Congenital and perinatal cytomegalovirus infection in infants born to mothers infected with human immunodeficiency virus
Congenital and perinatal cytomegalovirus infection in infants born to mothers infected with human immunodeficiency virus
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DOI：
10.1016/s0022-3476(98)70446-9
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发表时间：
1998-02-01
影响因子：
5.1
通讯作者：
Duarte, G
中科院分区：
文献类型：
--
作者：
Mussi-Pinhata, MM;Yamamoto, AY;Duarte, G
目的：确定在CMV免疫的低收入人群中，感染HIV的母亲所生婴儿与未感染HIV的母亲所生婴儿的先天性和围产期巨细胞病毒（CMV）感染率。研究设计：共有325名新生儿来自巨细胞病毒血清阳性的母亲，并评估先天性巨细胞病毒感染（150名来自HIV阳性母亲，175名来自HIV阴性母亲）。共有101名HIV阳性母亲的婴儿和33名HIV阴性母亲的婴儿被评估围产期巨细胞病毒感染。该病毒通过培养人成纤维细胞从尿液中分离出来，并在出生时、15天和12周龄时用聚合酶链反应检测。结果：在150名HIV阳性母亲中，仅有13名（8.7%）患有艾滋病定义疾病，且无晚期HIV感染。150名HIV阳性母亲的婴儿中有4名（2.7%）检测到先天性巨细胞病毒感染，175名HIV阴性母亲的婴儿中有5名（2.9%）检测到先天性巨细胞病毒感染（p = 1.00）。101名HIV阳性母亲的婴儿中有8名（7.9%）被诊断为围产期巨细胞病毒感染，33名HIV阴性母亲的婴儿中有13名（39.4%）被诊断为围产期巨细胞病毒感染（p < 0.00001）。大多数艾滋病毒母亲所生婴儿（93.3%）是母乳喂养的，只有5.9%的艾滋病毒阳性母亲所生婴儿是母乳喂养的。结论：CMV免疫人群中无晚期HIV疾病的母亲合并CMV感染不会增加先天性CMV感染的可能性。通过避免母乳喂养可以减少感染艾滋病毒的母亲的围产期巨细胞病毒传播。需要对感染艾滋病毒晚期的母亲进行进一步的研究。
Objectives: To determine the rates of congenital and perinatal cytomegalovirus (CMV) infection among infants born to mothers infected with HIV compared with infants born to mothers not infected with HIV from a CMV-immune, low-income population.Study design: A total of 325 newborns from CMV-seropositive mothers were enrolled and evaluated for congenital CMV infection (150 infants from HIV+ mothers and 175 infants from HIV- mothers. A total of 101 infants from HIV+ mothers and 33 infants from HIV- mothers were evaluated for perinatal CMV infection. The virus was isolated from urine by culture in human fibroblasts and was detected by polymerase chain reaction at birth and at 15 days and 12 weeks of age.Results: Only 13 of 150 HIV+ mothers (8.7%) had an AIDS-defining condition, and none had a late-stage HIV infection. Congenital CMV infection was detected in 4 of 150 (2.7%) infants from HIV+ mothers and in 5 of 175 (2.9%) infants from HIV- mothers (p = 1.00). Perinatal CMV infection was diagnosed in 8 of 101 (7.9%) infants from HIV+ mothers and in 13 of 33 (39.4%) infants from HIV- mothers (p < 0.00001). Most infants (93.3%) from HIV- mothers and only 5.9% of infants from HIV+ mothers were breastfed.Conclusions: CMV coinfection in mothers without advanced HIV disease from a CMV-immune population does not enhance the likelihood of congenital CMV infection. Perinatal CMV transmission from HIV-infected mothers may be decreased by avoiding breastfeeding. Further studies on mothers with late-stage HIV infection are needed.