title: The rationale for third trimester testing of vertical HIV transmission in neonates with CMV infection.
abstract: We report on a late-preterm neonate with severe congenital cytomegalovirus (CMV) infection, refractory to antiviral therapy with ganciclovir. Subsequent immune diagnostics led to the finding of HIV infection at day 69, even though the mother tested negative for HIV in early pregnancy. Thus, in congenital CMV infection, HIV testing should be performed to elucidate maternal HIV seroconversion during late pregnancy. Our case strongly supports third trimester screening of HIV infection acquired during pregnancy, yet recommended only for women with traditional risk factors for HIV or living in an area of high HIV prevalence.
authors.affiliation: Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. vinzenz.boos@charite.de.
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Boos
authors.affiliation: Department of Pediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Feiterna-Sperling
authors.affiliation: Department of Neuropediatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Akosua
authors.initials: A
authors.lastname: Sarpong
authors.affiliation: Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Garten
authors.affiliation: Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Cremer
authors.affiliation: Department of Obstetrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: von Weizsäcker
authors.affiliation: Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.affiliation: Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Dame
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections; D057210:Delayed Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D018445:Infectious Disease Transmission, Vertical; D015997:Neonatal Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011263:Pregnancy Trimester, Third; D013921:Thrombocytopenia; D055815:Young Adult
keywords: Cytomegalovirus; Human immunodeficiency virus; Seroconversion; Thrombocytopenia; Vertical transmission
references.citation: J Acquir Immune Defic Syndr. 2001 Apr 1;26(4):348-51
references.pmid: 11317077
references.citation: J Acquir Immune Defic Syndr. 2012 Apr 1;59(4):417-25
references.pmid: 22193774
references.citation: Pediatr Infect Dis J. 2010 Oct;29(10):915-8
references.pmid: 20431424
references.citation: J Clin Virol. 2009 Dec;46 Suppl 4:S22-6
references.pmid: 19766534
references.citation: J Trop Pediatr. 2001 Aug;47(4):208-10
references.pmid: 11523760
references.citation: Thromb Haemost. 2010 May;103(5):1016-21
references.pmid: 20216981
references.citation: J Int Assoc Physicians AIDS Care (Chic). 2012 Sep-Oct;11(5):293-5
references.pmid: 22628370
references.citation: Clin Infect Dis. 2012 Sep;55(6):877-84
references.pmid: 22675157
references.citation: Obstet Gynecol. 2015 Jun;125(6):1544-7
references.pmid: 26000543
references.citation: Clin Infect Dis. 2014 Mar;58(5):728-35
references.pmid: 24265360
references.citation: J Clin Virol. 2008 Feb;41(2):152-3
references.pmid: 18055251
references.citation: J Infect Dis. 2008 Mar 15;197(6):836-45
references.pmid: 18279073
references.citation: Rev Med Virol. 2007 Jul-Aug;17(4):253-76
references.pmid: 17579921
references.citation: PLoS One. 2014 Dec 26;9(12):e115014
references.pmid: 25542035
references.citation: MMWR Recomm Rep. 2006 Sep 22;55(RR-14):1-17; quiz CE1-4
references.pmid: 16988643