Cytomegalovirus Infection in Pregnant Women With Hiv Infection

Abstract

Purpose: еstablishment of the frequency of infection and clinical forms of cytomegalovirus infection in pregnant women with HIV infection. Materials and methods. A retrospective analysis of medical records of 254 HIV-infected pregnant women of the Krasnodar Territory was conducted, which were observed in the framework of the current regulations on HIV infection and the management of pregnant women. Verification of cytomegalovirus infection and distribution of clinical forms was carried out by serological tests. The comparison group is a prospective analysis of 29 pregnant women with HIV infection who were additionally examined for cytomegalovirus infection by polymerase chain reaction. Results. Latent form of CMV infection was diagnosed in 220 (90,5%) of HIV-infected pregnant women, primary — in 5 (2,1%) and reactivated (late primary, reinfection)— in 18 (7,4%). Cytomegalovirus infection frequency increase with growing pregnant, increasing stages of HIV infection, more frequent multiplicity pregnancy, reducing CD4+ T-lymphocytes and increase in HIV RNA. The well-being of obstetric history had no effect on the incidence of infection with cytomegalovirus and various forms of CMV infection. Reactivated forms of cytomegalovirus infection were significantly more frequent in pregnant women with HIV infection at the lowest CD4 + T-lymphocyte counts, maximal HIV viremia, later onset of perinatal antiretroviral prophylaxis, but did not depend on the well-being of the obstetric anamnesis. A comparison group study demonstrated the presence of latent cytomegalovirus infection in all pregnant women, confirmed by the detection of only specific IgG. From the whole blood, the DNA of CMV in low concentration was isolated by PCR method in 1 (3,4%) of the patient, from the cervix — in 8 (27,6%). The amount of detected CMV DNA in the cervix was different, had a direct correlation with the level of HIV RNA of pregnant women and did not depend on the number of CD4-lymphocytes. The calculation of the relative risk in our observations demonstrated that the presence of cytomegalovirus in the cervix did not increase the risk of premature termination of pregnancy.