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The impact of maternal HIV and malaria infection on the prevalence of congenital cytomegalovirus infection in Western Kenya.
Journal of Clinical Virology ( IF 4.0 ) Pub Date : 2019-09-17 , DOI: 10.1016/j.jcv.2019.09.007
Nancy A Otieno 1 , Bryan O Nyawanda 1 , Fredrick Otiato 1 , Martina Oneko 1 , Minal M Amin 2 , Michael Otieno 1 , Daniel Omollo 1 , Meredith McMorrow 3 , Sandra S Chaves 4 , Sheila C Dollard 2 , Tatiana M Lanzieri 2
Affiliation  

BACKGROUND Data on congenital cytomegalovirus (CMV) infection in Africa are limited. OBJECTIVE To describe the prevalence of congenital CMV infection in a population with high prevalence of maternal HIV and malaria infection in western Kenya. STUDY DESIGN We screened newborns for CMV by polymerase chain reaction assay of saliva swabs and dried blood spots (DBS), and assessed maternal CMV immunoglobulin G (IgG) status by testing serum eluted from newborn's DBS. We calculated adjusted prevalence ratios (aPRs) using log-binomial regression models. RESULTS Among 1066 mothers, 210 (19·7%) had HIV infection and 207 (19·4%) had malaria infection; 33 (3·1%) mothers had both. Maternal CMV IgG prevalence was 93·1% (95% confidence interval [CI]: 88·3%-96·0%). Among 1078 newborns (12 sets of twins), 39 (3·6%, 95% CI: 2·7-4·9%) were CMV positive. The prevalence of congenital CMV infection by maternal HIV and malaria infection status was 5·0% (95% CI: 2·7-9·2%) for HIV only, 5·1% (95% CI: 2·7-9·4%) for malaria only, 8·8 (95% CI: 3·1-23·0) for HIV and malaria co-infection, and 2·6% (95% CI: 1·7-4·1%) for none. Congenital CMV infection was independently associated with maternal HIV infection (aPR=2·1; 95% CI: 1·0-4·2), adjusting for maternal age, parity, and malaria infection. CONCLUSIONS The prevalence of congenital CMV infection was higher than the 0·2-0·7% in developed countries. Maternal HIV infection may increase the risk of congenital CMV infection, but the role of maternal malaria on intrauterine transmission of CMV remains unclear.

中文翻译:

肯尼亚西部母亲艾滋病毒和疟疾感染对先天性巨细胞病毒感染率的影响。

背景技术关于非洲先天性巨细胞病毒(CMV)感染的数据有限。目的描述肯尼亚西部母亲艾滋病毒和疟疾感染高发人群中先天性巨细胞病毒感染的流行情况。研究设计我们通过唾液拭子和干血斑(DBS)的聚合酶链反应分析筛选了新生儿的CMV,并通过测试从新生儿DBS洗脱的血清来评估母体CMV免疫球蛋白G(IgG)的状态。我们使用对数二项式回归模型计算了调整后的患病率(aPRs)。结果在1066名母亲中,有210名(19·7%)感染了艾滋病毒,207名(19·4%)患有疟疾。两者都有33名(3·1%)母亲。孕妇CMV IgG患病率为93·1%(95%置信区间[CI]:88·3%-96·0%)。在1078例新生儿(12对双胞胎)中,有39例(3·6%,95%CI:2·7-4·9%)是CMV阳性。母体艾滋病毒和疟疾感染状况导致的先天性巨细胞病毒感染的发生率,仅艾滋病毒为5·0%(95%CI:2·7-9·2%),5·1%(95%CI:2·7-9) ·仅针对疟疾·4%),针对HIV和疟疾共感染的8·8(95%CI:3·1-23·0)和2·6%(95%CI:1·7-4·1%) )。先天性巨细胞病毒感染与母体HIV感染独立相关(aPR = 2·1; 95%CI:1·0-4·2),并根据母体年龄,胎次和疟疾感染进行了调整。结论在发达国家,先天性巨细胞病毒感染的发生率高于0·2-0·7%。孕妇艾滋病毒感染可能会增加先天性巨细胞病毒感染的风险,但是,母源性疟疾在子宫内巨细胞病毒传播中的作用仍不清楚。(2·7-9·4%)仅针对疟疾,8·8(95%CI:3·1-23·0)对于HIV和疟疾共感染,以及2·6%(95%CI:1·7) -4·1%)。先天性巨细胞病毒感染与母体HIV感染独立相关(aPR = 2·1; 95%CI:1·0-4·2),并根据母体年龄,胎次和疟疾感染进行了调整。结论在发达国家,先天性巨细胞病毒感染的发生率高于0·2-0·7%。孕妇艾滋病毒感染可能会增加先天性巨细胞病毒感染的风险,但是,母源性疟疾在子宫内巨细胞病毒传播中的作用仍不清楚。(2·7-9·4%)仅针对疟疾,8·8(95%CI:3·1-23·0)对于HIV和疟疾共感染,以及2·6%(95%CI:1·7) -4·1%)。先天性巨细胞病毒感染与母体HIV感染独立相关(aPR = 2·1; 95%CI:1·0-4·2),并根据母体年龄,胎次和疟疾感染进行了调整。结论在发达国家,先天性巨细胞病毒感染的发生率高于0·2-0·7%。孕妇艾滋病毒感染可能会增加先天性巨细胞病毒感染的风险,但是,母源性疟疾在子宫内巨细胞病毒传播中的作用仍不清楚。结论在发达国家,先天性巨细胞病毒感染的发生率高于0·2-0·7%。孕妇艾滋病毒感染可能会增加先天性巨细胞病毒感染的风险,但是,母源性疟疾在子宫内巨细胞病毒传播中的作用仍不清楚。结论在发达国家,先天性巨细胞病毒感染的发生率高于0·2-0·7%。孕妇艾滋病毒感染可能会增加先天性巨细胞病毒感染的风险,但是,母源性疟疾在子宫内巨细胞病毒传播中的作用仍不清楚。
更新日期:2019-11-01
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