Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/33152
Title: Congenital cytomegalovirus and HIV perinatal transmission
Authors: 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
MPH for the NICHD HPTN 040 Study Team
Affilliation: David Geffen UCLA. School of Medicine. Los Angeles, CA, USA.
Westat. Rockville, MD, USA.
David Geffen UCLA. School of Medicine. Los Angeles, CA, USA.
U.S. Department of State. Office of the Global AIDS Coordinator. Washington, DC, USA.
Westat. Rockville, MD, USA.
National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Bethesda, MD, USA.
Hospital Geral de Nova Iguaçu. Nova Iguaçu, RJ, Brasil.
Hospital Federal dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.
University of Witwatersrand. SAMRC and Perinatal HIV Research Unit. Cape Town, South Africa.
Stellenbosch Universit. Tygerberg Hospital. Cape Town, South Africa.
Hospital Conceição. Porto Alegre, RS, Brasil.
Hospital Femina. Porto Alegre, RS, Brasil.
Irmandade da Santa Casa de Misericórdia de Porto Alegre. Porto Alegre, RS, Brasil.
Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
University of São Paulo. Ribeirão Preto Medical School. Ribeirão Preto, SP, Brazil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. São Paulo, SP, Brasil.
Foundation for Maternal and Infant Health. Buenos Aires, Argentina.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
David Geffen UCLA. School of Medicine. Los Angeles, CA, USA.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Boston University. School of Medicine. Boston, MA, USA.
National Institutes of Health. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Bethesda, MD, USA.
David Geffen UCLA. School of Medicine. Los Angeles, CA, USA.
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 uring 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.
Keywords: Congenital CMV
HIV MTCT
HIV perinatal transmission
Issue Date: 2018
Publisher: Lippincott, Williams & Wilkins
Citation: ADACHI, Kristina et al. Congenital cytomegalovirus and HIV perinatal. Transmission. Pediatric Infectious Disease Journal, v. 37, n. 10, p. 1016-1021, 2018.
Description: Valdilea Veloso e Beatriz Grinsztejn. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Mariza G.Morgado. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
DOI: 10.1097/INF.0000000000001975
ISSN: 0891-3668
Copyright: restricted access
Appears in Collections:IOC - Artigos de Periódicos
INI - Artigos de Periódicos

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