Urine qRT-PCR assay as a screening tool for the detection of congenital human cytomegalovirus infection of infants

Congenital cytomegalovirus (CMV) infection is the most common infectious cause of birth defects. It may cause both, immediate and long term health problems in infants. These include variety of symptoms, such as hearing loss, microcephaly, jaundice, hepatosplenomegaly and seizures. In more severe cases CMV infection can cause the death of an unborn baby and loss of pregnancy. Despite being one of the most extensively studied vertically transmitted infections recently, the adverse effects of vertically transmitted CMV infection are still not well presented to the general public, resulting in a low awareness among potential expectant mothers in Bosnia and Herzegovina. This study aims to elucidate the sensitivity of urine samples for CMV detection in infants as well as to reflect the importance of quantitative real-time PCR (qRT-PCR) in diagnostics of CMV infection in infants. qRT-PCR was used in this study as a technique for the screening of CMV DNA in a cohort of patients based in Sarajevo Canton. These results have shown that urine samples are sufficiently sensitive for the detection of CMV DNA in infants. Furthermore, the simultaneous analysis of several patients has shown a higher number of CMV DNA copies amplified in urine compared to blood samples, derived from the same patient, thus proposing urine as a reliable sample of choice for congenital CMV diagnostics. These findings may propose a need to classify qRT-PCR CMV test among one of the recommended first-trimester pregnancy screening tests, which could help in early detection of CMV infection in Sarajevo Canton.