Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS)
Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Virology Journal |
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| Online Access: | https://doi.org/10.1186/s12985-021-01494-3 |
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| author | Kerina Duri Simbarashe Chimhuya Exnevia Gomo Privilege Tendai Munjoma Panashe Chandiwana Louis Marie Yindom Kudakwashe Mhandire Asaph Ziruma Sekesai Mtapuri-Zinyowera Lovemore Ronald Mazengera Benjamin Misselwitz Felicity Zvanyadza Gumbo Sebastian Jordi Sarah Rowland-Jones for (UZBCS) The U Z Birth Cohort Study Team |
| author_facet | Kerina Duri Simbarashe Chimhuya Exnevia Gomo Privilege Tendai Munjoma Panashe Chandiwana Louis Marie Yindom Kudakwashe Mhandire Asaph Ziruma Sekesai Mtapuri-Zinyowera Lovemore Ronald Mazengera Benjamin Misselwitz Felicity Zvanyadza Gumbo Sebastian Jordi Sarah Rowland-Jones for (UZBCS) The U Z Birth Cohort Study Team |
| author_sort | Kerina Duri |
| collection | DOAJ |
| description | Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) technique. Antenatal plasma HIV-1-RNA load was quantified by reverse transcriptase PCR. Infants’ HIV-1 infection was detected using qualitative proviral DNA-PCR. Predictive value of antenatal plasma CMV-DNAemia (CMV-DNA of > 50 copies/mL) for HIV-1-MTCT was analyzed in univariate and multivariate regression analyses. Associations of CMV-DNAemia with HIV-1-RNA levels and pregnancy outcomes were also explored. Results CMV-DNAemia data were available for 11 HIV-1 transmitting mothers, 120 HIV-infected but non-transmitting controls and 46 HIV-uninfected mothers. In a multivariate logistic regression model, we found a significant association between CMV-DNAemia of > 50 copies/mL and HIV-1 vertical transmission (p = 0.035). There was no difference in frequencies of detectable CMV-DNAemia between HIV-infected and -uninfected pregnant women (p = 0.841). However, CMV-DNA levels were higher in immunosuppressed HIV-infected pregnant women, CD4 < 200 cells/µL (p = 0.018). Non-significant associations of more preterm births (< 37 weeks, p = 0.063), and generally lower birth weights (< 2500 g, p = 0.450) were observed in infants born of HIV-infected mothers with CMV-DNAemia. Furthermore, in a multivariate analysis of HIV-infected but non-transmitting mothers, CMV-DNAemia of > 50 copies/mL correlated significantly with antenatal plasma HIV-1-RNA load (p = 0.002). Conclusion Antenatal plasma CMV-DNA of > 50 copies/mL may be an independent risk factor for HIV-1-MTCT and higher plasma HIV-1-RNA load, raising the possibility that controlling antenatal CMV-DNAemia might improve infant health outcomes. Further studies with larger sample sizes are warranted to confirm our findings. |
| first_indexed | 2024-12-20T05:08:17Z |
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| issn | 1743-422X |
| language | English |
| last_indexed | 2024-12-20T05:08:17Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
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| series | Virology Journal |
| spelling | doaj.art-e9030327aa684affbc568dd171a44c7f2022-12-21T19:52:20ZengBMCVirology Journal1743-422X2021-01-0118111110.1186/s12985-021-01494-3Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS)Kerina Duri0Simbarashe Chimhuya1Exnevia Gomo2Privilege Tendai Munjoma3Panashe Chandiwana4Louis Marie Yindom5Kudakwashe Mhandire6Asaph Ziruma7Sekesai Mtapuri-Zinyowera8Lovemore Ronald Mazengera9Benjamin Misselwitz10Felicity Zvanyadza Gumbo11Sebastian Jordi12Sarah Rowland-Jones13for (UZBCS) The U Z Birth Cohort Study Team14Department of Immunology, University of Zimbabwe College of Health Science (UZ–CHS)Department of Paediatrics and Child Care, UZ-CHSDepartment of Medical Laboratory Sciences, UZ-CHSDepartment of Immunology, University of Zimbabwe College of Health Science (UZ–CHS)Department of Immunology, University of Zimbabwe College of Health Science (UZ–CHS)Nuffield Department of Medicine, University of OxfordDepartment of Chemical Pathology, UZ-CHSDepartment of Obstetrics and Gynaecology, UZ-CHSNational Microbiology Reference Laboratory, Harare Central HospitalDepartment of Immunology, University of Zimbabwe College of Health Science (UZ–CHS)Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern UniversityDepartment of Paediatrics and Child Care, UZ-CHSClinic for Visceral Surgery and Medicine, Inselspital Bern and Bern UniversityNuffield Department of Medicine, University of OxfordDepartment of Immunology, University of Zimbabwe College of Health Science (UZ–CHS)Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) technique. Antenatal plasma HIV-1-RNA load was quantified by reverse transcriptase PCR. Infants’ HIV-1 infection was detected using qualitative proviral DNA-PCR. Predictive value of antenatal plasma CMV-DNAemia (CMV-DNA of > 50 copies/mL) for HIV-1-MTCT was analyzed in univariate and multivariate regression analyses. Associations of CMV-DNAemia with HIV-1-RNA levels and pregnancy outcomes were also explored. Results CMV-DNAemia data were available for 11 HIV-1 transmitting mothers, 120 HIV-infected but non-transmitting controls and 46 HIV-uninfected mothers. In a multivariate logistic regression model, we found a significant association between CMV-DNAemia of > 50 copies/mL and HIV-1 vertical transmission (p = 0.035). There was no difference in frequencies of detectable CMV-DNAemia between HIV-infected and -uninfected pregnant women (p = 0.841). However, CMV-DNA levels were higher in immunosuppressed HIV-infected pregnant women, CD4 < 200 cells/µL (p = 0.018). Non-significant associations of more preterm births (< 37 weeks, p = 0.063), and generally lower birth weights (< 2500 g, p = 0.450) were observed in infants born of HIV-infected mothers with CMV-DNAemia. Furthermore, in a multivariate analysis of HIV-infected but non-transmitting mothers, CMV-DNAemia of > 50 copies/mL correlated significantly with antenatal plasma HIV-1-RNA load (p = 0.002). Conclusion Antenatal plasma CMV-DNA of > 50 copies/mL may be an independent risk factor for HIV-1-MTCT and higher plasma HIV-1-RNA load, raising the possibility that controlling antenatal CMV-DNAemia might improve infant health outcomes. Further studies with larger sample sizes are warranted to confirm our findings.https://doi.org/10.1186/s12985-021-01494-3Antenatal CMV-DNAemiaHIV-1-RNA loadBirth outcomesInfant healthHIV-1 vertical transmission |
| spellingShingle | Kerina Duri Simbarashe Chimhuya Exnevia Gomo Privilege Tendai Munjoma Panashe Chandiwana Louis Marie Yindom Kudakwashe Mhandire Asaph Ziruma Sekesai Mtapuri-Zinyowera Lovemore Ronald Mazengera Benjamin Misselwitz Felicity Zvanyadza Gumbo Sebastian Jordi Sarah Rowland-Jones for (UZBCS) The U Z Birth Cohort Study Team Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) Virology Journal Antenatal CMV-DNAemia HIV-1-RNA load Birth outcomes Infant health HIV-1 vertical transmission |
| title | Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) |
| title_full | Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) |
| title_fullStr | Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) |
| title_full_unstemmed | Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) |
| title_short | Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS) |
| title_sort | role of antenatal plasma cytomegalovirus dna levels on pregnancy outcome and hiv 1 vertical transmission among mothers in the university of zimbabwe birth cohort study uzbcs |
| topic | Antenatal CMV-DNAemia HIV-1-RNA load Birth outcomes Infant health HIV-1 vertical transmission |
| url | https://doi.org/10.1186/s12985-021-01494-3 |
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