title: Ongoing burden of disease and mortality from HIV/CMV coinfection in Africa in the antiretroviral therapy era.
abstract: Human Cytomegalovirus (CMV) is a well-recognized pathogen in the context of HIV infection, but since the roll out of ART, clinical and scientific interest in the problem of HIV/CMV coinfection has diminished. However, CMV remains a significant cofactor in HIV disease, with an influence on HIV acquisition, disease progression, morbidity, and mortality. Disease manifestations may be a result of direct interplay between the two viruses, or may arise as a secondary consequence of immune dysregulation and systemic inflammation. The problem is most relevant when the rates of coinfection are high, most notably in sub-Saharan Africa, and in children at risk of acquiring both infections early in life. Understanding the interplay between these viruses and developing strategies to diagnose, treat and prevent CMV should be a priority.
authors.affiliation: Department of Paediatrics, Peter Medawar Building for Pathogen Research, University of Oxford Oxford, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Adland
authors.affiliation: Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, University of Oxford Oxford, UK ; Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust Oxford, UK ; National Institute for Health Research Biomedical Research Centre Oxford, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Klenerman
authors.affiliation: Department of Paediatrics, Peter Medawar Building for Pathogen Research, University of Oxford Oxford, UK ; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal Durban, South Africa.
authors.forename: Philip
authors.initials: P
authors.lastname: Goulder
authors.affiliation: Nuffield Department of Medicine, Peter Medawar Building for Pathogen Research, University of Oxford Oxford, UK ; Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust Oxford, UK.
authors.forename: Philippa C
authors.initials: PC
authors.lastname: Matthews
keywords: CMV; HIV-1; antiretroviral therapy; coinfection; immune activation; pediatric infectious diseases; sub-Saharan Africa