Infant HIV Infection Ups Risk for Congenital CMV Infection
In utero HIV infection tied to higher cCMV risk in infants of HIV-infected women not on antiretrovirals
THURSDAY, Oct. 25, 2018 (HealthDay News) -- HIV-exposed infants have high rates of congenital cytomegalovirus (cCMV) infection, and in utero HIV infection seems to be a major risk factor for cCMV, according to a study published in the October issue of The Pediatric Infectious Disease Journal.
Kristina Adachi, M.D., from the David Geffen UCLA School of Medicine in Los Angeles, and colleagues determined cCMV and urinary CMV load in a cohort of infants born to HIV-infected women not receiving antiretrovirals during pregnancy. Qualitative and reflex quantitative real-time polymerase chain reaction were used to test for CMV DNA in neonatal urine obtained at birth.
With urine specimens available for 58.9 percent of 1,684 infants, the researchers found that 6.5 percent were CMV-positive, with a mean CMV load of 470,276 copies/ml. Eighteen percent of 89 HIV-infected infants had cCMV versus 4.9 percent of 858 HIV-exposed uninfected infants. cCMV was present in 23.2 and 9.1 percent of infants with in utero and intrapartum HIV infection, respectively. The rates of cCMV were fourfold higher (adjusted odds ratio, 4.4) and sixfold higher (adjusted odds ratio, 6) among HIV-infected infants and HIV in utero-infected infants, respectively, compared with HIV-exposed uninfected infants. Risk factors for primary cCMV included infant HIV infection, particularly in utero infection.
"CMV screening is an important component of a comprehensive evaluation needed for HIV-exposed infants, particularly among those born to women not on antiretrovirals during pregnancy," the authors write.
The study was supported in part by Boehringer Ingelheim Pharmaceuticals Inc. and GlaxoSmithKline on behalf of ViiV Healthcare.