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
AN - SCOPUS:85046167818
VL - 104
SP - 34
EP - 38
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
SN - 1386-6532
ER -