CMV acquisition and inflammation in HIV-exposed uninfected Zimbabwean infants

Evans, Ceri; Chasekwa, Bernard; Rukobo, Sandra; Govha, Margaret; Mutasa, Kuda; Ntozini, Robert; Humphrey, Jean H.; Prendergast, Andrew J.

doi:10.1093/infdis/jiw630

Cited by 10 publications

(14 citation statements)

References 16 publications

(22 reference statements)

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“…There is a growing recognition that HEU infants have higher morbidity and mortality than HIV-unexposed infants [ 29 ], and several immune abnormalities have been described [ 31 ]. We found that HEU infants had higher levels of inflammation than HIV-unexposed infants, as reported previously [ 44 ]. Here we extend these findings by showing that CRP concentrations in HEU infants at 6 weeks were similar to levels found in HIV-infected infants, and that CRP elevation persists at 6 months of age.…”

Section: Discussionsupporting

confidence: 90%

Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)–Exposed and HIV-Infected Zimbabwean Infants

Prendergast

Chasekwa

Rukobo

et al. 2017

The Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 90%

Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)–Exposed and HIV-Infected Zimbabwean Infants

Prendergast

Chasekwa

Rukobo

et al. 2017

The Journal of Infectious Diseases

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“…In previous studies carried out among infants in Zimbabwe, the prevalence of CMV infection at 6 weeks of age was greater than 70%, regardless of HIV exposure, emphasizing the early acquisition of CMV infection (11,16). However, there was no report on the prevalence of maternal CMV in both studies.…”

Section: Discussionmentioning

confidence: 80%

Seroprevalence of Cytomegalovirus Infection Among HIV-Infected and HIV-Uninfected Pregnant Women Attending Antenatal Clinic in Harare, Zimbabwe

et al. 2019

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This study aimed to investigate the seroprevalence of cytomegalovirus (CMV) infection and risk factors associated with CMV acquisition among pregnant women in Zimbabwe. In a cross-sectional study, pregnant women were recruited in late gestation, seeking antenatal care at council clinics in three high-density suburbs in Harare, Zimbabwe. Anti-CMV IgM and IgG antibodies were quantified in serum using an enzyme-linked immunosorbent assay. Antibody avidity tests were used to distinguish active infection from viral reactivation in anti-CMV IgM-positive cases. Five hundred and twenty four women were recruited: 278 HIV infected and 246 HIV uninfected. Current or active CMV infection defined as IgM positive+low avidity was detected in 4.6% (24/524), 95% confidence interval (CI): 3–6.9 in all women, 5.8% (16/278) in the HIV infected and 3.3% (8/246), 95% CI: 1.4–6.3 in the HIV uninfected. IgG seroprevalence was 99.6% (522/524), 95% CI: 98.6–99.9 in all women. Notably, the difference in the prevalence of active CMV infection between the HIV-infected and HIV-uninfected women was not statistically significant (p = 0.173). The study shows a low prevalence of primary or active CMV infection among the pregnant women, but the IgG seroprevalence suggests high previous CMV exposure. Importantly, CMV seroprevalence was not associated with the HIV status of the women, perhaps due to the ubiquitous exposure of the population to CMV.

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“…HIV-exposed infants may be at higher risk of congenital CMV than HIV-unexposed infants ( 17 , 18 ). In HIV-exposed, uninfected infants, CMV infection may contribute to immune activation ( 11 , 19 , 20 ) and increase the risk of postnatal HIV infection ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

2018

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The success of prevention of mother to child transmission programs over the last two decades has led to an increasing number of infants who are exposed to human immunodeficiency virus (HIV), but who are not themselves infected (HIV-exposed, uninfected infants). Although the morbidity and mortality among HIV-exposed, uninfected infants is considerably lower than that among HIV-infected infants, they may remain at increased risk of infections in the first 2 years of life compared with their HIV-unexposed peers, especially in the absence of breastfeeding. There is some evidence of immunological differences in HIV-exposed, uninfected infants, which could play a role in susceptibility to infection. Cytomegalovirus (CMV) may contribute to the increased immune activation observed in HIV-exposed, uninfected infants. Infants born to HIV-infected women are at increased risk of congenital CMV infection, as well as early acquisition of postnatal CMV infection. In infants with HIV infection, CMV co-infection in early life is associated with higher morbidity and mortality. This review considers how HIV infection, HIV exposure, and CMV infection affect infant responses to vaccination, and explores possible immunological and other explanations for these findings. HIV-infected infants have lower vaccine-induced antibody concentrations following tetanus, diphtheria, pertussis, hepatitis B, and pneumococcal vaccination, although the clinical relevance of this difference is not known. Despite lower concentrations of maternal-specific antibody at birth, HIV-exposed, uninfected infants respond to vaccination at least as well as their HIV-unexposed uninfected peers. CMV infection leads to an increase in activation and differentiation of the whole T-cell population, but there is limited data on the effects of CMV infection on infant vaccine responses. In light of growing evidence of poor clinical outcomes associated with CMV infection in HIV-exposed, uninfected infants, further studies are particularly important in this group. A clearer understanding of the mechanisms by which maternal viral infections influence the developing infant immune system is critical to the success of maternal and infant vaccination strategies.

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CMV acquisition and inflammation in HIV-exposed uninfected Zimbabwean infants

Cited by 10 publications

References 16 publications

Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)–Exposed and HIV-Infected Zimbabwean Infants

Intestinal Damage and Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV)–Exposed and HIV-Infected Zimbabwean Infants

Seroprevalence of Cytomegalovirus Infection Among HIV-Infected and HIV-Uninfected Pregnant Women Attending Antenatal Clinic in Harare, Zimbabwe

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

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