**Author details**

Şule Gökçe

Ege University Faculty of Medicine, Department of Pediatrics, General Pediatrics Unit, Ege University, Izmir, Turkey

\*Address all correspondence to: sule.gokce@ege.edu.tr

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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*Human Herpesvirus Infection - Biological Features, Transmission, Symptoms, Diagnosis...*

in tissue specimens.

**5. Treatment**

severe infection.

antiviral resistance occurs.

**6.1 Passive immunoprophylaxis**

in pregnant women with primary CMV infection.

**6. Prevention**

individuals can intermittently shed virus, body fluids such as saliva or urine do not provide the diagnosis of CMV infection. Polymerase chain reaction-based methods are also utilized for diagnosis of urine, saliva, and blood and in tissue specimens obtained at biopsy. A combination with immunofluorescence detection of CMV-encoded and conventional culture of CMV using human dermal fibroblasts remains standard in many institutions. Characteristic nuclear (and cytoplasmic) inclusions (owl's eye inclusions) can be detected by histologic stains

Treatment is recommended to be initiated to the infants who have a symptomatic infection or primary immunodeficiency or asymptomatic infection with an isolated hearing loss for congenital CMV infection within the first month of life. At the first line, ganciclovir through intravenous route and its orally available prodrug, valganciclovir, for treatment of congenital CMV disease are indicated. Randomized clinical trials of the Collaborative Antiviral Study Group suggested that 6 weeks of ganciclovir treatment could confine hearing loss and improve developmental outcome in infants infected symptomatically. In addition, infants with severe perinatal CMV infection caused by breast milk could be treated with ganciclovir [7, 16].

In the normal host and early-postnatal infections in term asymptomatic infants, treatment of acquired CMV infections is not recommended. However, treatment must be implemented in preterm or very-low-birth-weight (VLBW) infants with

Immunocompromised hosts are recommended with antiviral therapy with ganciclovir in children with active CMV disease. Even if there are no signs or symptoms of end-organ disease in immunocompromised children, it is also suggested to apply the antiviral therapy due to CMV viremia (e.g., positive or rising quantitative PCR). Treatment of CMV disease in immunocompromised pediatric patients consists of ganciclovir and oral valganciclovir similar to that in adults. Treatment is usually given in the form of intravenous ganciclovir or oral valganciclovir for 4–6 weeks on average [17]. Patients are recommended to seek for antiviral treatment monitorization with white blood cell count, AST, and ALT regularly. In some cases, when the antiviral therapy cannot improve clinical or virologic response within several weeks of treatment with ganciclovir or valganciclovir, foscarnet might be integrated to the treatment. Another specific anti-CMV treatment is cidofovir that may be used in children with careful monitoring of renal function and metabolic condition when

Intrauterine disease could be prevented from infection through passive transfer of anti-CMV antibodies. However, this transfer is not successful in allograft recipients. A neonatal transfer is prevented from CMV infection using CMV-seronegative or leukocyte-reduced blood for extremely preterm infants. Freezing/thawing or pasteurization eliminates the risk of transfusion-related CMV infection in breast milk contaminated with CMV, however; it might not be complete. The passive transfer of anti-CMV antibodies is recommended to limit transmission and disease
