Journal article
Effect of cytomegalovirus infection on breastfeeding transmission of HIV and on the health of infants born to HIV-infected mothers
AIDS (London), Vol.29(7), pp.831-836
04/24/2015
DOI: 10.1097/QAD.0000000000000617
PMCID: PMC4493887
PMID: 25985405
Abstract
Background:Cytomegalovirus (CMV) infection can be acquired in utero or postnatally through horizontal transmission and breastfeeding. The effect of postnatal CMV infection on postnatal HIV transmission is unknown.Methods:The Breastfeeding, Antiretrovirals and Nutrition study, conducted in Malawi, randomized 2369 mothers and their infants to three antiretroviral prophylaxis arms - mother (triple regimen), infant (nevirapine), or neither - for 28 weeks of breastfeeding, followed by weaning. Stored plasma and peripheral blood mononuclear cell specimens were available for 492 infants at 24 weeks and were tested with CMV PCR. Available samples from infants who were CMV PCR-positive at 24 weeks were also tested at birth (N=242), and from infants PCR-negative at 24 weeks were tested at 48 weeks (N=96). Cox proportional-hazards models were used to determine if CMV infection was associated with infant morbidity, mortality, or postnatal HIV acquisition.Results:At 24 weeks of age, CMV DNA was detected in 345/492 infants (70.1%); the estimated congenital CMV infection rate was 2.3%, and the estimated rate of CMV infection at 48 weeks was 78.5%. CMV infection at 24 weeks was associated with subsequent HIV acquisition through breastfeeding or infant death between 24 and 48 weeks of age (hazard ratio 4.27, P=0.05).Conclusion:Most breastfed infants of HIV-infected mothers in this resource-limited setting are infected with CMV by 24 weeks of age. Early CMV infection may be a risk factor for subsequent infant HIV infection through breastfeeding, pointing to the need for comprehensive approaches in order to achieve elimination of breastfeeding transmission of HIV.
Details
- Title: Subtitle
- Effect of cytomegalovirus infection on breastfeeding transmission of HIV and on the health of infants born to HIV-infected mothers
- Creators
- Tiffany S. Chang - Emory UniversityJeffrey Wiener - Centers for Disease Control and PreventionSheila C. Dollard - Centers for Disease Control and PreventionMinal M. Amin - Centers for Disease Control and PreventionSascha Ellington - Centers for Disease Control and PreventionCharles Chasela - UNC Project, Lilongwe, MalawiDumbani Kayira - UNC Project, Lilongwe, MalawiGerald Tegha - UNC Project, Lilongwe, MalawiDeborah Kamwendo - UNC Project, Lilongwe, MalawiDenise J. Jamieson - Centers for Disease Control and PreventionCharlie van der Horst - University of North Carolina at Chapel HillAthena P. Kourtis - Centers for Disease Control and PreventionBreastfeeding, Antiretrovirals and Nutrition (BAN) Study Team
- Resource Type
- Journal article
- Publication Details
- AIDS (London), Vol.29(7), pp.831-836
- DOI
- 10.1097/QAD.0000000000000617
- PMID
- 25985405
- PMCID
- PMC4493887
- NLM abbreviation
- AIDS
- ISSN
- 0269-9370
- eISSN
- 1473-5571
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 6
- Grant note
- Johnson Johnson; Johnson & Johnson; Johnson & Johnson USA Elizabeth Glaser Pediatric AIDS Foundation P30-AI50410 / University of North Carolina Center for AIDS Research OPP53107 / Bill and Melinda Gates Foundation; Bill & Melinda Gates Foundation World Food Program U.S. Agency for International Development; United States Agency for International Development (USAID) National Institute of Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) SIP 13-01 U48-CCU409660-09; SIP 26-04 U48-DP000059-01; SIP 22-09 U48-DP001944-01 / Prevention Research Centers Special Interest Project of the Centers for Disease Control and Prevention 2-D43 Tw01039-06; R24 Tw00798 / NIH Fogarty AIDS International Training and Research Program (DHHS/NIH/FIC) Malawi Ministry of Health and Population United Nations Children's Fund
- Language
- English
- Date published
- 04/24/2015
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446280602771
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