Cytomegalovirus Infection and HIV-1 Disease Progression in Infants Born to HIV-1–Infected Women

Kovács, Andrea; Schluchter, Mark D.; Easley, Kirk A.; Demmler, Gail J.; Shearer, William T.; Russa, Philip La; Pitt, Jane; Cooper, Ellen; Goldfarb, Johanna; Hodes, David S.; Kattan, Meyer; McIntosh, Kenneth

doi:10.1056/nejm199907083410203

Cited by 247 publications

(98 citation statements)

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“…Although CMV coinfection was associated with more-rapid HIV-1 progression and higher mortality in an American cohort, CMV coinfection was not associated with higher HIV-1 viral loads (17). To determine whether HIV-1 viral load was affected by acute CMV infection in this Kenyan cohort, we compared mean HIV-1 viral loads between children who were CMV infected and children who were CMV negative at 1 month of age.…”

Section: An Increase In Cd8mentioning

confidence: 99%

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Acute Cytomegalovirus Infection Is Associated with Increased Frequencies of Activated and Apoptosis-Vulnerable T Cells in HIV-1-Infected Infants

Slyker

Rowland‐Jones

Dong

et al. 2012

J Virol

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i Cytomegalovirus (CMV) coinfection is associated with infant HIV-1 disease progression and mortality. In a cohort of Kenyan HIV-infected infants, the frequencies of activated (CD38 ؉ HLA-DR ؉ ) and apoptosis-vulnerable (CD95 ؉ Bcl-2 ؊ ) CD4 ؉ and CD8 ؉ T cells increased substantially during acute CMV infection. The frequency of activated CD4 ؉ T cells was strongly associated with both concurrent CMV coinfection (P ‫؍‬ 0.001) and HIV-1 viral load (P ‫؍‬ 0.05). The frequency of apoptosis-vulnerable cells was also associated with CMV coinfection in the CD4 (P ‫؍‬ 0.02) and CD8 (P < 0.001) T cell subsets. Similar observations were made in HIV-exposed uninfected infants. CMV-induced increases in T cell activation and apoptosis may contribute to the rapid disease progression in coinfected infants.

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Section: An Increase In Cd8mentioning

confidence: 99%

“…Cytomegalovirus (CMV) coinfection is associated with more-rapid HIV-1 progression in children (10,17,23), and in adults, plasma CMV DNA is associated with survival time (6,12,34). In resource-poor settings, in which CMV is often acquired during infancy (21,32), a large population of children undergo simultaneous primary HIV-1 and CMV infection (32).…”

mentioning

confidence: 99%

Acute Cytomegalovirus Infection Is Associated with Increased Frequencies of Activated and Apoptosis-Vulnerable T Cells in HIV-1-Infected Infants

Slyker

Rowland‐Jones

Dong

et al. 2012

J Virol

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“…20 A child who had a positive culture at any age or who had a positive serologic test (immunoglobulin G or M) at 12 months of age or older was considered CMV positive. Patients older than 6 months were considered CMV-negative if they had a negative serologic test and no previous positive culture results.…”

Section: Infant and Child Covariatesmentioning

confidence: 99%

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

et al. 2001

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Objective-Many children with human immunodeficiency virus-1 (HIV-1) have chronic problems with growth and nutrition, yet limited information is available to identify infected children at high risk for growth abnormalities. Using data from the prospective, multicenter P 2 C 2 HIV study, we evaluated the relationships between maternal and infant clinical and laboratory factors and impaired growth in this cohort.Methods-Children of HIV-1-infected women were enrolled prenatally or within the first 28 days of life. Failure to thrive (FTT) was defined as an age-and sex-adjusted weight z score ≤−2.0 SD. Maternal baseline covariates included age, race, illicit drug use, zidovudine use, CD4 + T-cell count, and smoking. Infant baseline predictors included sex, race, CD4 + T-cell count, Centers for Disease Control stage, HIV-1 RNA, antiretroviral therapy, pneumonia, heart rate, cytomegalovirus, and Epstein-Barr virus infection status.Results-The study cohort included 92 HIV-1-infected and 439 uninfected children. Infected children had a lower mean gestational age, but birth weights, lengths, and head circumferences in the 2 groups were similar. Mothers of growth-delayed infants were more likely to have smoked Copyright © 2001 by the American Academy of Pediatrics. Reprint requests to (T.L.M.) Division of Pediatric Gastroenterology and Nutrition, Box 667, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642. tracie_miller@urmc.rochester.edu. National Heart, Lung, and Blood Institute, Bethesda, MD The institutions and investigators participating in this study are listed in the "Appendix." HHS Public Access Author manuscriptPediatrics. Author manuscript; available in PMC 2015 April 03. Published in final edited form as:Pediatrics. 2001 December ; 108(6): 1287-1296. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript tobacco and used illicit drugs during pregnancy. In repeated-measures analyses of weight and length or height z scores, the means of the HIV-1-infected group were significantly lower at 6 months of age (P < .001) and remained lower throughout the first 5 years of life. Conclusion-Clinical and laboratory factors associated with FTT among HIV-1-infected children include history of pneumonia, maternal illicit drug use during pregnancy, lower infant CD4 + T-cell count, exposure to antiretroviral therapy by 3 months of age (non-protease inhibitor), and HIV-1 RNA viral load. Keywordshuman immunodeficiency virus; children; failure to thrive; growth; malnutrition Many children with human immunodeficiency virus-1 (HIV-1) infection have chronic problems with linear growth and weight gain. 1-5 A variety of disturbed growth patterns have been described, ranging from symmetric delays in weight and length or height to severe wasting with normal length or height. The differences in growth patterns probably result from differences in disease manifestations in HIV-1-infected children. In developed countries, both weight and length or height decline in infected children as early as...

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“…Pode permanecer no organismo indefinidamente após a primeira infecção e, em determinadas situações de baixa imunidade do hospedeiro, o vírus pode ser ativado e causar infecções recorrentes (LOBATO-SILVA, 2016). Em indivíduos imunocompetentes geralmente estabelece uma infecção primária assintomática com baixos ou nenhum nível de replicação viral.…”

Section: Eraldo Schunk Silvaunclassified

“…Em uma coorte de crianças nascidas de mães infectadas pelo HIV, as coinfectadas apresentaram maior risco de progressão para a aids e morte do que as monoinfectadas pelo HIV (KOVACS et al, 1999). Em outro estudo de coorte de pacientes que participaram de profilaxia oral com Ganciclovir, a presença de CMV no sangue foi fator desencadeante para aids e morte dos pacientes, e a quantidade desse vírus foi o mais forte preditor, quando comparado à contagem de células T CD4+ ou aos níveis de carga viral do HIV (SPECTOR et al, 1999).…”

Section: Eraldo Schunk Silvaunclassified

Soroprevalência de citomegalovírus em HIV positivos em um centro de referência no Brasil

et al. 2017

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O Citomegalovírus (CMV) é um vírus oportunista que causa altos índices de morbidade e mortalidade em pacientes portadores de HIV. O objetivo desse estudo foi estimar a soroprevalência do CMV em pacientes infectados pelo HIV. Estudo de corte transversal realizado em prontuários de pacientes infectados pelo HIV, atendidos em um centro de referência no Sul do Brasil, entre 2005 a 2014. A soroprevalência de HIV-CMV foi de 63,98%, sendo significativamente maior em pacientes pertencentes às faixas etárias de 30-39 anos (Odds ratio (OR) 4,3; 95% IC 1,29-14,58; p=0,02) e ≥ 40 anos (OR 4,8; 95% IC 1,4-16,3; p=0,01). Contagens de células T CD4+ e níveis de carga viral do HIV não mostraram associação estatística entre os grupos com sorologia positiva e negativa para CMV. Nossos achados reportam alta prevalência de HIV-CMV na região e as faixas etárias entre 30-39 e ≥ 40 anos estiveram associadas à infecção por CMV.

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Cytomegalovirus Infection and HIV-1 Disease Progression in Infants Born to HIV-1–Infected Women

Cited by 247 publications

References 50 publications

Acute Cytomegalovirus Infection Is Associated with Increased Frequencies of Activated and Apoptosis-Vulnerable T Cells in HIV-1-Infected Infants

Acute Cytomegalovirus Infection Is Associated with Increased Frequencies of Activated and Apoptosis-Vulnerable T Cells in HIV-1-Infected Infants

Maternal and Infant Factors Associated With Failure to Thrive in Children With Vertically Transmitted Human Immunodeficiency Virus-1 Infection: The Prospective, P2C2 Human Immunodeficiency Virus Multicenter Study

Soroprevalência de citomegalovírus em HIV positivos em um centro de referência no Brasil

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