The detection of cytomegalovirus DNA in maternal plasma is associated with mortality in HIV-1-infected women and their infants.

Slyker, J; Lohman-Payne, B; Rowland-Jones, S; Otieno, P; Maleche-Obimbo, E; Richardson, B; Farquhar, C; Mbori-Ngacha, D; Emery, VC; John-Stewart, G

Journal article

The detection of cytomegalovirus DNA in maternal plasma is associated with mortality in HIV-1-infected women and their infants.

Abstract:: OBJECTIVE: Cytomegalovirus (CMV) is an important pathogen in healthy neonates and individuals with human immunodeficiency virus (HIV-1). The objective of this study was to determine whether the detection of CMV DNA (CMV DNAemia) in maternal plasma was associated with mortality in HIV-1-infected women or their infants. METHODS: A longitudinal study was designed to examine the relationship between maternal CMV DNAemia and maternal-infant mortality during 2 years postpartum. Sixty-four HIV-1-infected women and their infants were studied. CMV DNA loads were quantified in plasma from the mothers near the time of delivery. Baseline maternal CD4 cell counts, CD4%, HIV-1 RNA, and CMV DNAemia were evaluated as covariates of subsequent maternal or infant mortality in univariate and multivariate Cox regression. RESULTS: CMV DNA was detected in 11/64 (17%) of the HIV-1-infected women. HIV-1 and CMV viral load were strongly correlated in CMV DNAemic women (rho = 0.84, P = 0.001). Detection of CMV DNAemia was associated with decreased maternal survival at 24 months postpartum (log-rank P = 0.006). Additionally, HIV-1-infected infants born to CMV DNAemic women had a four-fold increased risk of mortality during 24 months of follow-up. Maternal CMV DNAemia remained a significant risk factor for mortality in HIV-1-infected infants after adjusting for maternal CD4 cells/microl [adjusted hazard ratio (HR) = 4.3, confidence interval (CI) = 1.4-13], CD4% (HR = 3.2, CI = 1.0-10), HIV-1 viral load (HR = 4.1, CI = 1.4-12) or maternal death (HR = 3.7, CI = 1.0-13). CONCLUSION: Maternal plasma CMV DNAemia identified a subgroup of Kenyan women and infants at high risk for death in the 2 years following delivery.

Publication status:: Published

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APA Style

Slyker, J., Lohman-Payne, B., Rowland-Jones, S., Otieno, P., Maleche-Obimbo, E., Richardson, B., Farquhar, C., Mbori-Ngacha, D., Emery, V. C., & John-Stewart, G. (2009). The detection of cytomegalovirus DNA in maternal plasma is associated with mortality in HIV-1-infected women and their infants. AIDS (London, England), 23(1), 117–124.

MLA Style

Slyker, J., et al. “The Detection of Cytomegalovirus DNA in Maternal Plasma Is Associated with Mortality in HIV-1-Infected Women and Their Infants.” AIDS (London, England), vol. 23, no. 1, 2009, pp. 117–24.

Chicago Style

Slyker, J, B Lohman-Payne, S Rowland-Jones, P Otieno, E Maleche-Obimbo, B Richardson, C Farquhar, D Mbori-Ngacha, VC Emery, and G John-Stewart. 2009. “The Detection of Cytomegalovirus DNA in Maternal Plasma Is Associated with Mortality in HIV-1-Infected Women and Their Infants.” AIDS (London, England) 23 (1): 117–24.
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