Severe Neutropenia in Infants With Congenital Cytomegalovirus on Antiviral Therapy
Year: 2025
Type: article
Study design: Observational Study
Abstract: 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.
Authors: Vassiliki Papaevangelou, Roberto Pedrero-Tomé, Garyfallia Syridou, Fernando Baquero-Artigao, Paula Rodríguez-Molino, Teresa del Rosal, Antoni Noguera-Julián, María Ríos-Barnés, Claudia Fortuny, Serena Villaverde, María Antoinnette Frick, Beatriz Álvarez Vallejo, Pere Soler-Palacín, Jesús Saavedra, Elena Rincón, Sofia Karagiannidou, Itziar Sota Busselo, Oihana Muga Zuriarrain, Elisenda Moliner Calderón, Alfredo Tagarro, María Malumbres, Elena Colino, Elisa Garrote Llanos, Ana Menasalvas Ruiz, Miguel Sánchez Mateos, Xavier Bringué Espuny, Almudena Alonso-Ojembarrena, Laura Ferreras-Antolin, Irene Cuadrado Pérez, Ana Filgueira Posse, Hermione Lyall, Daniel Blázquez-Gamero, on behalf of cCMVnet Registry Study Group
Institutions: National and Kapodistrian University of Athens, University General Hospital Attikon, Research Institute Hospital 12 de Octubre, Hospital Universitario 12 De Octubre, Hospital Universitario La Paz, Centro de Investigación Biomédica en Red, Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Donostiako Unibertsitate Ospitalea, Hospital de Sant Pau, Hospital Universitario Infanta Sofía, Complejo Hospitalario de Navarra, Hospital Universitario Insular de Gran Canaria, Hospital de Basurto, Hospital Universitario Virgen de la Arrixaca, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Universitari Arnau de Vilanova, Biomedical Research and Innovation Institute of Cadiz, Hospital Universitario Puerta del Mar, Hospital Universitario de Getafe, Hospital Son Llatzer, Imperial College Healthcare NHS Trust, Instituto de Salud Carlos III
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4412490519