age, weight-for-age >2 standard deviations below the mean, and previously diagnosed AIDS. The subsequent development of cytomegalovirus (CMV)-associated disease, Mycobacterium avium intracellulare (MAI) infection, wasting syndrome, or esophageal candidiasis was also independently associated with a higher risk of death., Conclusion: Survival in HIV-infected children with very low CD4 counts before introduction of highly active antiretroviral therapy was highly variable. Poor nutritional status and the development of CMV disease or MAI infection were associated with the shortest survival times.

The human herpesviruses, a group of DNA viruses that includes herpes simplex viruses types 1 and 2, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and human herpes viruses types 6, 7, and 8, cause substantial neurological morbidity among infants and children. This review describes the biology of these viruses and summarizes the clinical manifestations and therapy of the diseases that result from childhood infection with these important pathogens.