Current approaches to treating generalized cytomegalovirus infection in infants


Kochkina S.S., Sitnikova E.P.

Yaroslavl State Medical University, Ministry of Health of Russia, Yaroslavl, Russia
The paper deals with the topical childhood problem cytomegalovirus infection (CMVI) due to its widespread and increased incidence.
Objective. To improve treatment for generalized infant CMVI with the concomitant use of ganciclovir and interferon-α-2b (IFN-α-2b, viferon®).
Subjects and methods. The investigation enrolled 24 babies aged less than 2 months, who were diagnosed with generalized CMVI. Among them, there were 15 (62.5%) boys and 9 (37.5%) girls. There were 3 groups: 1) 13 babies treated with ganciclovir for 14–21 days and then with IFN-α-2b in combination with vitamins C and E; 2) 5 infants who underwent only symptomatic treatment for CMVI: hepatoprotective agents, broad-spectrum antibiotics (ceftriaxone, ampicillins) in the age dosage range; 3) 6 patients who received only ganciclovir. The therapy was performed through serum viral load monitoring at 14 and 21 days after treatment initiation. When Group 1 patients showed a reduction in the clinical manifestations of CMVI and a decrease in the viral load to 104–103 copies/ml, they were switched to IFN-α-2b in combination with vitamins C and E (rectal suppositories 150,000 IU) at 14–21 days according to the original scheme.
Results. In Group 1, the virus was eliminated from the blood of all the infants within 3-6 months. Recurrent CMVI was absent in the babies. The agents were well tolerated and caused no adverse reactions. At the same time, the viral load in Group 2 not only decreased, but increased by 10–102 copies/ml in 1 patient. In Group 3, there was no blood elimination of the virus or its conversion to an inactive state.
Conclusion. The combined use of ganciclovir and IFN-α-2b (viferon®) contributes to the elimination of the virus from blood and cerebrospinal fluid and to the keeping of the virus in the passive state, which prevents the development of complications. The proposed treatment for CMVI can be successfully used in both the inpatient and outpatient settings.
Keywords: cytomegalovirus infection, infants, treatment
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About the Autors

For correspondence:
Svetlana S. Kochkina, Cand. Med. Sci., Аssociate Professor, Department of Infectious Diseases, Epidemiology and Childhood Infections, Yaroslavl State Medical University, Ministry of Health of Russia
Address: 5, Revolyutsionnaya St., Yaroslavl 150000, Russia
Telephone: +7(4852) 73-61-69
E-mail: sema7476@mail.ru
Information about the authors:
Prof. Elena P. Sitnikova, MD, Head, Department of Childhood Diseases, Medical Faculty, Yaroslavl State Medical University of the Ministry of Healthcare of the Russia, Yaroslavl, Russia; e-mail: sep.med@mail.ru


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