| Autor: |
Adachi, Kristina, Jiahong Xu, 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 |
| Předmět: |
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| Zdroj: |
Clinical Infectious Diseases; 8/1/2017, Vol. 65 Issue 3, p405-413, 9p, 1 Diagram, 3 Charts |
| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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