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Congenital Cytomegalovirus and HIV Perinatal Transmission
- Adachi, Kristina;
- Xu, Jiahong;
- Ank, Bonnie;
- Watts, D Heather;
- Camarca, Margaret;
- Mofenson, Lynne M;
- Pilotto, Jose Henrique;
- Joao, Esau;
- Gray, Glenda;
- Theron, Gerhard;
- Santos, Breno;
- Fonseca, Rosana;
- Kreitchmann, Regis;
- Pinto, Jorge;
- Mussi-Pinhata, Marisa M;
- Machado, Daisy Maria;
- Ceriotto, Mariana;
- Morgado, Mariza G;
- Bryson, Yvonne J;
- Veloso, Valdilea G;
- Grinsztejn, Beatriz;
- Mirochnick, Mark;
- Moye, Jack;
- Nielsen-Saines, Karin
Published Web Location
https://doi.org/10.1097/inf.0000000000001975Abstract
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.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.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.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.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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