Cytomegalovirus Disease in HIV-infected Children-A Single-Centre Clinical Experience over 23 Years

J Trop Pediatr. 2018 Jun 1;64(3):215-224. doi: 10.1093/tropej/fmx052.

Abstract

Background: Cytomegalovirus (CMV) results in significant morbidity and mortality in Human Immunodeficiency Virus (HIV)-infected individuals. There is paucity of literature on paediatric CMV disease, especially from developing countries.

Methods: A retrospective review of records of all HIV-infected children with evidence of CMV disease was done.

Results: A total of 15 children were found to have CMV disease (retinitis in all, pneumonia in two and invasive gastrointestinal disease in one). Median CD4+ T cell count and percentage at diagnosis of CMV disease was 64.5 cells/µl and 3.6%, respectively. Intravenous ganciclovir was used in patients with active CMV disease. Of the 15 children, three died while two were lost to follow-up. Symptomatic patients had poor visual outcome and almost all children who were diagnosed on active screening attained normal vision.

Conclusion: Retinitis is the most common CMV disease in HIV-infected children. Early detection by active screening and initiation of systemic ganciclovir reduces the morbidity.

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / mortality
  • Administration, Intravenous
  • Antiretroviral Therapy, Highly Active
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Child
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / mortality
  • Cytomegalovirus Infections / virology
  • Cytomegalovirus Retinitis / diagnosis
  • Cytomegalovirus Retinitis / drug therapy
  • Cytomegalovirus Retinitis / mortality
  • Cytomegalovirus Retinitis / virology
  • Female
  • Ganciclovir / administration & dosage*
  • Ganciclovir / therapeutic use
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • India / epidemiology
  • Male
  • Pneumonia, Pneumocystis / drug therapy
  • Survival Rate

Substances

  • Antiviral Agents
  • Ganciclovir