Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection
BACKGROUND:Older children and adolescents with perinatally acquired human immunodeficiency virus (PHIV) infection in Africa experience multiple comorbidities that are not typical of HIV-associated opportunistic infections, including growth impairment and chronic lung disease. We examined association...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Oxford University Press
2019
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| _version_ | 1826257934558953472 |
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| author | Yindom, L Simms, V Majonga, E McHugh, G Dauya, E Bandason, T Vincon, H Rylance, J Munyati, S Ferrand, R Rowland-Jones, S |
| author_facet | Yindom, L Simms, V Majonga, E McHugh, G Dauya, E Bandason, T Vincon, H Rylance, J Munyati, S Ferrand, R Rowland-Jones, S |
| author_sort | Yindom, L |
| collection | OXFORD |
| description | BACKGROUND:Older children and adolescents with perinatally acquired human immunodeficiency virus (PHIV) infection in Africa experience multiple comorbidities that are not typical of HIV-associated opportunistic infections, including growth impairment and chronic lung disease. We examined associations between plasma cytomegalovirus (CMV) DNA and lung function and growth. METHODS:Plasma CMV DNA loads were measured children aged 6-16 years with PHIV (n = 402) and HIV-uninfected controls (n = 224). The HIV-infected children were either newly diagnosed or known HIV infected and stable on antiretroviral therapy (ART) for >6 months. CMV DNA loads were measured using quantitative polymerase chain reaction. CMV DNAemia was modeled as a time-varying outcome using longitudinal mixed-effects logistic regression. RESULTS:At enrollment, CMV DNAemia ≥1000 copies/mL (defined as "clinically significant") was detected in 5.8% of uninfected children, 14.7% of HIV-infected participants stable on ART, and 22.6% of HIV-infected ART-naive children (χ2 = 23.8, P < .001). The prevalence of CMV DNAemia ≥1000 copies/mL was associated with CD4 counts <350 cells/µL. Among HIV-infected ART-naive children, the presence of CMV DNAemia of ≥1000 copies/mL was independently associated with reduced lung function (adjusted odds ratio [aOR] = 3.23; 95% confidence interval [CI], 1.23-8.46; P = .017). Among ART-treated children, stunting was associated with CMV DNAemia of ≥1000 copies/mL (aOR = 2.79; 95% CI, 0.97-8.02; P = .057). CONCLUSIONS:Clinically significant levels of CMV DNAemia were common in older children with PHIV, even those on ART, suggesting a role for inadequately controlled CMV infection in the pathogenesis of PHIV comorbidities in Africa. |
| first_indexed | 2024-03-06T18:26:03Z |
| format | Journal article |
| id | oxford-uuid:07fe7273-e0b8-4a5b-8ece-0f6cc40f69ff |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:26:03Z |
| publishDate | 2019 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:07fe7273-e0b8-4a5b-8ece-0f6cc40f69ff2022-03-26T09:10:34ZUnexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infectionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:07fe7273-e0b8-4a5b-8ece-0f6cc40f69ffEnglishSymplectic Elements at OxfordOxford University Press2019Yindom, LSimms, VMajonga, EMcHugh, GDauya, EBandason, TVincon, HRylance, JMunyati, SFerrand, RRowland-Jones, SBACKGROUND:Older children and adolescents with perinatally acquired human immunodeficiency virus (PHIV) infection in Africa experience multiple comorbidities that are not typical of HIV-associated opportunistic infections, including growth impairment and chronic lung disease. We examined associations between plasma cytomegalovirus (CMV) DNA and lung function and growth. METHODS:Plasma CMV DNA loads were measured children aged 6-16 years with PHIV (n = 402) and HIV-uninfected controls (n = 224). The HIV-infected children were either newly diagnosed or known HIV infected and stable on antiretroviral therapy (ART) for >6 months. CMV DNA loads were measured using quantitative polymerase chain reaction. CMV DNAemia was modeled as a time-varying outcome using longitudinal mixed-effects logistic regression. RESULTS:At enrollment, CMV DNAemia ≥1000 copies/mL (defined as "clinically significant") was detected in 5.8% of uninfected children, 14.7% of HIV-infected participants stable on ART, and 22.6% of HIV-infected ART-naive children (χ2 = 23.8, P < .001). The prevalence of CMV DNAemia ≥1000 copies/mL was associated with CD4 counts <350 cells/µL. Among HIV-infected ART-naive children, the presence of CMV DNAemia of ≥1000 copies/mL was independently associated with reduced lung function (adjusted odds ratio [aOR] = 3.23; 95% confidence interval [CI], 1.23-8.46; P = .017). Among ART-treated children, stunting was associated with CMV DNAemia of ≥1000 copies/mL (aOR = 2.79; 95% CI, 0.97-8.02; P = .057). CONCLUSIONS:Clinically significant levels of CMV DNAemia were common in older children with PHIV, even those on ART, suggesting a role for inadequately controlled CMV infection in the pathogenesis of PHIV comorbidities in Africa. |
| spellingShingle | Yindom, L Simms, V Majonga, E McHugh, G Dauya, E Bandason, T Vincon, H Rylance, J Munyati, S Ferrand, R Rowland-Jones, S Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title | Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title_full | Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title_fullStr | Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title_full_unstemmed | Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title_short | Unexpectedly high prevalence of cytomegalovirus DNAemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
| title_sort | unexpectedly high prevalence of cytomegalovirus dnaemia in older children and adolescents with perinatally acquired human immunodeficiency virus infection |
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