Journal
AIDS
Volume 23, Issue 16, Pages 2173-2181Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e32833016e8
Keywords
acute infection; cytomegalovirus; opportunistic infection; paediatric HIV; pathogenesis
Categories
Funding
- United States National Institutes of Child Health and Disease (NICHD) [R01 HD-23412, 1. K24 HD054314]
- Medical Research Council (MRC)
- National Institutes of Health (NIH) [T32 AI007140, D43 TW000007]
- United States Public Health Service (USPHS)
- Fogarty International Center
- Office of Research on Women's Health
- IDS Foundation Elizabeth Glaser Scientist
- MRC Centre for Clinical Virology
- MRC [G0600520, MC_U137884180] Funding Source: UKRI
- Medical Research Council [MC_U137884180, G0600520] Funding Source: researchfish
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objective: Cytomegalovirus (CMV) coinfection may influence HIV-1 disease progression during infancy. Our aim was to describe the incidence of CMV infection and the kinetics of viral replication in Kenyan HIV-infected and HIV-exposed uninfected infants. Methods: HIV-1 and CMV plasma viral loads were serially measured in 20 HIV-exposed uninfected and 44 HIV-infected infants born to HIV-infected mothers. HIV-infected children were studied for the first 2 years of life, and HIV-exposed uninfected infants were studied for 1 year. Results: CMV DNA was detected frequently during the first months of life; by 3 months of age, CMV DNA was detected in 90% of HIV-exposed uninfected infants and 93% of infants who had acquired HIV-1 in utero. CMV viral loads were highest in the 1-3 monthsfollowing the first detection of virus and declined rapidly thereafter. CMV peak viral loads were significantly higher in the HIV-infected infants compared with the HIV-exposed uninfected infants (mean 3.2 versus 2.7 log(10) CMV DNA copies/ml, respectively, P=0.03). The detection of CMV DNA persisted to 7-9 months post-CMV infection in both the HIV-exposed uninfected (8/17, 47%) and HIV-infected (13/18, 72%, P=0.2) children. Among HIV-infected children, CMV DNA was detected in three of the seven (43%) surviving infants tested between 19 and 21 months post-CMV infection. Finally, a strong correlation was found between peak CMV and HIV-1 viral loads (rho=0.40, P=0.008). Conclusion: Acute CMV coinfection is common in HIV-infected Kenyan infants. HIV-1 infection was associated with impaired containment of CMV replication. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
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