High Rates of Congenital Cytomegalovirus Infection Linked With Maternal HIV Infection Among Neonatal Admissions at a Large Referral Center in sub-Saharan Africa

Clin Infect Dis. 2014 Mar;58(5):728-35. doi: 10.1093/cid/cit766. Epub 2013 Nov 21.

Abstract

Background: Congenital cytomegalovirus (CMV) infection is the major infectious cause of birth defects and hearing loss globally. There is a growing recognition of the potential clinical impact of congenital CMV infections in high-seroprevalence settings.

Methods: A cross-sectional study of neonatal admissions at a large referral center in sub-Saharan Africa to determine the prevalence of both symptomatic and asymptomatic congenital CMV infection was performed. Real-time polymerase chain reaction was used to screen DNA-extracted sera, urine, and saliva, and an enzyme-linked immunosorbent assay was used to screen serum samples for anti-CMV immunoglobulin M. Multivariate binary logistic regression was used to identify risk factors associated with increased odds of congenital CMV infection.

Results: Congenital CMV was detected in 3.8% (15/395) of neonates. Among these infants, 6 of 15 (40%) presented with jaundice, 1 of whom also had petechiae. Congenital CMV infection was detected in 9 of 79 (11.4%; 95% confidence interval [CI], 6.1%-20.3%) neonates born to human immunodeficiency virus (HIV)-infected mothers, and both maternal HIV (odds ratio [OR], 6.661 [95% CI, 2.126-20.876], P = .001) and jaundice (OR, 5.701 [95% CI, 1.776-18.306], P = .003) were independently linked with significantly increased odds of congenital CMV infection.

Conclusions: Congenital and early infant CMV infections may have important consequences for child health in sub-Saharan Africa and other high HIV and CMV seroprevalence populations globally.

Keywords: Africa; CMV; HIV; congenital; neonate.

Publication types

  • Observational Study

MeSH terms

  • Africa South of the Sahara
  • Antibodies, Viral / blood
  • Cross-Sectional Studies
  • Cytomegalovirus Infections / congenital*
  • Cytomegalovirus Infections / epidemiology*
  • DNA, Viral / analysis
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections / complications*
  • Hospitalization* / statistics & numerical data
  • Humans
  • Immunoglobulin M / blood
  • Infant, Newborn
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Prevalence
  • Real-Time Polymerase Chain Reaction
  • Risk Factors
  • Saliva / virology
  • Serum / virology
  • Tertiary Care Centers
  • Urine / virology

Substances

  • Antibodies, Viral
  • DNA, Viral
  • Immunoglobulin M