Symptomatic primary Cytomegalovirus infection in a HIV-positive pregnant woman

Bergin, Sarah; Ferguson, Wendy; Corcoran, Siobhan; Varughese, Allan; Byrne, David; Lawless, Mairead; Eogan, Maeve; Lambert, John S.

doi:10.1177/0956462414528314

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…The earlier reports on primary CMV-infection in HIV-patients have not been linked with lymphoma nor with an aggressive and lethal course. Two previously reported cases had been treated with antiretroviral therapy [3, 4]. One was treated with gancyclovir for the CMV infection and responded with a rapid resolution of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…As the majority of HIV-infected patients are CMV-seropositive at the time of seroconversion little is known about primary CMV infection in HIV-patients with or without severe immunodeficiency. Recently two case reports have been published [3, 4]. The first case was a pregnant HIV positive woman on antiretroviral therapy, who was diagnosed with primary CMV-infection after 30 weeks gestation.…”

Section: Introductionmentioning

confidence: 99%

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Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection

Grützmeier

Porwit

Schmitt

et al. 2016

Infect Agents Cancer

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BackgroundMost malignant lymphomas in HIV-patients are caused by reactivation of EBV-infection. Some lymphomas have a very rapid fulminant course. HHV-8 has also been reported to be a cause of lymphoma. The role of CMV in the development of lymphoma is not clear, though both CMV and HHV-8 have been reported in tissues adjacent to the tumour in Burkitt lymphoma patients. Here we present a patient with asymptomatic HIV infection, that contracted a primary cytomegalovirus (CMV) infection and human herpes virus 8 (HHV-8) infection. Three weeks before onset of symptoms the patient had unprotected sex which could be possible source of his CMV and also HHV-8 infection He deteriorated rapidly and died with a generalized anaplastic large cell lymphoma (ALCL).MethodsA Caucasian homosexual male with asymptomatic human immunodeficiency virus (HIV) infection contracted a primary cytomegalovirus (CMV) infection and human herpes virus 8 (HHV-8) infection. He deteriorated rapidly and died with a generalized anaplastic large cell lymphoma (ALCL). Clinical and laboratory records were compiled. Immunohistochemistry was performed on lymphoid tissues, a liver biopsy, a bone marrow aspirate and the spleen during the illness and at autopsy. Serology and PCR for HIV, CMV, EBV, HHV-1–3 and 6–8 was performed on blood drawn during the course of disease.ResultsThe patient presented with an acute primary CMV infection. Biopsies taken 2 weeks before death showed a small focus of ALCL in one lymph node of the neck. Autopsy demonstrated a massive infiltration of ALCL in lymph nodes, liver, spleen and bone marrow. Blood samples confirmed primary CMV- infection, a HHV-8 infection together with reactivation of Epstein- Barr-virus (EBV).ConclusionPrimary CMV-infection and concomitant HHV-8 infection correlated with reactivation of EBV. We propose that these two viruses influenced the development and progression of the lymphoma. Quantitative PCR blood analysis for EBV, CMV and HHV-8 could be valuable in diagnosis and treatment of this type of very rapidly developing lymphoma. It is also a reminder of the importance of prevention and prophylaxis of several infections by having protected sex.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection

Grützmeier

Porwit

Schmitt

et al. 2016

Infect Agents Cancer

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“…El GCV y el VGCV se han utilizado para el tratamiento de la infección fetal en los tres trimestres de la gestación, sin que se haya demostrado toxicidad en los RN, pero la experiencia es muy limitada 84 . Existen escasos reportes de su uso en el embarazo, en el contexto de mujeres gestantes con inmunosupresión secundaria a trasplante renal o infección por el virus de la inmunodeficiencia humana (VIH) con reactivación o reinfección por CMV 85,86 . Seidel et al 84 reportaron tres pacientes con detección de infección fetal a las que se administró VGCV, 900 mg al día, en el tercer trimestre.…”

Section: Antiviralesunclassified

Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

Izquierdo¹,

Sandoval²,

Abarzúa-Camus³

et al. 2024

RECHOG

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infección por citomegalovirus (CMV) en la mujer embarazada y el recién nacido. Esta guía aborda el manejo de la infección en el binomio, su enfrentamiento diagnóstico y terapéutico, orientado al equipo de salud que atiende a mujeres embarazadas y recién nacidos con infección por CMV en Chile. Considera la situación epidemiológica global y latinoamericana, con recomendaciones para la evaluación clínica y de laboratorio; establece criterios de diagnóstico, propone enfoques terapéuticos de acuerdo a la situación clínica, analiza las medidas de prevención y establece una propuesta nacional para el seguimiento de esta enfermedad. Se ha puesto especial énfasis en entregar, de forma práctica, y con la mayor evidencia posible, las recomendaciones para el manejo del binomio con infección por CMV.

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“…trimester, none of the four neonates treated in utero had any birth defect. [52][53][54][55] One publication reported in utero treatment of two infected fetuses. 31 Their two mothers were treated for 6 to 8 weeks with T A B L E 2 Hyper-immune globulins and valaciclovir to prevent fetal transmission after maternal primary infection…”

Section: Prevention Of Transplacental Transmission Infection By Hypmentioning

confidence: 99%

“…Five publications reported the use of Ganciclovir or valganciclovir in transplanted or AIDS pregnant women in the first, second, and third trimester, none of the four neonates treated in utero had any birth defect 52‐55 …”

Section: Treatment Of Infected Fetusesmentioning

confidence: 99%

Is it time for routine prenatal serological screening for congenital cytomegalovirus?

Leruez‐Ville

Ville

2020

Prenatal Diagnosis

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Congenital CMV infection (cCMV) is the most prevalent congenital infection, main non-genetic cause of sensorineural hearing loss (SNHL) and major cause of neurological disability. Despite the burden of cCMV, no Public Health body recommends universal serology screening in pregnancy. This was explained by gaps in knowledge of epidemiology, diagnosis, prognosis and the absence of any validated treatment. Over

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Symptomatic primary Cytomegalovirus infection in a HIV-positive pregnant woman

Cited by 6 publications

References 8 publications

Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection

Fulminant anaplastic large cell lymphoma (ALCL) concomitant with primary cytomegalovirus (CMV) infection, and human herpes virus 8 (HHV-8) infection together with Epstein-Barr-virus (EBV) reactivation in a patient with asymptomatic HIV-infection

Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

Is it time for routine prenatal serological screening for congenital cytomegalovirus?

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