Clinical and immunological characteristics of congenital cytomegalovirus infection in children with HIV infection

Abstract

Objective – to characterize the clinic and the immune status state in children with HIV infection, taking into account the presence of congenital CMVI.Methods. A clinical and laboratory examination of 91 children with HIV infection with congenital CMVI (20; group I) and without it (71; group II) was carried out. Results. The anamnestic risk groups for congenital CMVI on the part of the mother included age over 30 years (55%), drug use (75%), chronic metroendometritis (85%), colpitis (55%), features of HIV status (secondary disease stage 4 — in 20%, CD4-lymphocyte count 0,5 х 109/l or less in 85%, HIV blood viral load 50 cop./ml or more in 80%), pregnancy pathology (threat of miscarriage — in 50%, developmental delay fetus — in 65%), lack of chemoprophylaxis for vertical transmission of HIV (55%). The clinical criteria for diagnosing of congenital CMVI in newborns included prematurity (40%), congenital malformations (45%), intrauterine growth retardation (65%), jaundice syndrome (50%), and perinatal CNS damage (80%). Children with congenital CMVI at the age of three months developed multiple organ pathology — lymphadenopathy (80%), hepatomegaly (65%), splenomegaly (40%), underweight (75%), pneumonia (60%), hepatitis (30%), pancreatitis (15%), enterocolitis (20%), nephritis (25%), carditis (20%), encephalitis (15%), chorioretinitis (20%), anemia (60%), thrombocytopenia (15%). A severe immunodeficiency state with a predominant violation of the T-cell link was revealed. A high titer of CMV was found in biological materials, IgG antibodies in the blood.Conclusion. The use of clinical and laboratory criteria makes it possible to timely diagnose congenital CMVI in children with HIV infection and prescribe complex therapy.