Document Detail


Congenital cytomegalovirus infection in infants infected with human immunodeficiency virus type 1.
MedLine Citation:
PMID:  8970220     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the rate of in utero transmission of cytomegalovirus (CMV) in perinatally HIV-exposed infants and to determine whether coinfection with CMV in early life affects outcome. METHODS: Infants born to HIV-infected women between March, 1988, and March, 1995, were evaluated (n = 206). Congenital or in utero CMV infection was defined as a positive CMV culture or shell vial assay on urine obtained in the first 3 weeks of life. HIV-infected infants either had positive serology beyond 18 months of age or, for an infant younger than 18 months, had a positive HIV PCR or HIV culture on at least two separate occasions. RESULTS: There were 30 HIV-infected and 171 uninfected infants (144 who seroreverted and 27 infants with at least 2 negative HIV PCR or culture results and normal immunologic studies during the first 6 months of age). Urine culture for CMV was obtained during the first 3 weeks of life on 154 infants: 24 of 30 (80%) HIV-infected infants; and 130 of 171 (76%) HIV-uninfected infants. Overall 10 of 154 (6.5%) infants were infected with CMV: 5 of 24 (21%) HIV-infected and 5 of 130 (3.8%) HIV-uninfected infants. The rate of in utero CMV infection was significantly higher in HIV-infected infants (P = 0.008). Dually infected infants were more immunosuppressed than their CMV-negative counterparts. At 3 months of age the percentage of CD4+ T lymphocytes (P = 0.0021) and CD4:CD8 ratios (P = 0.0018) were significantly lower in the CMV-infected infants than in the CMV-uninfected infants. At 6 months of age the absolute CD4+ T lymphocyte counts (P = 0.0038), percentage of CD4+ T lymphocytes (P = 0.044) and CD4:CD8 ratios (P = 0.037) were significantly lower in the CMV-infected infants. The mean survival of HIV-infected infants who were coinfected with CMV in early life (5 in utero and 1 perinatally infected infant identified at 7 weeks) was 24.77 months. Kaplan-Meier survival analysis indicated a trend toward decreased survival in the infants who were coinfected with CMV in early life (P = 0.088). CONCLUSIONS: Congenital CMV infection is more common in HIV-infected infants than in HIV-uninfected infants. Infection with CMV in early life is associated with greater immunosuppression and may be associated with a more rapid progression of HIV infection in infants.
Authors:
M Doyle; J T Atkins; I R Rivera-Matos
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  15     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-03-19     Completed Date:  1997-03-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1102-6     Citation Subset:  IM; X    
Affiliation:
Department of Pediatrics, University of Texas-Houston Medical School, Houston, USA.
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections* / complications,  immunology
CD4-CD8 Ratio
CD4-Positive T-Lymphocytes
Cytomegalovirus / immunology*,  isolation & purification
Cytomegalovirus Infections / complications,  congenital*,  epidemiology*,  immunology
Female
HIV-1 / immunology*
Humans
Incidence
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical
Male
Prognosis
Reference Values
Risk Factors
Survival Rate
Grant Support
ID/Acronym/Agency:
A127551//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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