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Background. Cytomegalovirus (CMV) infection during fetal life causes severe symptoms and is associated with prolonged viral excretion. Previous studies reported low CD4+ T-cell responses to CMV infection in early life, contrasting with large responses of effector CD8+ T cells. The mechanisms underlying the defective CD4+ T-cell responses and the possible dissociation with CD8+ T-cell responses have not been clarified. Methods. The magnitude and the quality of the fetal CD8+ and CD4+ T-cell responses to CMV infection were compared to those of adults with primary or chronic infection. Results. In utero CMV infection induced oligoclonal expansions of fetal CD4+ and CD8+ T lymphocytes expressing a T-helper type 1 or Tc1 effector phenotype similar to that of adult CMV-specific cells. However, the effector cytokine responses and the polyfunctionality of newborn CD4+ and CD8+ T cells were markedly lower than those of adult cells. This reduced functionality was associated with a higher expression of the programmed death 1 inhibitory receptor, and blockade of this receptor increased newborn T-cell responses. Conclusions. Functional exhaustion limits effector CD4+ and CD8+ T-lymphocyte responses to CMV during fetal life. [ABSTRACT FROM AUTHOR]

Background. Although neutralizing antibodies play a central role in the control of cytomegalovirus (CMV) dissemination, little is known about the response of B lymphocytes to primary human CMV infection.Methods. The proportion, phenotype, specificity, and functionality of B-cell subsets were studied in a cohort of pregnant women with primary CMV infection. CMV-seronegative pregnant women, as well as CMV-seronegative and CMV-seropositive healthy adults, were included as controls.Results. Primary CMV infection was associated with a sustained expansion of activated (CD27+CD20+CD21low) and atypical (CD27−CD20+CD21low) memory B cells (MBCs). Both subsets expressed an effector phenotype, and their proportions were correlated with viremia. Activated MBCs expressed high levels of activation markers and included high frequencies of tumor necrosis α (TNF-α)–producing cells, whereas atypical MBCs expressed high levels of inhibitory receptors and had low TNF-α responses. Fluorescent-labeled antigen experiments indicated that activated and atypical MBCs were enriched in CMV-specific cells.Conclusions. Primary CMV infection mobilizes a large pool of memory B cells that includes activated and atypical MBCs. The functional regulation of CMV-specific MBCs may limit the production of antibodies and the control of viral dissemination. [ABSTRACT FROM AUTHOR]

A neonate with lower-limb hypoplasia, cutaneous scars, bilateral chorioretinitis, and multiple brain abnormalities is presented. Intrauterine herpes simplex virus type 2 (HSV-2) infection was established on the basis of serological testing of the mother and viral cultures of the child's cutaneous lesions, obtained soon after birth. This is, to the best of our knowledge, the first case of a patient with in utero-acquired HSV-2 infection presenting with a limb hypoplasia. It illustrates that, in addition to congenital varicella-zoster syndrome, HSV-2 infection should also be considered in patients presenting with limb hypoplasia. [ABSTRACT FROM AUTHOR]

The aim of this work was to prepare European guidelines concerning the screening for infectious diseases in the setting of gamete donation. Existing guidelines have been reviewed and commented. In particular, the problem of cytomegalovirus (CMV) was a matter of debate following the decision by the French Government to reject CMV seropositive donors. Other remarks and suggestions concerning various pathogens and perspectives of new molecular techniques for the detection of pathogens are also included. [ABSTRACT FROM PUBLISHER]

Passive transfer of immunity from the mother to the first trimester fetus is of particular interest because of the reported high incidence of serious fetal sequelae due to congenital infection. We have examined the relationship between maternal serum, coelomic fluid and amniotic fluid concentrations of immunoglobulin (Ig) and complement. Ig fractions G (IgG), A (IgA), and M (IgM) and complement factors 3 (C3) and 4 (C4) were measured in 34 normal pregnancies between 6 and 12 weeks of gestation. The concentrations of specific antibodies for Toxoplasma gondii, cytomegalovirus (CMV) and rubella were also measured on 21 matched samples from the same study group. IgG and IgA concentrations were detected in all coelomic fluid samples whereas IgG was only measurable in two amniotic fluid samples. IgG and IgA concentrations were respectively 28 and 128 times lower in coelomic fluid than in maternal serum and probably reflect fetal serum concentrations. Significant positive linear correlations were found between gestational age and the coelomic concentrations of IgG (P = 0.001) and IgA (P = 0.014). There was no obvious association between immunoglobulin concentrations in coelomic fluid and maternal serum suggesting increasing active transport across the placenta with advancing gestation. IgM, C3 and C4 were not detected in coelomic or amniotic fluid samples. Specific antibodies were found in 13 out of 63 samples of coelomic fluid and in 32 out of 63 samples of maternal serum. They were found in coelomic fluid only if they were present in maternal serum. These results suggest that maternal IgG and IgA are potentially available to the embryo as early as the 6th week of gestation. The presence in the coelomic fluid of the IgG fraction, both total and infectious agent-specific transferred via the placenta, indicates that they may provide limited protection against congenital infection in the first trimester. [ABSTRACT FROM AUTHOR]

Presents a comment and a response to a study on hepatitis B vaccination in persons with isolated hepatitis B core antibodies. Function of a booster response system; Inadequacy of hepatitis B virus vaccination; Implications of hepatitis B virus vaccination.

Reports on an observation that reverse transcriptase inhibitor foscarnet is active in the central nervous system when used to treat HIV encephalopathy-related symptoms. Details of clinical characteristics of a man with Burkitt's lymphoma; Administration of therapy; Mechanism of action of foscarnet.