title: Cytomegalovirus Infection in Human Immunodeficiency Virus (HIV)-Exposed and HIV-Infected Infants: A Systematic Review.
abstract: Cytomegalovirus is highly prevalent worldwide and an important opportunistic pathogen in human immunodeficiency virus (HIV)-infected individuals. The effects of cytomegalovirus infection on HIV-exposed infants are poorly understood. We conducted a systematic review to assess the relationship between cytomegalovirus and HIV infections among HIV-exposed infants. Limited evidence suggests that HIV-induced immunosuppression in the mother increases the rate of congenital cytomegalovirus infection, while maternal antiretroviral therapy may reduce it. Limited information exists on the direction of the relationship between cytomegalovirus and HIV transmission among HIV-exposed infants. Only 2 studies have addressed this temporal sequence of events, and they suggest that cytomegalovirus can lead to subsequent HIV infection in HIV-exposed infants. Most evidence suggests that early cytomegalovirus infection accelerates HIV disease progression in infants. Gaps remain in understanding the role that cytomegalovirus infection plays in HIV-exposed infants. Decreasing cytomegalovirus transmission prenatally and in infancy might further decrease HIV transmission and lead to better health among HIV-exposed infants.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Sascha R
authors.initials: SR
authors.lastname: Ellington
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kristie E N
authors.initials: KE
authors.lastname: Clarke
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
mesh_terms: D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy
keywords: HIV; HIV-exposed infant; cytomegalovirus; mother-to-child transmission