The impact of maternal HIV and malaria infection on the prevalence of congenital cytomegalovirus infection in Western Kenya.
Antibodies, Viral
/ blood
Coinfection
/ epidemiology
Cytomegalovirus
/ genetics
Cytomegalovirus Infections
/ congenital
DNA, Viral
/ analysis
Female
HIV Infections
/ epidemiology
Humans
Infant, Newborn
Kenya
/ epidemiology
Logistic Models
Malaria
/ epidemiology
Maternal Age
Pregnancy
Pregnancy Complications, Infectious
/ epidemiology
Prevalence
Young Adult
Cytomegalovirus
HIV infections
Kenya
Malaria
Prevalence
Journal
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
ISSN: 1873-5967
Titre abrégé: J Clin Virol
Pays: Netherlands
ID NLM: 9815671
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
29
01
2019
revised:
21
08
2019
accepted:
15
09
2019
pubmed:
24
9
2019
medline:
20
6
2020
entrez:
24
9
2019
Statut:
ppublish
Résumé
Data on congenital cytomegalovirus (CMV) infection in Africa are limited. To describe the prevalence of congenital CMV infection in a population with high prevalence of maternal HIV and malaria infection in western Kenya. We screened newborns for CMV by polymerase chain reaction assay of saliva swabs and dried blood spots (DBS), and assessed maternal CMV immunoglobulin G (IgG) status by testing serum eluted from newborn's DBS. We calculated adjusted prevalence ratios (aPRs) using log-binomial regression models. Among 1066 mothers, 210 (19·7%) had HIV infection and 207 (19·4%) had malaria infection; 33 (3·1%) mothers had both. Maternal CMV IgG prevalence was 93·1% (95% confidence interval [CI]: 88·3%-96·0%). Among 1078 newborns (12 sets of twins), 39 (3·6%, 95% CI: 2·7-4·9%) were CMV positive. The prevalence of congenital CMV infection by maternal HIV and malaria infection status was 5·0% (95% CI: 2·7-9·2%) for HIV only, 5·1% (95% CI: 2·7-9·4%) for malaria only, 8·8 (95% CI: 3·1-23·0) for HIV and malaria co-infection, and 2·6% (95% CI: 1·7-4·1%) for none. Congenital CMV infection was independently associated with maternal HIV infection (aPR=2·1; 95% CI: 1·0-4·2), adjusting for maternal age, parity, and malaria infection. The prevalence of congenital CMV infection was higher than the 0·2-0·7% in developed countries. Maternal HIV infection may increase the risk of congenital CMV infection, but the role of maternal malaria on intrauterine transmission of CMV remains unclear.
Sections du résumé
BACKGROUND
Data on congenital cytomegalovirus (CMV) infection in Africa are limited.
OBJECTIVE
To describe the prevalence of congenital CMV infection in a population with high prevalence of maternal HIV and malaria infection in western Kenya.
STUDY DESIGN
We screened newborns for CMV by polymerase chain reaction assay of saliva swabs and dried blood spots (DBS), and assessed maternal CMV immunoglobulin G (IgG) status by testing serum eluted from newborn's DBS. We calculated adjusted prevalence ratios (aPRs) using log-binomial regression models.
RESULTS
Among 1066 mothers, 210 (19·7%) had HIV infection and 207 (19·4%) had malaria infection; 33 (3·1%) mothers had both. Maternal CMV IgG prevalence was 93·1% (95% confidence interval [CI]: 88·3%-96·0%). Among 1078 newborns (12 sets of twins), 39 (3·6%, 95% CI: 2·7-4·9%) were CMV positive. The prevalence of congenital CMV infection by maternal HIV and malaria infection status was 5·0% (95% CI: 2·7-9·2%) for HIV only, 5·1% (95% CI: 2·7-9·4%) for malaria only, 8·8 (95% CI: 3·1-23·0) for HIV and malaria co-infection, and 2·6% (95% CI: 1·7-4·1%) for none. Congenital CMV infection was independently associated with maternal HIV infection (aPR=2·1; 95% CI: 1·0-4·2), adjusting for maternal age, parity, and malaria infection.
CONCLUSIONS
The prevalence of congenital CMV infection was higher than the 0·2-0·7% in developed countries. Maternal HIV infection may increase the risk of congenital CMV infection, but the role of maternal malaria on intrauterine transmission of CMV remains unclear.
Identifiants
pubmed: 31546088
pii: S1386-6532(19)30212-4
doi: 10.1016/j.jcv.2019.09.007
pmc: PMC6815230
mid: NIHMS1052390
pii:
doi:
Substances chimiques
Antibodies, Viral
0
DNA, Viral
0
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
33-37Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Informations de copyright
Published by Elsevier B.V.
Références
Pediatr Infect Dis J. 2015 Mar;34(3):322-4
pubmed: 25742080
J Clin Virol. 2011 Nov;52(3):244-6
pubmed: 21820954
Clin Infect Dis. 2014 May;58(10):1467-72
pubmed: 24567248
JAMA. 2010 Apr 14;303(14):1375-82
pubmed: 20388893
Clin Infect Dis. 2009 Jun 1;48(11):1516-25
pubmed: 19388872
Infect Dis Obstet Gynecol. 2014;2014:989721
pubmed: 24723745
Arch Dis Child. 1978 Jul;53(7):536-9
pubmed: 210722
Pediatrics. 2014 Nov;134(5):972-82
pubmed: 25349318
Int J Infect Dis. 2014 May;22:44-8
pubmed: 24631522
J Med Virol. 2016 Jun;88(6):1051-8
pubmed: 26519647
Clin Infect Dis. 2014 Mar;58(5):728-35
pubmed: 24265360
PLoS One. 2014 Feb 04;9(2):e87855
pubmed: 24504006
PLoS Med. 2017 May 2;14(5):e1002290
pubmed: 28463996
Pediatr Infect Dis J. 2018 Oct;37(10):1016-1021
pubmed: 30216294
AIDS. 2015 Apr 24;29(7):831-6
pubmed: 25985405
Int J Epidemiol. 2006 Oct;35(5):1322-8
pubmed: 16543363
Lancet Infect Dis. 2018 Apr;18(4):e107-e118
pubmed: 29396010
AIDS. 2009 Oct 23;23(16):2173-81
pubmed: 19617812
Pediatr Infect Dis J. 1992 Feb;11(2):93-9
pubmed: 1311066
J Pediatric Infect Dis Soc. 2019 Jul 1;8(3):205-212
pubmed: 29554325
AIDS Res Hum Retroviruses. 2018 Jun;34(6):527-535
pubmed: 29620934
PLoS One. 2007 Jun 06;2(6):e492
pubmed: 17551573
J Matern Fetal Neonatal Med. 2016 Nov;29(21):3439-44
pubmed: 26689083
Ultrasound Obstet Gynecol. 2009 Oct;34(4):379-86
pubmed: 19402076