Details

Autor(en) / Beteiligte

• Adachi, Kristina
• Xu, Jiahong
• Ank, Bonnie
• Watts, D. Heather
• Mofenson, Lynne M.
• Pilotto, Jose Henrique
• Joao, Esau
• Santos, Breno
• Fonseca, Rosana
• Kreitchmann, Regis
• Pinto, Jorge
• Mussi-Pinhata, Marisa M.
• Gray, Glenda
• Theron, Gerhard
• Morgado, Mariza G.
• Bryson, Yvonne J.
• Veloso, Valdilea G.
• Klausner, Jeffrey D.
• Moye, Jack
• Nielsen-Saines, Karin

Titel

Cytomegalovirus Urinary Shedding in HIV-infected Pregnant Women and Congenital Cytomegalovirus Infection

Ist Teil von

• Clinical infectious diseases, 2017-08, Vol.65 (3), p.405-413

Ort / Verlag

United States: Oxford University Press

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Cytomegalovirus (CMV) urinary shedding in pregnant women infected with human immunodeficiency virus (HIV) was evaluated to determine whether it poses an increased risk for congenital CMV infection (cCMV). Methods. A subset of mother-infant pairs enrolled in the perinatal NICHD HPTN 040 study (distinguished by no antiretroviral use before labor) was evaluated. Maternal and infant urines were tested by qualitative real-time polymerase chain reaction (RT-PCR) for CMV DNA with quantitative RT-PCR performed on positive specimens. Results. Urine specimens were available for 260 women with 85.4% from the Americas and 14.6% from South Africa. Twenty-four women (9.2%) had detectable CMV viruria by qualitative PCR. Maternal CMV viruria was not associated with mean CD4 cell counts or HIV viral load but was associated with younger maternal age (P = .02). Overall, 10 of 260 infants (3.8%) had cCMV. Women with detectable peripartum CMV viruria were more likely to have infants with cCMV than those without: 20.8% (5/24) versus 2.1% (5/236), (P = .0001). Women with CMV viruria had significantly higher rates of HIV perinatal transmission (29.2% vs. 8.1%, P= .002). They were 5 times (adjusted odds ratio [aOR] = 5.6, 95% confidence interval [CI] 1.9–16.8) and nearly 30 times (aOR, 29.7; 95% CI, 5.4–164.2) more likely to transmit HIV and CMV to their infants, respectively. Maternal gonorrhea (aOR, 19.5; 95% CI, 2.5–151.3) and higher maternal HIV log10 viral load (OR, 2.8; 95% CI, 1.3–6.3) were also significant risk factors for cCMV. Conclusion. In this cohort of HIV-infected pregnant women not on antiretrovirals, urinary CMV shedding was a significant risk factor for CMV and HIV transmission to infants. Clinical Trials Registration Number. NCT00099359.