CONGENITAL AND PERINATAL CYTOMEGALOVIRUS-INFECTION IN INFANTS BORN TOMOTHERS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Objectives: To determine the rates of congenital and perinatal cytomeg alovirus (CMV) infection among infants born to mothers infected with H IV compared with infants born to mothers not infected with HIV from a CMV-immune, low-income population. Study design: A total of 325 newbor ns from CMV-seropositive mothers were enrolled and evaluated for conge nital CMV infection (150 infants from HIV+ mothers and 175 infants fro m HIV- mothers. A total of 101 infants from HIV+ mothers and 33 infant s from HIV- mothers were evaluated for perinatal CMV infection. The vi rus was isolated from urine by culture in human fibroblasts and was de tected by polymerase chain reaction at birth and at 15 days and 12 wee ks of age. Results: Only 13 of 150 HIV+ mothers (8.7%) had an AIDS-def ining condition, and none had a late-stage HIV infection. Congenital C MV infection was detected in 4 of 150 (2.7%) infants from HIV+ mothers and in 5 of 175 (2.9%) infants from HIV- mothers (p = 1.00). Perinata l CMV infection was diagnosed in 8 of 101 (7.9%) infants from HIV+ mot hers and in 13 of 33 (39.4%) infants from HIV- mothers (p < 0.00001). Most infants (93.3%) from HIV- mothers and only 5.9% of infants from H IV+ mothers were breastfed. Conclusions: CMV coinfection in mothers wi thout advanced HIV disease from a CMV-immune population does not enhan ce the likelihood of congenital CMV infection. Perinatal CMV transmiss ion from HIV-infected mothers may be decreased by avoiding breastfeedi ng. Further studies on mothers with late-stage HIV infection are neede d.