| 总结: | <h4>Objective</h4> <p>Factors associated with poor health in HIV-exposed-uninfected (HEU) infants are poorly defined.Wedescribe the prevalence and correlates of cytomegalovirus (CMV) viraemia in HEU and HIV-unexposed-uninfected (HUU) infants, and quantify associations with anthropometric, haematological, and immunological outcomes.</p> <h4>Design</h4> <p>Cross-sectional, including HEU and HUU infants from rural coastal Kenya.</p> <h4>Methods</h4> <p>Infants aged 2–8 months were studied. The primary outcome was CMV viraemia and viral load, determined by quantitative PCR. Correlates were tested by logistic and linear regression; coefficients were used to describe associations between CMV viraemia and clinical/immunological parameters.</p> <h4>Results</h4> <p>In total, 42 of 65 (64.6%) infants had CMV viraemia [median viral load, 3.0 (interquartile ranges: 2.7–3.5) log10 IU/ml]. Compared to community controls, HEU infants had six-fold increased odds of being viraemic (adjusted odds ratio 5.95 [95% confidence interval: 1.82–19.36], P=0.003). Age, but not HEU/HUU status, was a strong correlate of CMV viral load (coefficient=-0.15, P=0.009). CMV viral load associated negatively with weight-for-age (WAZ) Z-score (coefficient= -1.06, P=0.008) and head circumference-for-age Z-score (coefficient= -1.47, P=0.012) and positively with CD8þ T-cell coexpression of CD38/human leucocyte antigen DR (coefficient=15.05, P=0.003).</p> <h4>Conclusion</h4> <p>The odds of having CMV viraemia was six-fold greater in HEU than HUU infants when adjusted for age. CMV viral load was associated with adverse growth and heightened CD8þ T-cell immune activation. Longitudinal assessments of the clinical effects of primary CMV infection and associated immunomodulation in early life in HEU and HUU populations are warranted.</p>
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