Asymptomatic primary cytomegalovirus infection: Virologic and immunologic features

We followed 45 seronegative adolescents for acquisition of cytomegalovirus (CMV); 6 (5 female, 1 male) seroconverted after a median of 7.5 months. All were free of signs and symptoms, CMV was isolated from 32 (59.2%) of 54 ur ines, 2-80 weeks after infection; viruria was less frequent after 6 months. CMV was isolated from saliva of 3 subjects, vaginal swabs of 2 of 5, and 1 white blood cell (WBC) sample, CMV DNA was detected by polymerase chain re action in WBCs and plasma from all subjects tested, The proportion of WBC s amples with CMV DNAemia was 75%-80% within 16 weeks of infection, declining to 0%-25% after 48 weeks, The rate of plasma DNAemia was 25%-40% at 8-16 w eeks, declining with time, IgG antibody to CMV, glycoprotein B (gB), and ne utralizing antibody were present after 6-8 weeks. Lymphocyte proliferative responses to CMV and to gB were low, compared with those of controls, CMV s hedding was of shorter duration than expected. Although antibody response w as prompt and vigorous, CMV DNA could be detected in blood for months.