title: Incidence of CMV co-infection in HIV-positive women and their neonates in a tertiary referral centre: a cohort study.
abstract: Co-infection with CMV in HIV-positive pregnant women is associated with perinatal mother-to-child transmission (MTCT) of both viruses. This retrospective study reports on the incidence of maternal and neonatal CMV (presence of anti-CMV IgG and IgM, CMV DNA PCR and/or CMV virus isolation) in high-risk pregnancies due to maternal HIV infection, MTCT of HIV and/or CMV. One hundred and eleven maternal samples and 75 matched neonatal samples were available for HIV and subsequent CMV testing. In this cohort of HIV-positive pregnant women, 96 (86.5 %) serum samples were anti-CMV IgG positive. In nine (9.4 %) of these, anti-CMV IgM was detected, and in none of them a maternal primary CMV infection was suspected. Fifty-seven (51.8 %) maternal serum samples were tested retrospectively by CMV DNA PCR; one sample was positive (0.9 %). All matched neonates were tested for HIV by PCR in the first month of life; HIV transmission was detected in one case. In 74 (67.2 %) of neonates, CMV testing was performed. Sixty-six of these serum samples were tested retrospectively by CMV DNA PCR. Two newborns (2.7 %) showed laboratory markers for CMV infection (one by detection of CMV DNA in plasma, and one by isolation of CMV from a urine sample). In the follow-up, neither of these two showed clinical signs for active CMV disease. We discussed these findings in the light of the national official guidelines. All CMV transmissions occurred due to maternal reinfection or endogenous reactivation. This suggests the success of highly active antiretroviral therapy in preventing MTCT of HIV and CMV disease and highlights the importance of adequate care and follow-up.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany. ankereitter@googlemail.com.
authors.forename: A
authors.identifier: http://orcid.org/0000-0001-5737-3033
authors.initials: A
authors.lastname: Reitter
authors.affiliation: Division of Neonatology, Department of Pediatrics, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Buxmann
authors.affiliation: Department of Infectious Diseases, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
authors.forename: A E
authors.initials: AE
authors.lastname: Haberl
authors.affiliation: Division of Neonatology, Department of Pediatrics, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Schlösser
authors.affiliation: Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kreibich
authors.affiliation: Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany.
authors.forename: O T
authors.initials: OT
authors.lastname: Keppler
authors.affiliation: Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Berger
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D004279:DNA, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007231:Infant, Newborn; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral
keywords: Congenital CMV infection; Cytomegalovirus (CMV); Human immunodeficiency virus (HIV); Intrauterine transmission; Mother-to-child transmission (MTCT); Neonatal period; Pregnancy