CMV and HCV infections in HIV/non-HIV mothers and newborns: prevalence, frequency and risk factors

Abstract publicado em: ESCV2011-Program Book / European Society of Clinical Virology, p. 73. Disponível em: http://escv.ivdnews.net/public/show_abstract/1126The incidence of HIV infections in gestational age is an important Public Health issue as are concerns about co-infection with opportunistic viruses, such as CMV/HCV. Several authors refer higher ratios of congenital CMV infection in children born to HIV infected mother than in uninfected. In the case of HCV, perinatal transmission increases in cases of mothers co-infected with HIV. Aims:To study CMV/HCV infection/co-infection in HIV/non-HIV women and their newborns between 2006-2010, according to epidemiological, laboratory and clinical data; to evaluate frequency of CMV/HIV/HCV maternal-fetal transmission and analyse risk factors for infections. Methods:Plasma and/or urine of 137 HIV and 140 non-HIV women, attending a Lisbon Hospital and their 140 newborns were analysed at NIH. HIV-1 and/or HIV-2 proviral DNA nested-PCR was performed on HIV mothers and their newborn’s plasma. Maternal plasma was screened for CMV and HCV antibodies; RNA determination, genotyping and viral load were performed on women with HCV antibodies, their newborn’s plasma was also screened for HCV. Newborn’s urine was inoculated for CMV detection. Data analysis was performed using SPSS 17.0 and Fisher's exact test. Results:HIV1 vertical transmission was diagnosed in 3/140(2.1%) cases. CMV congenital infection was diagnosed in 4(2.9%) newborns from HIV women and no congenital CMV infection was diagnosed in newborns from non-HIV women. 2/137(1.5%) HIV women and 14/140(10.0%) non-HIV women were CMV seronegative. HCV infection was detected in 6(4.4%) HIV women; all had HCV positive viral load; different genotypes were found. One case of HCV perinatal transmission was diagnosed. No HCV antibodies were found in non-HIV women. No children were HIV/HCV or CMV/HCV coinfected but 2 were HIV/CMV coinfected. There is evidence of significant statistical associations with race/ethnicity and time of pregnancy. Conclusion:In this study HIV women had higher CMV/HCV antibody prevalence and frequency of maternal-fetal transmission than non-HIV women. 2/137 HIV seronegative newborns and 2/3 HIV newborns were CMV congenitally infected; this difference should be further studied, as the consequences of CMV/HCV infections may become increasingly serious and complex in the presence of HIV. This specific group is not representative of the Portuguese infected women, nevertheless the significant risk factors found and other risk factors studied without strong associations should be considered in larger studies