Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants.
<h4>Background</h4>HIV-infected infants in sub-Saharan Africa have rapid disease progression. We hypothesized that co-infection with cytomegalovirus (CMV) or Epstein Barr virus (EBV) increases mortality in HIV-infected infants.<h4>Methods</h4>257 antiretroviral therapy-naïve...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0114870 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849726498069544960 |
|---|---|
| author | Hlanai Gumbo Bernard Chasekwa James A Church Robert Ntozini Kuda Mutasa Jean H Humphrey Andrew J Prendergast |
| author_facet | Hlanai Gumbo Bernard Chasekwa James A Church Robert Ntozini Kuda Mutasa Jean H Humphrey Andrew J Prendergast |
| author_sort | Hlanai Gumbo |
| collection | DOAJ |
| description | <h4>Background</h4>HIV-infected infants in sub-Saharan Africa have rapid disease progression. We hypothesized that co-infection with cytomegalovirus (CMV) or Epstein Barr virus (EBV) increases mortality in HIV-infected infants.<h4>Methods</h4>257 antiretroviral therapy-naïve HIV-infected Zimbabwean infants were tested for CMV and EBV at 6 weeks of age by real-time PCR; if positive, birth samples were retrieved where available to distinguish congenital and postnatal infection. The impact of co-infection on mortality through 6 months was estimated using Kaplan-Meier and Cox proportional hazards methods.<h4>Results</h4>At 6 weeks, 203/257 (79%) HIV-infected infants were CMV-positive; 27 (11%) had congenital CMV, 108 (42%) postnatal CMV and 68 (26%) indeterminate timing of infection. By 6 months, 37/108 (34%) infants with postnatal CMV versus 16/54 (30%) CMV-negative infants died (adjusted hazard ratio (aHR) 1.1 [95%CI 0.6, 2.2]). At 6 weeks, 33/257 (13%) HIV-infected infants had EBV co-infection; 6 (2%) had congenital EBV, 18 (7%) postnatal EBV and 9 (4%) indeterminate timing of infection. By 6 months, 5/18 (28%) infants with postnatal EBV versus 72/224 (32%) EBV-negative infants died (aHR 0.8 [95%CI 0.3, 2.3]).<h4>Conclusions</h4>The vast majority of HIV-infants had acquired CMV by 6 weeks, and EBV co-infection occurred earlier than expected, with one in eight HIV-infected infants positive for EBV by 6 weeks. There was a high prevalence of congenital CMV infection and we identified 6 infants with congenital EBV infection, which has not previously been reported in Africa or in the context of HIV infection. Neither CMV nor EBV co-infection was associated with increased mortality. |
| format | Article |
| id | doaj-art-e5be80aa902d4387875acec0b9ea6c5e |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-e5be80aa902d4387875acec0b9ea6c5e2025-08-20T03:10:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11487010.1371/journal.pone.0114870Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants.Hlanai GumboBernard ChasekwaJames A ChurchRobert NtoziniKuda MutasaJean H HumphreyAndrew J Prendergast<h4>Background</h4>HIV-infected infants in sub-Saharan Africa have rapid disease progression. We hypothesized that co-infection with cytomegalovirus (CMV) or Epstein Barr virus (EBV) increases mortality in HIV-infected infants.<h4>Methods</h4>257 antiretroviral therapy-naïve HIV-infected Zimbabwean infants were tested for CMV and EBV at 6 weeks of age by real-time PCR; if positive, birth samples were retrieved where available to distinguish congenital and postnatal infection. The impact of co-infection on mortality through 6 months was estimated using Kaplan-Meier and Cox proportional hazards methods.<h4>Results</h4>At 6 weeks, 203/257 (79%) HIV-infected infants were CMV-positive; 27 (11%) had congenital CMV, 108 (42%) postnatal CMV and 68 (26%) indeterminate timing of infection. By 6 months, 37/108 (34%) infants with postnatal CMV versus 16/54 (30%) CMV-negative infants died (adjusted hazard ratio (aHR) 1.1 [95%CI 0.6, 2.2]). At 6 weeks, 33/257 (13%) HIV-infected infants had EBV co-infection; 6 (2%) had congenital EBV, 18 (7%) postnatal EBV and 9 (4%) indeterminate timing of infection. By 6 months, 5/18 (28%) infants with postnatal EBV versus 72/224 (32%) EBV-negative infants died (aHR 0.8 [95%CI 0.3, 2.3]).<h4>Conclusions</h4>The vast majority of HIV-infants had acquired CMV by 6 weeks, and EBV co-infection occurred earlier than expected, with one in eight HIV-infected infants positive for EBV by 6 weeks. There was a high prevalence of congenital CMV infection and we identified 6 infants with congenital EBV infection, which has not previously been reported in Africa or in the context of HIV infection. Neither CMV nor EBV co-infection was associated with increased mortality.https://doi.org/10.1371/journal.pone.0114870 |
| spellingShingle | Hlanai Gumbo Bernard Chasekwa James A Church Robert Ntozini Kuda Mutasa Jean H Humphrey Andrew J Prendergast Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. PLoS ONE |
| title | Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. |
| title_full | Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. |
| title_fullStr | Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. |
| title_full_unstemmed | Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. |
| title_short | Congenital and postnatal CMV and EBV acquisition in HIV-infected Zimbabwean infants. |
| title_sort | congenital and postnatal cmv and ebv acquisition in hiv infected zimbabwean infants |
| url | https://doi.org/10.1371/journal.pone.0114870 |
| work_keys_str_mv | AT hlanaigumbo congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT bernardchasekwa congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT jamesachurch congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT robertntozini congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT kudamutasa congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT jeanhhumphrey congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants AT andrewjprendergast congenitalandpostnatalcmvandebvacquisitioninhivinfectedzimbabweaninfants |