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Infeção por citomegalovírus : patogénese e diagnóstico da infeção congénita
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O relatório de estágio do Mestrado de Análises Clínicas da Faculdade de Farmácia da
Universidade de Lisboa está organizado em duas partes: relatório de estágio e monografia.
O estágio decorreu no Laboratório Joaquim Chaves Saúde, entre o dia 22 de abril e
11 de novembro de 2022, nos módulos Colheitas, Triagem, Hematologia Clínica, Bioquímica
Clínica, Química Analítica e Radioimunoensaio e Genética.
A monografia é uma revisão da literatura com o tema “Infeção por Citomegalovírus:
patogénese e diagnóstico da infeção congénita”. O citomegalovírus, é a principal causa de
infeções congénitas, e concomitantemente é o fator mais comum, não genético, da perda
auditiva nos infantes, contribuindo, significativamente, para um atraso do neuro
desenvolvimento. Representa, assim, um grave problema de saúde pública.
A transmissão do referido vírus pode ocorrer por várias vias, incluindo contacto direto
com fluidos corporais. A infeção congénita só ocorre após a infeção materna. O risco de
aparecimento de manifestações clínicas aumenta com a idade gestacional. Na maioria dos
casos é assintomática ou com sintomas inespecíficos. Mesmo a exposição prévia da mãe ao
vírus (imunizada), não exclui a infeção congénita.
Apesar da sua importância clínica, a infeção congénita não é, frequentemente,
detetada, pois apenas 10% dos infetados apresentam manifestações clínicas ao nascimento.
Para além que ainda não há nenhuma forma farmacológica disponível, a nível clínico, para a
prevenção da transmissão viral.
O diagnóstico pré-natal do citomegalovírus tem um papel significativo na identificação
de fetos com elevado risco de desenvolvimento de sequelas. Este baseia-se na
seroconversão de imunoglobulinas G, na reatividade das imunoglobulinas M e na possível
avidez das imunoglobulinas G. Consoante os resultados dos testes serológicos, segue-se o
algoritmo por meio de amniocenteses à 21ª semana ou por um seguimento pós-natal do feto,
em particular, na deteção de DNA viral.
he internship report for the Master Degree of Clinical Analysis at the Faculty of Pharmacy of the University of Lisbon is organized into two parts: internship report and monograph. The internship took place at the Joaquim Chaves Saúde Laboratory, between April 22nd and November 11th, 2022, in the modules of Phlebotomy, Screening, Clinical Haematology, Clinical Biochemistry, Analytical Chemistry and Radioimmunoassay and Genetics. The monograph is a review of the literature with the theme “Cytomegalovirus Infection: pathogenesis and diagnosis of congenital infection”. Cytomegalovirus is the main cause of congenital infections, and at the same time it is the most common, non-genetic factor in hearing loss in infants, contributing significantly to delayed neurodevelopment. It therefore represents a serious public health problem. Transmission of this virus can occur through various routes, including direct contact with bodily fluids. Congenital infection only occurs after maternal infection. The risk of clinical manifestations increases with gestational age. In most cases it is asymptomatic or with non specific symptoms. Even the mother's previous exposure to the virus (immunized) does not exclude congenital infection. Despite its clinical importance, congenital infection is often not detected, as only 10% of infected people present clinical manifestations at birth. In despite, there is still no pharmacological way available, at a clinical level, to prevent viral transmission. Prenatal diagnosis of cytomegalovirus plays a significant role in identifying fetuses at high risk of developing sequelae. This is based on the seroconversion of immunoglobulins G, the reactivity of immunoglobulins M and the possible avidity of immunoglobulins G. Depending on the results of the serological tests, the algorithm is followed by means of amniocentesis at the 21st week or by postnatal follow-up of the fetus in the detection of viral DNA.
he internship report for the Master Degree of Clinical Analysis at the Faculty of Pharmacy of the University of Lisbon is organized into two parts: internship report and monograph. The internship took place at the Joaquim Chaves Saúde Laboratory, between April 22nd and November 11th, 2022, in the modules of Phlebotomy, Screening, Clinical Haematology, Clinical Biochemistry, Analytical Chemistry and Radioimmunoassay and Genetics. The monograph is a review of the literature with the theme “Cytomegalovirus Infection: pathogenesis and diagnosis of congenital infection”. Cytomegalovirus is the main cause of congenital infections, and at the same time it is the most common, non-genetic factor in hearing loss in infants, contributing significantly to delayed neurodevelopment. It therefore represents a serious public health problem. Transmission of this virus can occur through various routes, including direct contact with bodily fluids. Congenital infection only occurs after maternal infection. The risk of clinical manifestations increases with gestational age. In most cases it is asymptomatic or with non specific symptoms. Even the mother's previous exposure to the virus (immunized) does not exclude congenital infection. Despite its clinical importance, congenital infection is often not detected, as only 10% of infected people present clinical manifestations at birth. In despite, there is still no pharmacological way available, at a clinical level, to prevent viral transmission. Prenatal diagnosis of cytomegalovirus plays a significant role in identifying fetuses at high risk of developing sequelae. This is based on the seroconversion of immunoglobulins G, the reactivity of immunoglobulins M and the possible avidity of immunoglobulins G. Depending on the results of the serological tests, the algorithm is followed by means of amniocentesis at the 21st week or by postnatal follow-up of the fetus in the detection of viral DNA.
Descrição
Tese de mestrado, Análises Clínicas, 2024, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Relatório de estágio Citomegalovírus Infeção congénita Manifestações clínicas Diagnóstico Teses de mestrado - 2024