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Congenital Cytomegalovirus and HIV Perinatal Transmission.
- Source :
-
The Pediatric infectious disease journal [Pediatr Infect Dis J] 2018 Oct; Vol. 37 (10), pp. 1016-1021. - Publication Year :
- 2018
-
Abstract
- Background: Congenital cytomegalovirus (CMV) infection (cCMV) is an important cause of hearing loss and cognitive impairment. Prior studies suggest that HIV-exposed children are at higher risk of acquiring cCMV. We assessed the presence, magnitude and risk factors associated with cCMV among infants born to HIV-infected women, who were not receiving antiretrovirals during pregnancy.<br />Methods: cCMV and urinary CMV load were determined in a cohort of infants born to HIV-infected women not receiving antiretrovirals during pregnancy. Neonatal urines obtained at birth were tested for CMV DNA by qualitative and reflex quantitative real-time polymerase chain reaction.<br />Results: Urine specimens were available for 992 (58.9%) of 1684 infants; 64 (6.5%) were CMV-positive. Mean CMV load (VL) was 470,276 copies/ml (range: < 200-2,000,000 copies/ml). Among 89 HIV-infected infants, 16 (18%) had cCMV versus 42 (4.9%) of 858 HIV-exposed, uninfected infants (P < 0.0001). cCMV was present in 23.2% of infants with in utero and 9.1% infants with intrapartum HIV infection (P < 0.0001). Rates of cCMV among HIV-infected infants were 4-fold greater (adjusted OR, 4.4; 95% CI: 2.3-8.2) and 6-fold greater among HIV in utero-infected infants (adjusted OR, 6; 95% CI: 3-12.1) compared with HIV-exposed, uninfected infants. cCMV was not associated with mode of delivery, gestational age, Apgar scores, 6-month infant mortality, maternal age, race/ethnicity, HIV viral load or CD4 count. Primary cCMV risk factors included infant HIV-infection, particularly in utero infection.<br />Conclusion: High rates of cCMV with high urinary CMV VL were observed in HIV-exposed infants. In utero HIV infection appears to be a major risk factor for cCMV in infants whose mothers have not received combination antiretroviral therapy in pregnancy.
- Subjects :
- Anti-Retroviral Agents therapeutic use
Cohort Studies
Cytomegalovirus
Cytomegalovirus Infections etiology
DNA, Viral urine
Female
Humans
Infant
Infant, Newborn
Pregnancy
Real-Time Polymerase Chain Reaction
Risk Factors
Viral Load
Cytomegalovirus Infections congenital
HIV Infections complications
HIV Infections transmission
Infectious Disease Transmission, Vertical
Pregnancy Complications, Infectious virology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-0987
- Volume :
- 37
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Pediatric infectious disease journal
- Publication Type :
- Academic Journal
- Accession number :
- 30216294
- Full Text :
- https://doi.org/10.1097/INF.0000000000001975