CHERI Study

Congenital and postnatal cytomegalovirus (cCMV, pCMV) affects 3% and 21% of term South African infants, and is likely to be higher in premature infants who have developing immune systems that may be unable to adequately control CMV.

In addition, HIV-exposure is recognised to result in immune-dysregulation and be associated with CMV infection. In these vulnerable infants cCMV can cause hearing loss and neurological deficits, and pCMV can be associated with pneumonia, multi-organ dysfunction and necrotising enterocolitis but not in all infants.

We aim to determine prevalence of cCMV and pCMV, and clinical/immunological risk factors for severe CMV disease in this population.

CHERI-2 will:

• Measure the incidence of postnatal CMV in premature infants in episodes of suspected sepsis
• Assess whether testing for postnatal CMV during episodes of suspected sepsis in premature infants will detect cases of postnatal CMV that need treatment
• Measure CMV in several body compartments (saliva, urine, and where possible – respiratory secretions, blood and cerebral spinal fluid) and describe the associated clinical condition of the infant
• Describe pharmacokinetics and viral dynamics of crushed valganciclovir in premature infants