Universal Newborn Screening for Congenital Cytomegalovirus Infection - From Infant to Maternal Infection: A Prospective Multicenter Study.

Introduction: Most infants at risk for cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) are unrecognized because of the absence of a universal neonatal CMV screening. The search of CMV-DNA by molecular methods in salivary swabs was demonstrated to be a reliable approach. This study describes the results obtained by carrying out a universal screening for congenital CMV (cCMV) infection including all live-born newborns in three Italian sites, as well as the therapeutic interventions and clinical outcome of the CMV-infected neonates.

Evaluation of the vitros hiv combo 4th generation test for the identification of HIV infections.

Background: Simultaneous detection of HIV 1 and 2 antibodies and HIV-1 p-24 antigen in the 4th generation tests is particularly effective for the identification of early acute HIV infections while maintaining accurate detection of long-established infections.

Objectives: The aim of this study was to evaluate the new 4th generation VITROS HIV Combo test from Ortho-Clinical Diagnostics by comparing its results with those obtained using a 3rd generation HIV 1/2 antibody test (VITROS Anti HIV 1 + 2 from Ortho-Clinical Diagnostics) and a 4th generation test (LIAISON XL HIV Ab/Ag, DiaSorin) currently used in the Microbiology Unit of Legnano Hospital.

Study Design: One thousand and three samples of the normal daily routine (Group 1) were analyzed simultaneously with the three systems.

Threshold value of LIAISON XL anti-HCV screening assay predicting positive immunoblotting results.

Some international guidelines recommend evaluating the need to confirm positive anti-hepatitis C virus (HCV) antibody screening results by means of a more specific antibody or molecular biology test on the basis of a screening threshold value (such as the sample signal/cut-off ratio) that can predict the positivity of additional antibody testing in at least 95% of cases. The aim of this study was to determine the threshold value of the DiaSorin LIAISON XL chemiluminescence test. Two hundred and twenty-eight routine laboratory samples that were chemiluminescence positive for anti-HCV antibodies but had different signal/cut-off ratios were assayed using immunoblotting, which indicated that 155 (68.

Evaluation of LIAISON® XL system for HBsAg, and anti-HCV and anti-HIV/Ag p24.

The aim of this study was to compare the data obtained using the new LIAISON® XL chemiluminescence system to search for HBsAg, anti-HCV, and anti-HIV1-2/p24 Ag with those obtained using the VITROS system currently adopted by the Microbiology Unit of the Hospital of Legnano. Routine samples of patients who were referred by practitioners for the determination of HBsAg (1,000 samples) and/or anti-HCV (1,002 samples) and/or anti-HIV1-2 (995 samples) were simultaneously analyzed using both systems. The concordant positive and discordant samples were re-examined for confirmation by means of an HBsAg neutralization assay, anti-HCV immunoblot, or anti-HIV1-2 Western blot; HBV-DNA, or HCV-RNA or HIV-RNA was also sought in the discordant samples.

Prevalence of markers of hepatitis B virus infection or vaccination in HBsAg-negative subjects.

Background: The implementation of mass vaccinations against hepatitis B virus (HBV) has significantly reduced the prevalence of HBsAg-positive subjects. At the same time, the prevalence of the other markers of infection has decreased, but there has been an increase in the percentage of subjects with markers of a successful vaccination. It has been suggested that increasing immigration from countries in which this virus is highly endemic is changing the epidemiology of HBV infection.

Rubella antibody screening during pregnancy in an urban area of Northern Italy.

Various countries have implemented anti-rubella vaccination campaigns with the main aim of preventing congenital infection. In 2003, Italy joined the European WHO programme for the elimination of congenital rubella and issued a special healthcare plan, one of the objectives of which was to reduce the proportion of rubella-susceptible pregnant women to less than 5% by 2005. The aim of this study was to determine the percentage of seronegative pregnant women after the implementation of this plan.

Implementation of Screening for Toxoplasma gondii Infection in Pregnancy.

Background: Since 1998, Italian law requires serological screening for toxoplasmosis by the thirteenth week of pregnancy, and seronegative women should undergo further checks every 30 - 40 days until delivery (a total of 5 - 7 screenings). This is an improvement of the previous law which foresaw three free tests (one by the end of the third month, one in the fifth, and one in the ninth month of pregnancy). The aim of this study was to assess the implementation, in an urban area of Northern Italy, of the 1998 law about 10 years after its entry into force.

Search for Anti-EA(D) Antibodies in Subjects with an "Isolated VCA IgG" Pattern.

The presence of an "isolated viral capsid antigen (VCA) IgG" pattern in serum is not easy to interpret without the aid of further tests, such as specific immunoblotting or a virus genome search, that often give rise to organisational and economic problems. However, one alternative is to use an enzyme-linked immunosorbent assay (ELISA) to detect anti-early antigen (EA) antibodies, which can be found in about 85% of subjects with acute Epstein-Barr virus (EBV) infections. The purpose of this work was to search for anti-EA(D) antibodies in 130 samples with an isolated VCA IgG pattern at ELISA screening and classified as being indicative of past (102 cases) or acute (28 cases) infection on the basis of the immunoblotting results.

Positive predictive value of anti-HCMV IgM as an index of primary infection.

A search for specific IgM antibodies was used for the detection of primary human cytomegalovirus (HCMV) infections, but the significance of the results is limited by the possible persistence of specific IgM over time, the fact that they are also produced during episodes of reactivation or reinfection, and possible cross-reactions with other viruses. Anti-HCMV antibody screening was carried out to assess the positive predictive value of detecting specific IgM antibodies using IgG and IgM enzyme-linked immunosorbent assays (ELISAs) in 6990 patients examined during the period 2005-2007. In comparison with IgG avidity, the positive predictive value of screening by IgM ELISA alone was 49.

Incidence and risk of cytomegalovirus infection during pregnancy in an urban area of Northern Italy.

The fetal consequences of CMV infection make it one of the most serious infections contracted during pregnancy, but the scientific community is divided over the proposed implementation of preventive screening for anti-CMV antibodies. The aim of this study was to assess the incidence and risk of infection during pregnancy in 2817 women who underwent anti-CMV IgG and IgM antibody screening during the period 2005-2007. The prevalence of anti-CMV IgG antibodies was 68.

Seroepidemiology of EBV and interpretation of the "isolated VCA IgG" pattern.

The presence of VCA IgG in the absence of VCA IgM and EBNA-1 IgG antibodies makes classifying EBV infection more difficult as this serological picture can be seen in the case of past infection with EBNA-1 IgG loss or non-appearance, or acute infections with the early disappearance or delayed onset of VCA IgM. The aim of this study was to assess the prevalence of this pattern in 2,422 outpatients with suspected EBV infection examined in 2005-2006, and to interpret its significance by means of immunoblotting. One hundred and seventy-seven (7.

Revision of the positive predictive value of IgM anti-Toxoplasma antibodies as an index of recent infection.

The severity of congenital Toxoplasma gondii infection underlines the need for a precise diagnosis of acute infection during pregnancy. The search for specific IgM has been widely used for this purpose, but their possible early disappearance or persistence over time limits their meaning. In order to estimate the positive predictive value of anti-Toxoplasma IgM testing, we made an epidemiological analysis of the presence of anti-Toxoplasma IgG and IgM using ELISA in 4786 subjects attending the Hospital of Legnano in 2004-2005: 1360 seen for a clinical check-up and 3426 pregnant women for serological screening.