| The Effect of Prenatal Highly Active Antiretroviral Therapy (HAART) on the Transmission of Congenital and Perinatal/Early Postnatal Cytomegalovirus (CMV) Among HIV-Infected and Exposed Infants. | |
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MedLine Citation:
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PMID: 22675157 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background. Before highly active antiretroviral therapy (HAART), congenital CMV rates were higher among HIV-exposed infants compared to unexposed infants. This study examines congenital and perinatal/early postnatal (P/EP) CMV rates among HIVexposed infants before and after HAART.Methods. Infants born to HIV-infected women were evaluated for congenital CMV infection (CMV+ culture in the first 3 weeks of life) and P/EP CMV (positive culture in first 6 months of life). Prenatal maternal HAART was defined as triple antiretroviral therapy (ART) with at least one non-nucleoside or protease inhibitor.Results. Among 414 infants evaluated within the first 6 months of life, 1678 CMV assessment days were completed (mean = 3 assessment days/child). Congenital CMV rates did not differ by time period, HAART use or infant HIV infection status. P/EP CMV rates were greater for birth cohort 1988-1996 (17.9%) compared to 1997-2002 (8.9%) (P < .01), infants HIV-infected vs uninfected (P < .01), and infants with no maternal ART vs those with ART (P < .01). Controlling for potential confounders, P/EP CMV was associated with no maternal ART (OR = 4.7, P < .01) and among those with no maternal ART, P/EP CMV was associated with mothers CD4 count ≤200 cells/mm(3) (P < .01). For HIV-uninfected infants with P/EP CMV, symptoms including splenomegaly, lymphadenopathy and hepatomegaly were greater in those with no maternal HAART vs those with HAART (41% vs 6%, P < .05).Conclusions. While congenital CMV rates did not change, the post HAART era showed reduced perinatal/early postnatal CMV and occurrence of related clinical symptoms. These findings underscore the importance of prenatal HAART for all HIV-infected pregnant women. |
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Authors:
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Toni Frederick; James Homans; Lashonda Spencer; Francoise Kramer; Alice Stek; Eva Operskalski; Andrea Kovacs |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-6 |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: - ISSN: 1537-6591 ISO Abbreviation: - Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-6-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Dept. of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California 90033. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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