Infección congénita por citomegalovirus en hijos de madres infectadas por el VIH

Abstract

Background Cytomegalovirus (CMV) is the most common congenital viral infection, mainly in the infants of HIV-infected women. The aim of this study was to evaluate the prevalence of congenital CMV infection in infants born to HIV-infected women in our hospital, the possible influence of maternal antiretroviral therapy, the relationship between vertical HIV transmission and congenital CMV infection, and the clinical outcome of these infants. Patients and methods Between 1987 and 2003, we performed a prospective, cohort study of all the infants born to HIV-infected mothers, in whom CMV was cultured in urine in the neonatal period. Congenital CMV infection was defined as a CMV positive urine culture obtained in the first 3 weeks of life. Results A total of 257 patients were included in the study, with positive CMV urine culture in 12 (4.6 %). Before 1997 the prevalence was 9.2 % vs 1.34 % in the second period (p < 0.01). In infants born to HIV-infected women without zidovudine therapy the prevalence was 6.3 % compared with 3.1 % in the group with zidovudine therapy (p > 0.05). Vertical HIV transmission was observed in 23 infants, of which six (26 %) had congenital CMV coinfection. Only six infants (2.5 %) without HIV-infection had congenital CMV infection (p < 0.01). The outcome of congenital CMV infection was good in all infants. Conclusions Congenital CMV infection is more frequent in infants born to HIV-infected women. The prevalence was higher in the first study period and in infants with vertical HIV transmission. All infants with congenital CMV infection had a favorable outcome.