Abstract:
Cytomegalovirus (CMV) is the leading infectious cause of congenital neurological disabilities. Valacyclovir and CMV hyperimmune globulin (HIG) may reduce vertical transmission and sequelae in neonates. A systematic review on valacyclovir and CMV HIG in preventing vertical transmission or reducing sequelae in neonates was conducted to 3 September 2021. Valacyclovir as a preventive strategy was supported by a well-conducted randomized controlled trial. Evidence supporting valacyclovir as a treatment strategy was limited to observational studies at moderate risk of bias. CMV HIG was not supported as a preventive strategy in 2 randomized controlled trials, which contrasted with observational studies. Evidence favoring CMV HIG as a treatment strategy was limited to observational studies at moderate risk of bias. The role of valacyclovir and CMV HIG in CMV infection in pregnancy is still being defined. Valacyclovir to prevent vertical transmission has the highest quality evidence in favor of use.
摘要:
巨细胞病毒(CMV)是先天性神经系统残疾的主要传染性原因。伐昔洛韦和CMV超免疫球蛋白(HIG)可以减少新生儿的垂直传播和后遗症。截至2021年9月3日,对伐昔洛韦和CMVHIG预防新生儿垂直传播或减少后遗症的系统评价。伐昔洛韦作为预防策略得到了一项进行良好的随机对照试验的支持。支持伐昔洛韦作为治疗策略的证据仅限于中等偏倚风险的观察性研究。在2项随机对照试验中,CMVHIG未被支持作为预防策略,这与观察性研究形成了对比。支持CMVHIG作为治疗策略的证据仅限于中等偏倚风险的观察性研究。伐昔洛韦和CMVHIG在妊娠CMV感染中的作用仍在确定中。伐昔洛韦预防垂直传播具有最高质量的证据,有利于使用。