Progressive cytomegalovirus encephalopathy following congenital infection in an infant with acquired immunodeficiency syndrome

Abstract

Congenital central nervous system infection with cytomegalovirus (CMV) usually results in a nonprogressive encephalopathy. Ninety percent of patients with clinically apparent infections at birth have a permanent neurological disability. It has been suggested that some infants may have persistent infection manifested by progressive encephalopathy during infancy. In the present case, clinical and pathological findings suggest the reactivation of a prior intrauterine CMV infection in a child with human T-lymphotrophic virus type III (HTLV-III) infection. The presence of HTLV-III may have reduced the immune surveillance of this infant, allowing the CMV to reactivate.

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

“…Microglial nodules are found in patients with AIDS and those with CMV central nervous system disease. 48,49 There was a positive association between mean HIV-1 RNA levels and disease progression in infants who were infected only with HIV-1, but not in infants who were infected with both HIV-1 and CMV. This implies that coinfection accelerates disease progression not by enhancing overall HIV-1 replication, but by other mechanisms, such as increased immunosuppression, combined effects of HIV-1 and CMV on local replication, combined pathologic effects of two independent viral infections, or exaggerated immunopathologic effects or tissue damage due to soluble mediators.…”