Genotypic Characteristics And Clinical Significance Of Thrombocytopenia Caused By Cytomegalovirus Infection In Infants

Objective:To investigate the clinical features,laboratory data and treatment of infants and young children with cytomegalovirus(CMV)-related thrombocytopenia,and to study the relationship between glycoprotein B(g B)and glycoprotein H(g H)genotypes and CMV-related thrombocytopenia possible relationship.Methods:The study design included cytomegalovirus(CMV)-positive and thrombocytopenic infants treated in the First Affiliated Hospital of Bengbu Medical College from January 2017 to December 2021,using nested polymerase chain reaction(n PCR)and restriction Genotyping of g B and g H by methods such as length polymorphism.Results:The prevalence of CMV congenital,perinatal and postnatal infection was1.4%(76/5428),29.1%(378/1301)and 41.8%(243/581),respectively.A total of 29immunocompromised CMV-patients were analyzed for associated thrombocytopenia,including 7(9.2%,7/76)congenital infections,14(3.7%,14/378)perinatal infections and 8(9.2%,7/76)perinatal infections(3.3%,8/243)postpartum infections.A platelet count<20×10~9/L at diagnosis is a common hematologic finding of CMV-related thrombocytopenia in perinatal infections(1/7 congenital infections vs.10/14 perinatal infections vs.3/8 postpartum infections,χ~2=6.616,P=0.037).Notably,significantly higher rates of hepatobiliary symptoms were found in the congenital and perinatal infection groups(4/7 congenital infections vs.10/14 perinatal infections vs.1/8postpartum infections,χ~2=7.188,P=0.027).Twenty-four(82.8%,24/29)patients used intravenous immunoglobulin,and 9(31.0%,9/29)patients used antiviral drugs.The most prevalent CMV genotypes in this study were g B1(60.7%,17/28)and g H2(57.1%,16/28).Conclusion:Patients younger than 12 months had symptomatic CMV infection.Thrombocytopenia is one of the common clinical manifestations of congenital CMV infection.The g B1 genotype is more virulent in infants with acquired CMV infection.The g H2 genotype of CMV may be associated with CMV-related thrombocytopenia.