Severe Neutropenia in Infants With Congenital Cytomegalovirus on Antiviral Therapy

Aim: To describe European real-life experience of severe neutropenia (SN) during ganciclovir (GCV) and/or valganciclovir (VGCV) treatment in infants with congenital cytomegalovirus (cCMV) infection and identify risk factors associated with the development of SN. Methods: A multicenter retrospective...

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Detalles Bibliográficos
Autores: Papaevangelou, V, Pedrero-Tomé, R, Syridou, G, Baquero-Artigao, F, Rodríguez-Molino, P, del Rosal, T, Noguera-Julián, A, Ríos-Barnés, M, Fortuny, C, Villaverde, S, Frick, MA, Vallejo, BA, Soler-Palacín, P, Saavedra, J, Karagiannidou, S, Rincón, E, Busselo, IS, Zuriarrain, OM, Calderón, EM, Tagarro, A, Malumbres, M, Colino, E, Llanos, EG, Ruiz, AM, Mateos, MS, Espuny, XB, Alonso-Ojembarrena, A, Ferreras-Antolin, L, Pérez, IC, Posse, AF, Lyall, H, Blázquez-Gamero, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p20320
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20320
Access Level:acceso abierto
Palabra clave:congenital cytomegalovirus
antiviral treatment
neutropenia
prematurity
Descripción
Sumario:Aim: To describe European real-life experience of severe neutropenia (SN) during ganciclovir (GCV) and/or valganciclovir (VGCV) treatment in infants with congenital cytomegalovirus (cCMV) infection and identify risk factors associated with the development of SN. Methods: A multicenter retrospective cohort study from the European cCMVnet registry included infants with confirmed cCMV infection treated since 2011 with GCV and/or VGCV. Details of treatment, including age at initiation, route of administration and duration, are described. Prevalence and risk factors associated with the development of SN, defined as neutrophil count of <500 cells/mm(3), were analyzed. Results: Overall, 566 children with confirmed cCMV treated with antivirals were included; 165 (29.7%) were born prematurely (gestational age <37 weeks). Administration of intravenous GCV, alone or in combination with oral VGCV, was associated with prematurity and date of birth before 2017. SN occurred in 102 infants (18%). Multivariate logistic regression analysis identified 2 independent risk factors for the development of SN: prematurity almost doubled the risk of developing SN [odds ratio (OR) = 1.961; 95% confidence interval (CI): 1.163-3.300], while the risk of developing SN increased by 11% for every 1000 neutrophils decrease in the absolute neutrophil count at baseline (OR = 1.104; 95% CI: 1.031-1.192). When term newborns were analyzed alone, baseline absolute neutrophil count remained an important risk factor for developing SN. Conclusions: In children with cCMV treated with GCV/VGCV prematurity and low pretreatment neutrophil counts are associated with an increased risk of developing SN. This is important for patient management, and when informing parents about treatment side effects.

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