Document Detail


Birth Prevalence of Congenital CMV among Infants of HIV-infected Women on Prenatal Antiretroviral Prophylaxis in South Africa.
MedLine Citation:
PMID:  24567248     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. A high rate of congenital CMV has been documented in HIV exposed infants in industrialized settings, both in pre- and post-HAART era. Only limited data on the birth prevalence of congenital CMV among infants of HIV-infected women on prenatal antiretroviral (ARV) prophylaxis are available from sub-Saharan Africa, despite a high prevalence of both infections. We evaluated the prevalence of congenital CMV in HIV-exposed infants in the Western Cape, South Africa. Methods. HIV-infected mothers were recruited in the immediate postnatal period at a referral maternity hospital between April and October 2012. Maternal and infant clinical data and newborn saliva swabs were collected. Saliva swabs were assayed by real-time PCR for CMV. Data were analyzed using univariate and multivariate logistic regression analyses to determine specific demographic, maternal and newborn characteristics associated with congenital CMV. Results. CMV was detected in 22/748 newborn saliva swabs (2.9%; 95% CI, 1. 9-4.4%). Overall, 96% of mothers used prenatal ARV prophylaxis (prenatal AZT 43.9%, HAART 52.1%). Maternal age, gestational age, prematurity (< 37 weeks gestation), type of ARV prophylaxis, length of ARV prophylaxis, birth weight, small for gestational age and infant feeding choice were not significantly different between CMV-infected and uninfected infants. Maternal CD4 count less than 200 cells/μL during pregnancy was independently associated with congenital CMV (aOR 2.9; 95% CI, 1.2-7.3). A negative correlation between CMV viral load in saliva and maternal CD4 count was observed (r=-0.495, n=22, p=0.019). Conclusions. The birth prevalence of congenital CMV was high despite prenatal ARV prophylaxis, and was associated with advanced maternal immunosuppression.
Authors:
S Manicklal; A M van Niekerk; S M Kroon; C Hutto; Z Novak; Sunil K Pati; Nazma Chowdhury; N Y Hsiao; S B Boppana
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-23
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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