About Us

About Us

Giovanni Nigro is a Pediatrician specialized in Infectious Diseases, Pediatrics and Gastroenterology, who started since 1980 to take care of infants with congenital cytomegalovirus (CMV) infection, both by clinical and laboratory examinations. Antiviral therapy was started in 1988 with intravenous ganciclovir and in 1991 with foscarnet. Although the results were encouraging, it was clear that the treatment needed a duration longer than that allowed by the intravenous administration.
Because some disabilities (i.e. cerebral malformations, deafness) were irreversible, to make an early diagnosis of CMV infection (mostly primary) in pregnancy, in 1989 pregnant women with CMV infection were also followed in the Obstetrical Institute of Sapienza University in Rome. Following the favorable outcome after hyperimmune globulin (HIG) of a twin fetus with CMV infection and severe intrauterine growth restriction (IUGR), a prospective, controlled, multi-center study was performed and the results for prevention of mother-to-infant XMV transmission and, mostly, the severe consequences of the fetal infection, were published in New England Journal of Medicine, 2005. Other studies followed and confirmed the initial favorable results.

A recent story

Adesso che è trascorso qualche mese, sento finalmente di raccontare la nostra storia. Voglio condividere la mia esperienza per informare e sensibilizzare quante più persone su un nemico purtoppo poco conosciuto e, soprattutto, per dare speranza a chi in questo momento lo sta affrontando.
Al quinto mese della mia gravidanza ho contratto il citomegalovirus. Sapevo sin dall’inizio della gravidanza di non averlo mai avuto e quindi stavo molto attenta.… Read more… “La storia di Giusy”

My name is Fiammetta from Milan (Italy): In June 2018, I became pregnant wishing to give a sister to my first son, as confirmed by a fetal DNA test. My dream was close to be realized! But on September 24, I was told to be positive to anti-CMV IgM and IgG, and the avidity of IgG was very low. Although the meaning of these results was ignored by me, I… Read more… “Flavia’s happy ending story”

I discovered to have acquired a primary CMV infection. I and my husband were informed about the serious risk of damages to the fetus, that no treatments were available and that we hade the choice between an abortion within week 12 or continue the pregnancy doing ultrasounds and amniocentesis at week 20 to evaluate if  CMV has been transmitted. After deep thoughts we decided to go ahead and by internet… Read more… “The story of Francesca and Matilde”

PUBLICATIONS about CMV infection in Journals with Impact Factor

  1. Nigro G et al. Persistent virus infection and type 1 diabetes. Lancet 1988;II:450
  2. Nigro G et al. Simultaneous detection of specific serum IgM and IgA antibodies for rapid serodiagnosis of congenital or acquired cytomegalovirus infection. Serodiagn Immunother Infect Dis 1989;3:355-61
  3. Nigro G et al. Viral infections in transfusion-dependent patients with β-thalassemia major: the predominant role of cytomegalovirus. Transfusion 1990;30:808-13
  4. Iannetti P, Nigro G, Imperato C. Cytomegalovirus encephalitis and ganciclovir. Lancet 1991;I:373
  5. Nigro G et al. Hepatitis in pre-school children: prevalent role of cytomegalovirus. Arch Virol 1992;Suppl 4:268-72.]
  6. Nigro G et al. Acute hepatitis in childhood: virological, immunological and clinical aspects. Biomed Pharmacother 1992;46:155-60
  7. Nigro G et al. Symptomatic congenital cytomegalovirus infection in two consecutive sisters. Arch Dis Child 1993;69:527-8
  8. Nigro G et al. Cytomegalovirus infection in two infants with congenital or neonatal solid tumors. Pediatr Hematol Oncol 1993;10:351-5
  9. Nigro G et al. Multiple viral infections in HIV-infected children with chronically-evolving hepatitis. Arch Virol 1993; Suppl 8:237-48
  10. Nigro G et al. Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: a two-regimen experience. J Pediatr 1994;124:318-22. Reviewed in Year Book of Infectious Diseases 1996:167-8
  11. Nigro G et al. Gancyclovir therapy for cytomegalovirus infection in infants. J Pediatr 1994;125:670-1. Reply to comment
  12. Nigro G et al. Cytomegalovirus-associated stage 4S neuroblastoma relapsed stage 4. Med Pediatr Oncol 1995; 24:200-3
  13. Nigro G et al. Rapid progression of HIV disease in children with cytomegalovirus DNAemia. AIDS 1996;10:1127-33
  14. Nigro G et al. Ganciclovir therapy for cytomegalovirus-associated liver disease in immunocompetent or immunocompromised children. Arch Virol 1997;142:573-80
  15. Iannetti P, Nigro G, et al. Cytomegalovirus infection and schizencephaly: Case reports. Ann Neurol 1998;43:123-7
  16. Nigro G et al. Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection and growth restriction. Am J Obstet Gynecol 1999;180:1222-6
  17. Piazze J, Nigro G, et al. The effect of primary cytomegalovirus infection on fetal lung maturity indices. Early Hum Dev 1999;54:137-44
  18. Nigro G et al. Prenatal diagnosis of fetal cytomegalovirus infection following primary or recurrent maternal infection. Obstet Gynecol 1999;94:909-14
  19. Nigro G et al. Multi-system cytomegalovirus fetopathy by recurrent infection in a pregnant woman with hepatitis B. Prenat Diagn 1999;19:1070-2
  20. Nigro G et al. Hyperimmunoglobulin therapy for cytomegalovirus-associated infertility. Fertil Steril 2000;74:830-1
  21. Nigro G et al. Intraventricular haemorrhage in a fetus with cerebral cytomegalovirus infection. Prenat Diagn 2002;22:558-61
  22. Nigro G et al. Clinical manifestations and abnormal laboratory findings in pregnant women with primary cytomegalovirus infection, Brit J Obstet Gynaecol 2003;110:572-7
  23. Nigro G et al. Foscarnet therapy far congenital hepatic fibrosis by cytomegalovirus infection. J Matern Fetal Neonatal Med 2004;15:325-9
  24. Nigro G et al. Passive maternal immunization during pregnancy for congenital cytomegalovirus infection. N Engl J Med 2005;353:1350-62. Reply to letters. N Engl J Med 2005;353:2818-20
  25. Adler S, Nigro G. Progress towards interrupting intrauterine transmission of cytomegalovirus? Rev Med Virol 2006;16:1-3
  26. La Torre R, Nigro G, et al. Placental enlargement in women with a primary maternal cytomegalovirus infection is associated with fetal and neonatal disease. Clin Infect Dis 2006;43:994-1000
  27. Adler SP, Nigro G, Pereira L. Recent advances in the prevention and treatment of cytomegalovirus infections. Semin Perinatol 2007;31:10-8
  28. Nigro G et al. Regression of fetal cerebral abnormalities by primary cytomegalovirus infection following hyperimmunoglobulin therapy. Prenat Diagn 2008;28:512-7
  29. Adler SP, Nigro G. The importance of CMV specific antibodies for the prevention of fetal CMV infection or disease. Herpes 2008;15:24-7
  30. Nigro G. Maternal-fetal cytomegalovirus infection: from diagnosis to therapy. J Matern Fetal Neonatal Med 22:169-74
  31. Adler SP, Nigro G. Findings and conclusions from CMV hyperimmune globulin treatment trials. J Clin Virol 2009;46 Suppl 4:S54-7
  32. Nigro G et al. Oral ganciclovir therapy for immunocompetent infants with cytomegalovirus-associated hemorrhagic or intractable enterocolitis. J Pediatr Gastroenterol Nutr 2010;50:111-3
  33. Adler SP, Nigro G, Pereira L. Screening for cytomegalovirus during pregnancy. Am J Obstet Gynecol 2010;203:e15
  34. Maidji E, Nigro G, et al. Antibody treatment promotes compensation for human cytomegalovirus-induced pathogenesis and a hypoxia-like condition in placentas with congenital infection. Am J Pathol 2010:177:1298-1310
  35. Nigro G, Adler SP. Cytomegalovirus infections in pregnancy. Curr Opin Obstet Gynecol 2011;23:123-8
  36. Nigro G et al. Role of the infections in recurrent spontaneous abortion. J Matern Fetal Neonatal Med 2011;24:983-9
  37. Nigro G et al. Immunoglobulin therapy of fetal cytomegalovirus infection occurring in the first half of pregnancy – a case-control study of the outcome in children. J Infect Dis 2012;205:215-27
  38. Nigro G et al. Fetal hyperechogenic bowel may indicate congenital cytomegalovirus disease responsive to immunoglobulin therapy. J Matern Fetal Neonatal Med 2012;25:2202-5
  39. Polilli E, …..Nigro G. Preliminary evaluation of the safety and efficacy of standard intravenous immunoglobulins in pregnant women with primary cytomegalovirus infection. Clin Vaccine Immunol 2012; 19:1991-3
  40. Coclite E, Di Natale C, Nigro G. Congenital and perinatal citomegalovirus lung infection. J Matern Fetal Neonatal Med 2013;26:1671-5
  41. Adler SP, Nigro G. Prevention of maternal-fetal transmission of cytomegalovirus. Clin Infect Dis 2013;57(S4):S189-92
  42. Nigro G, Adler SP. Hyperimmunoglobulin for prevention of congenital cytomegalovirus disease. Clin Infect Dis 2013;57(S4):S193-5
  43. Nigro G et al. Primary maternal cytomegalovirus infections during pregnancy: association of CMV hyperimmune globulin with gestational age at birth and birth weight. J Matern Fetal Neonatal Med 2015;28:168-71
  44. Nigro G. Hyperimmune globulin to prevent congenital CMV infection. N Engl J Med. 2014;370:2544
  45. Mareri A, ….. Nigro G. Antiviral therapy for congenital cytomegalovirus infection: pharmacokinetics, efficacy and side effects. J Matern Fetal Neonatal Med 2016;29:1657-64
  46. Nigro G. Hyperimmune globulin in pregnancy for prevention of congenital cytomegalovirus disease. Expert Rev Anti Infect Ther 2017;15:977-86
  47. Nigro G, Adler SP. High-Dose cytomegalovirus (CMV) hyperimmune globulin  and maternal CMV DNAemia independently predict infant outcome in pregnant women with a primary CMV infection. Clin Infect Dis 2020;71(6):1491-8