False human cytomegalovirus IgG-positivity at prenatal screening

Research output: Contribution to journalArticle

Abstract

Background: An incorrect definition of immune status to human cytomegalovirus (HCMV) can lead to incorrect management of pregnant women. Objectives: Aims of the study were: i) to describe 10 cases of unconfirmed HCMV IgG-seroconversion in pregnancy; ii) to develop a panel of confirmatory tests to define HCMV serostatus; iii) to investigate the frequency of false IgG-positive results in pregnant women screened with the LIAISON®CMVIgGII automated assay. Study design: Blood samples from 10 pregnant women referred for HCMV IgG-seroconversion were examined to confirm/exclude a primary infection. In addition, samples were tested for HCMV IgG by immunoblotting, neutralization assay, and ELISA against gB, gH/gL/pUL128L and gH/gL/gO recombinant glycoproteins. LIAISON®CMVIgGII results obtained on 1158 pregnant women were reviewed and samples with low IgG titers were further investigated. Results: A primary infection was excluded in the 10 women referred for HCMV IgG seroconversion. None of them was confirmed to be IgG-seropositive. Of the 1158 women prenatally screened by LIAISON®CMVIgGII, 678 (59%) were IgG-positive and, of these, 40 (5.9%) showed low levels of IgG (14–50 U/mL). Thirty-three women with low IgG-positivity were further tested by confirmatory tests and 11 (33.3%) were found to be non reactive to HCMV. Conclusions: At least 1.6% (11/678) women who tested positive with LIAISON®CMVIgGII were found to be seronegative when tested with confirmatory tests. These women should be informed to reduce the risk of a primary HCMV infection. Furthermore, should a congenital infection occur in any of these women, a maternal non-primary infection could be erroneously diagnosed.

Original languageEnglish
Pages (from-to)34-38
Number of pages5
JournalJournal of Clinical Virology
Volume104
DOIs
Publication statusPublished - Jul 1 2018

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Prenatal Diagnosis
Cytomegalovirus
Immunoglobulin G
Pregnant Women
Infection
Cytomegalovirus Infections
Immunoblotting
Glycoproteins
Enzyme-Linked Immunosorbent Assay
Mothers
Pregnancy

Keywords

  • Confirmatory tests
  • Fully automatized assays
  • Human cytomegalovirus
  • Non-primary infection
  • Pregnancy
  • Prenatal screening

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

@article{c8c410d6b9964ac6a8c55ca29893a878,
title = "False human cytomegalovirus IgG-positivity at prenatal screening",
abstract = "Background: An incorrect definition of immune status to human cytomegalovirus (HCMV) can lead to incorrect management of pregnant women. Objectives: Aims of the study were: i) to describe 10 cases of unconfirmed HCMV IgG-seroconversion in pregnancy; ii) to develop a panel of confirmatory tests to define HCMV serostatus; iii) to investigate the frequency of false IgG-positive results in pregnant women screened with the LIAISON{\circledR}CMVIgGII automated assay. Study design: Blood samples from 10 pregnant women referred for HCMV IgG-seroconversion were examined to confirm/exclude a primary infection. In addition, samples were tested for HCMV IgG by immunoblotting, neutralization assay, and ELISA against gB, gH/gL/pUL128L and gH/gL/gO recombinant glycoproteins. LIAISON{\circledR}CMVIgGII results obtained on 1158 pregnant women were reviewed and samples with low IgG titers were further investigated. Results: A primary infection was excluded in the 10 women referred for HCMV IgG seroconversion. None of them was confirmed to be IgG-seropositive. Of the 1158 women prenatally screened by LIAISON{\circledR}CMVIgGII, 678 (59{\%}) were IgG-positive and, of these, 40 (5.9{\%}) showed low levels of IgG (14–50 U/mL). Thirty-three women with low IgG-positivity were further tested by confirmatory tests and 11 (33.3{\%}) were found to be non reactive to HCMV. Conclusions: At least 1.6{\%} (11/678) women who tested positive with LIAISON{\circledR}CMVIgGII were found to be seronegative when tested with confirmatory tests. These women should be informed to reduce the risk of a primary HCMV infection. Furthermore, should a congenital infection occur in any of these women, a maternal non-primary infection could be erroneously diagnosed.",
keywords = "Confirmatory tests, Fully automatized assays, Human cytomegalovirus, Non-primary infection, Pregnancy, Prenatal screening",
author = "Milena Furione and Antonella Sarasini and Alessia Arossa and Chiara Fornara and Daniele Lilleri and Laurent Perez and Maurizio Parea and Maurizio Zavattoni and Arsenio Spinillo and Piero Marone and Fausto Baldanti",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.jcv.2018.04.009",
language = "English",
volume = "104",
pages = "34--38",
journal = "Journal of Clinical Virology",
issn = "1386-6532",
publisher = "Elsevier",

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TY - JOUR

T1 - False human cytomegalovirus IgG-positivity at prenatal screening

AU - Furione, Milena

AU - Sarasini, Antonella

AU - Arossa, Alessia

AU - Fornara, Chiara

AU - Lilleri, Daniele

AU - Perez, Laurent

AU - Parea, Maurizio

AU - Zavattoni, Maurizio

AU - Spinillo, Arsenio

AU - Marone, Piero

AU - Baldanti, Fausto

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: An incorrect definition of immune status to human cytomegalovirus (HCMV) can lead to incorrect management of pregnant women. Objectives: Aims of the study were: i) to describe 10 cases of unconfirmed HCMV IgG-seroconversion in pregnancy; ii) to develop a panel of confirmatory tests to define HCMV serostatus; iii) to investigate the frequency of false IgG-positive results in pregnant women screened with the LIAISON®CMVIgGII automated assay. Study design: Blood samples from 10 pregnant women referred for HCMV IgG-seroconversion were examined to confirm/exclude a primary infection. In addition, samples were tested for HCMV IgG by immunoblotting, neutralization assay, and ELISA against gB, gH/gL/pUL128L and gH/gL/gO recombinant glycoproteins. LIAISON®CMVIgGII results obtained on 1158 pregnant women were reviewed and samples with low IgG titers were further investigated. Results: A primary infection was excluded in the 10 women referred for HCMV IgG seroconversion. None of them was confirmed to be IgG-seropositive. Of the 1158 women prenatally screened by LIAISON®CMVIgGII, 678 (59%) were IgG-positive and, of these, 40 (5.9%) showed low levels of IgG (14–50 U/mL). Thirty-three women with low IgG-positivity were further tested by confirmatory tests and 11 (33.3%) were found to be non reactive to HCMV. Conclusions: At least 1.6% (11/678) women who tested positive with LIAISON®CMVIgGII were found to be seronegative when tested with confirmatory tests. These women should be informed to reduce the risk of a primary HCMV infection. Furthermore, should a congenital infection occur in any of these women, a maternal non-primary infection could be erroneously diagnosed.

AB - Background: An incorrect definition of immune status to human cytomegalovirus (HCMV) can lead to incorrect management of pregnant women. Objectives: Aims of the study were: i) to describe 10 cases of unconfirmed HCMV IgG-seroconversion in pregnancy; ii) to develop a panel of confirmatory tests to define HCMV serostatus; iii) to investigate the frequency of false IgG-positive results in pregnant women screened with the LIAISON®CMVIgGII automated assay. Study design: Blood samples from 10 pregnant women referred for HCMV IgG-seroconversion were examined to confirm/exclude a primary infection. In addition, samples were tested for HCMV IgG by immunoblotting, neutralization assay, and ELISA against gB, gH/gL/pUL128L and gH/gL/gO recombinant glycoproteins. LIAISON®CMVIgGII results obtained on 1158 pregnant women were reviewed and samples with low IgG titers were further investigated. Results: A primary infection was excluded in the 10 women referred for HCMV IgG seroconversion. None of them was confirmed to be IgG-seropositive. Of the 1158 women prenatally screened by LIAISON®CMVIgGII, 678 (59%) were IgG-positive and, of these, 40 (5.9%) showed low levels of IgG (14–50 U/mL). Thirty-three women with low IgG-positivity were further tested by confirmatory tests and 11 (33.3%) were found to be non reactive to HCMV. Conclusions: At least 1.6% (11/678) women who tested positive with LIAISON®CMVIgGII were found to be seronegative when tested with confirmatory tests. These women should be informed to reduce the risk of a primary HCMV infection. Furthermore, should a congenital infection occur in any of these women, a maternal non-primary infection could be erroneously diagnosed.

KW - Confirmatory tests

KW - Fully automatized assays

KW - Human cytomegalovirus

KW - Non-primary infection

KW - Pregnancy

KW - Prenatal screening

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U2 - 10.1016/j.jcv.2018.04.009

DO - 10.1016/j.jcv.2018.04.009

M3 - Article

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SP - 34

EP - 38

JO - Journal of Clinical Virology

JF - Journal of Clinical Virology

SN - 1386-6532

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