Moraka Natasha O, Moyo Sikhulile, Smith Christiana, Ibrahim Maryanne, Mayondi Gloria, Leidner Jean, Powis Kathleen M, Cassidy Adam R, Kammerer Betsy, Ajibola Gbolahan, Williams Paige L, Weinberg Adriana, Musonda Rosemary, Shapiro Roger, Gaseitsiwe Simani, Lockman Shahin
Research Laboratory Department, The Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana.
Division of Medical Virology, Department of Pathology, Stellenbosch University Tygerberg, Cape Town, South Africa.
Open Forum Infect Dis. 2020 Aug 22;7(10):ofaa373. doi: 10.1093/ofid/ofaa373. eCollection 2020 Oct.
We sought to identify predictors of child cytomegalovirus (CMV) infection overall and by maternal HIV status and to assess associations of child CMV status with growth and neurodevelopmental outcomes at 24 months of age in Botswana.
Data and samples were used from the Botswana-based observational Tshipidi study (2010-2014), enrolling pregnant women living with and without HIV and following their infants through 2 years of age. Child plasma samples were tested at 18 months of age for anti-CMV immunoglobulin G (IgG). Associations were assessed between detectable anti-CMV IgG and growth (using the World Health Organization Child Growth Standards) and neurodevelopment (using the Bayley Scales of Infant and Toddler Development III and the Developmental Milestones Checklist) at 24 months of age.
Of 317 children, 215 (68%) had detectable anti-CMV IgG at 18 months of age. Comparatively, 83% (n = 178) of HIV-unexposed uninfected (HUU) children had positive CMV serology vs 47% (n = 139) of HIV-exposed uninfected (HEU) children ( < .01); 100% of HUU vs 10.5% of HEU children breastfed. Child CMV infection was not associated with weight-for-age, weight-for-length, or length-for-age z-scores at 24 months. In HUU children, CMV infection was associated with smaller head circumference ( < .01). No difference was observed by child CMV status in any neurodevelopmental domain at 24 months.
We observed high CMV seropositivity in 18-month-old children in Botswana, with higher seropositivity among breastfed (HUU) children. Positive CMV serostatus was not associated with 24-month child growth or neurodevelopmental outcomes, with the exception of smaller head circumference among HUU CMV-positive children.
我们试图确定儿童巨细胞病毒（CMV）感染的总体预测因素，并按母亲的HIV感染状况进行区分，同时评估博茨瓦纳24月龄儿童的CMV感染状况与生长发育及神经发育结局之间的关联。
使用了基于博茨瓦纳的观察性齐皮迪研究（2010 - 2014年）的数据和样本，该研究纳入了感染和未感染HIV的孕妇，并对其婴儿进行2年的随访。在儿童18月龄时检测血浆样本中的抗CMV免疫球蛋白G（IgG）。评估18月龄时可检测到的抗CMV IgG与24月龄时的生长发育（使用世界卫生组织儿童生长标准）和神经发育（使用贝利婴幼儿发展量表第三版和发育里程碑检查表）之间的关联。
在317名儿童中，215名（68%）在18月龄时可检测到抗CMV IgG。相比之下，未暴露于HIV且未感染（HUU）的儿童中83%（n = 178）CMV血清学呈阳性，而暴露于HIV但未感染（HEU）的儿童中这一比例为47%（n = 139）（P <.01）；HUU儿童中100%进行母乳喂养，而HEU儿童中这一比例为10.5%。儿童CMV感染与24月龄时的年龄别体重、身长别体重或年龄别身长Z评分无关。在HUU儿童中，CMV感染与较小的头围相关（P <.01）。在24月龄时，未观察到儿童CMV感染状况在任何神经发育领域存在差异。
我们观察到博茨瓦纳18月龄儿童中CMV血清阳性率较高，母乳喂养（HUU）儿童的血清阳性率更高。CMV血清阳性与24月龄儿童的生长发育或神经发育结局无关，但HUU CMV阳性儿童的头围较小除外。
