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Rev Esp Quimioter 2022; July 18

Congenital cytomegalovirus infection, is more prevalent in our country in newborns exposed to HIV?

JORGE BUSTAMANTE-AMADOR, ISABEL MELLADO-SOLA, MARÍA PILAR ROMERO-GÓMEZ, MARTA CABRERA-LAFUENTE, MARÍA DE LA CALLE-FERNÁNDEZ-MIRANDA, TALÍA SAINZ-COSTA, MARÍA JOSÉ MELLADO-PEÑA, LUIS ESCOSA-GARCÍA, EN REPRESENTACIÓN DEL GRUPO DE TRABAJO SOBRE INFECCIÓN PERINATAL-NEONATOLOGÍA-GINECOLOGÍA (GINPER)

Published: 18 July 2022

http://www.doi.org/10.37201/req/037.2022

Objectives. Congenital cytomegalovirus infection (cCMV) has been considered more prevalent among HIV-exposed children during pregnancy. Spanish national guidelines recommend the cCMV screening in these newborns. Nowadays, pregnant women have a better control of HIV infection compared to previous decades. We aim to analyze the prevalence and associated risk factors to cCMV in these children.
Patients and methods. A retrospective cross-sectorial study was performed. All newborns exposed to HIV were assisted in a third-level hospital (2014-2020). Epidemiological and clinical data of the mother and newborn were recorded. Shell vial urine culture and/or CRP were performed along the two first weeks of life for the neonatal screening of cCMV.
Results. Overall 69 newborns were enrolled. A high proportion (82.4%) of the mothers had been diagnosed with HIV before getting pregnant. All women received ART during the pregnancy. Median T-CD4 lymphocytes before delivery was 641/mm3 (IQR: 480-865) and the viral load was undetectable in 83.6%. Serological test for CMV along the first trimester of pregnancy was performed in 73.5% (positive IgG in 96%). There were no congenital cases of HIV neither cCMV (CI 95%:0-5.3%).
Conclusions. The cCMV prevalence in newborns exposed to HIV was 0%, lower than reported before, probably related to a better and earlier ART during pregnancy, leading to a better immunological status.

Rev Esp Quimioter 2022; July  18 [Texto completo PDF]