Cytomegalovirus Update: Congenital CMV Is a ‘Disease of Disparity’ | IDWeek 2023


Cytomegalovirus (CMV) expert Sallie Permar, M.D., Ph.D., of NewYork-Presbyterian/Weill Cornell Medical Center says the epidemiology of congenital CMV hasn’t varied much over the years and that the condition does disproportionately affect lower socioeconomic populations and communities of color in the U.S.

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Between 1 in 150 and 1 in 200 babies are born with infected with cytomegalovirus (CMV) that was transmitted to them from their mothers and that figure hasn’t much, according to Sallie Permar, M.D., Ph.D.

The rate of transmission and the epidemiology of the congenital CMV is “very consistent” Permar noted in an interview with Managed Healthcare Executive and consistent in low-, medium- and high-income countries.

But Permar said if you “drill down further,” CMS is a disease of disparity. “Individuals who live in regions who have lower socioeconomic status, born in country outside of the U.S., or who are from communities of color are more likely to experience congenital infection and therefore making it a disease of disparity in high-income countries like the U.S.,” said Permar.

Permar spoke about CMV vaccine development this afternoon at the IDWeek 2023 meeting in Boston. She is a leading researcher of neonatal viral infections, including HIV as wells as CMV, and vertical transmission of infectious disease from mothers to infants. Permar is chair of the Department of Pediatrics at Weill Cornell Medicine and pediatrician-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center and the NewYork-Presbyterian Komansky Children’s Hospital.

Permar explained in her interview with MHE that there is a 30% to 40% chance of women who become infected with CMV for the first time during pregnancy transmitting it to the infant. The chance of transmission is ten time less in women who have been previously infected and become re-infected but it is not zero.

That small but greater-than-zero chance surprised infectious disease experts when it was recognized about 20 year ago, Permar said.

“From the rubella experience, from the measles experience, immunity was for life and immunity to rubella completely prevented congenital infection. That is not true of CMV,” Permar said.

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