Prevalence and risk factors of cytomegalovirus infection among HIV-infected and HIV-exposed uninfected infants in Nigeria.

Emmanuel Ademola Anigilaje,Joseph Othniel Dabit,Nnamdi Okechukwu Nweke,Augustine Aondohemba Agbedeh

doi:10.3855/jidc.6131

Emmanuel Ademola Anigilaje, Joseph Othniel Dabit + Show 2 more

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https://doi.org/10.3855/jidc.6131

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Abstract

Cytomegalovirus (CMV) co-infection increases morbidity and mortality in human immunodeficiency virus (HIV) disease. There has been no study on CMV infection and its risk factors among Nigerian HIV-infected and/or HIV-exposed uninfected infants. This was a cross-sectional cohort study at the Federal Medical Center, Makurdi, between January 2012 and March 2013. Acute CMV infection among consecutive three-month- old HIV-infected and HIV-exposed uninfected infants was determined using the enzyme-linked immunosorbent assay of the CMV immunoglobulin M (IgM). The relationship between acute CMV infections in the infants and the potential risk factors was tested using logistic regression analyses. The prevalence of acute CMV infection was 41.4% (91/220), including 12.1% (11/91) and 87.9% (80/91) among the HIV-infected and the HIV-exposed uninfected infants, respectively. In multivariate logistic regression analyses, oropharyngeal candidiasis in the infants, HIV co-infection in the infants, maternal mastitis during breastfeeding, and the absence of maternal chronic CMV infections significantly increased the risk of acute CMV in the young infants. In our setting, concerted efforts to prevent and/or promptly treat oropharyngeal candidiasis and mastitis during breastfeeding may reduce the burden of CMV among HIV-infected and HIV-exposed uninfected infants. Public enlightenment on the mode of CMV transmission and its prevention is also important.

Highlights

Cytomegalovirus (CMV) co-infection increases morbidity and mortality in human immunodeficiency virus (HIV) disease
Infection was 41.4% (91/220), including 12.1% (11/91) and 87.9% (80/91) for the HIV-infected and the HIVexposed uninfected (HEU) infants, respectively. These values were lower than the prevalence of 93% among HIV-infected and the 90% among the HEU Kenyan infants at three months of age found in another study [15]
Our study revealed that the presence of maternal mastitis during breastfeeding increased the risk of perinatal CMV infection in the infant by nine times

Summary

Introduction

Cytomegalovirus (CMV) co-infection increases morbidity and mortality in human immunodeficiency virus (HIV) disease. There has been no study on CMV infection and its risk factors among Nigerian HIV-infected and/or HIV-exposed uninfected infants. The relationship between acute CMV infections in the infants and the potential risk factors was tested using logistic regression analyses. Results: The prevalence of acute CMV infection was 41.4% (91/220), including 12.1% (11/91) and 87.9% (80/91) among the HIV-infected and the HIV-exposed uninfected infants, respectively. In multivariate logistic regression analyses, oropharyngeal candidiasis in the infants, HIV co-infection in the infants, maternal mastitis during breastfeeding, and the absence of maternal chronic CMV infections significantly increased the risk of acute CMV in the young infants. Conclusions: In our setting, concerted efforts to prevent and/or promptly treat oropharyngeal candidiasis and mastitis during breastfeeding may reduce the burden of CMV among HIV-infected and HIV-exposed uninfected infants. CMV infection is important because it is the main infectious cause of mental retardation, neurodevelopmental impairment, and hearing loss in children, stemming from congenital infection in utero [6,7,8,9]

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