Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Oral valganciclovir for symptomatic congenital cytomegalovirus infection in an extremely low birth weight infant

Abstract

Cytomegalovirus (CMV) infection is the most important congenital viral infection. Intravenous (i.v.) Ganciclovir (GCV) improved outcome in term infants with symptomatic congenital CMV infection. We present data on oral valganciclovir (VGCV) in an extremely low birth weight infant.

A male preterm infant was delivered at 28 weeks of gestation because of abnormal fetal perfusion with severe intrauterine growth retardation. The infant developed hepatitis and a severe thrombocytopenia. Serology revealed a positive CMV IgM in maternal serum 3 days after delivery and CMV DNA was detected in plasma and urine samples of the infants. Treatment with i.v. GCV was started at day 4 of life for 35 days and continued with oral VGCV for further 6 weeks. Plasma GCV levels were 1.68 ng ml−1 (peak) and 0.92 ng ml−1 (trough) on day 10 of oral treatment. Clinical signs resolved and virus load decreased slowly during therapy. At discharge brain stem-evoked audiometry was normal.

Oral treatment with VGCV in an extremely low birth weight preterm infant with congenital CMV infection resulted in adequate GCV plasma levels, reduced effectively the CMV viral load and was well tolerated without apparent adverse effects.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Kimberlin DW, Lin CY, Sanchez PJ, Demmler GJ, Dankner W, Shelton M et al. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Pediatr 2003; 143: 16–25.

    Article  CAS  Google Scholar 

  2. Whitley RJ, Cloud G, Gruber W, Storch GA, Demmler GJ, Jacobs RF et al. Ganciclovir treatment of symptomatic congenital cytomegalovirus infection: results of a phase II study. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. J Infect Dis 1997; 175: 1080–1086.

    Article  CAS  Google Scholar 

  3. Michaels MG, Greenberg DP, Sabo DL, Wald ER . Treatment of children with congenital cytomegalovirus infection with ganciclovir. Pediatr Infect Dis J 2003; 22: 504–509.

    PubMed  Google Scholar 

  4. Acosta EP, Brundage RC, King JR, Sanchez PJ, Sood S, Agrawal V et al. Ganciclovir population pharmacokinetics in neonates following intravenous administration of ganciclovir and oral administration of a liquid valganciclovir formulation. Clin Pharmacol Ther 2007; 81: 867–872.

    Article  CAS  Google Scholar 

  5. Meine Jansen CF, Toet MC, Rademaker CM, Ververs TF, Gerards LJ, van Loon AM . Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir. J Perinat Med 2005; 33: 364–366.

    PubMed  Google Scholar 

  6. Schulzke S, Buhrer C . Valganciclovir for treatment of congenital cytomegalovirus infection. Eur J Pediatr 2006; 165: 575–576.

    Article  Google Scholar 

  7. Galli L, Novelli A, Chiappini E, Gervaso P, Casseta MI, Fallani S et al. Valganciclovir for congenital CMV infection: a pilot study on plasma concentration in newborns and infants. Pediatr Infect Dis J 2007; 26: 451–453.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A Müller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Müller, A., Eis-Hübinger, A., Brandhorst, G. et al. Oral valganciclovir for symptomatic congenital cytomegalovirus infection in an extremely low birth weight infant. J Perinatol 28, 74–76 (2008). https://doi.org/10.1038/sj.jp.7211854

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211854

Keywords

This article is cited by

Search

Quick links