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Incidence of CMV co-infection in HIV-positive women and their neonates in a tertiary referral centre: a cohort study

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Abstract

Co-infection with CMV in HIV-positive pregnant women is associated with perinatal mother-to-child transmission (MTCT) of both viruses. This retrospective study reports on the incidence of maternal and neonatal CMV (presence of anti-CMV IgG and IgM, CMV DNA PCR and/or CMV virus isolation) in high-risk pregnancies due to maternal HIV infection, MTCT of HIV and/or CMV. One hundred and eleven maternal samples and 75 matched neonatal samples were available for HIV and subsequent CMV testing. In this cohort of HIV-positive pregnant women, 96 (86.5 %) serum samples were anti-CMV IgG positive. In nine (9.4 %) of these, anti-CMV IgM was detected, and in none of them a maternal primary CMV infection was suspected. Fifty-seven (51.8 %) maternal serum samples were tested retrospectively by CMV DNA PCR; one sample was positive (0.9 %). All matched neonates were tested for HIV by PCR in the first month of life; HIV transmission was detected in one case. In 74 (67.2 %) of neonates, CMV testing was performed. Sixty-six of these serum samples were tested retrospectively by CMV DNA PCR. Two newborns (2.7 %) showed laboratory markers for CMV infection (one by detection of CMV DNA in plasma, and one by isolation of CMV from a urine sample). In the follow-up, neither of these two showed clinical signs for active CMV disease. We discussed these findings in the light of the national official guidelines. All CMV transmissions occurred due to maternal reinfection or endogenous reactivation. This suggests the success of highly active antiretroviral therapy in preventing MTCT of HIV and CMV disease and highlights the importance of adequate care and follow-up.

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Acknowledgments

The authors would like to acknowledge Dr. Andrew Bisits, MD, FRANZCOG, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia, for statistical and writing assistance during the development of this article.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany

    A. Reitter

  2. Division of Neonatology, Department of Pediatrics, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany

    H. Buxmann & R. Schlösser

  3. Department of Infectious Diseases, University Hospital Frankfurt, Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany

    A. E. Haberl

  4. Institute of Medical Virology, National Reference Center for Retroviruses, University Hospital Frankfurt, Goethe-University, Paul Ehrlich Strasse 40, 60596, Frankfurt am Main, Germany

    M. Kreibich, O. T. Keppler & A. Berger

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Correspondence to A. Reitter.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from the Ethics Committee at the JW-Goethe University Frankfurt (Number30/13).

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Reitter, A., Buxmann, H., Haberl, A.E. et al. Incidence of CMV co-infection in HIV-positive women and their neonates in a tertiary referral centre: a cohort study. Med Microbiol Immunol 205, 63–71 (2016). https://doi.org/10.1007/s00430-015-0427-9

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