Cytomegalovirus IgG Level and Avidity in Breastfeeding Infants of HIV-Infected Mothers in Malawi

ABSTRACTCytomegalovirus (CMV) infection is common among infants of HIV-infected mothers in resource-limited settings. We examined the prevalence and timing of infant CMV infection during the first year of life using IgG antibody and avidity among HIV-exposed infants in Malawi and correlated the results with the presence of detectable CMV DNA in the blood. The Breastfeeding, Antiretrovirals and Nutrition (BAN) study randomized 2,369 mothers and their infants to maternal antiretrovirals, infant nevirapine, or neither for 28 weeks of breastfeeding, followed by weaning. Stored plasma specimens were tested for CMV IgG and antibody avidity from a random subset of infants who had been previously tested with blood CMV PCR and had available specimens at birth and at 24 and 48 weeks of age. Ninety-four of 127 infants (74.0%) tested at 24 weeks of age had CMV IgG of low or intermediate avidity, signifying primary CMV infections. An additional 22 infants (17.3%) had IgG of high avidity; 19 of them had CMV DNA detected in their blood, indicating infant infections. Taken together, these results show that the estimated prevalence of CMV infection at 24 weeks was 88.9%. By 48 weeks of age, 81.3% of infants had anti-CMV IgG; most of them (70.9%) had IgG of high avidity. The CMV serology and avidity testing, combined with the PCR results, confirmed a high rate of primary CMV infection by 6 months of life among breastfeeding infants of HIV-infected mothers. The CMV PCR in blood detected most, but not all, infant CMV infections.

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Cytomegalovirus seroepidemiology in an urban community of São Paulo, Brazil

Revista de Saúde Pública ◽

10.1590/s0034-89102001000200004 ◽

2001 ◽

Vol 35 (2) ◽

pp. 124-129 ◽

Cited By ~ 21

Author(s):

LNB Almeida ◽

RS Azevedo ◽

M Amaku ◽

E Massad

Keyword(s):

Transmission Rate ◽

Sao Paulo ◽

Reproductive Age ◽

Cluster Sampling ◽

First Year ◽

São Paulo ◽

Cmv Infection ◽

Force Of Infection ◽

Age Dependent ◽

First Year Of Life

INTRODUCTION: After the era of rubella vaccine, cytomegalovirus (CMV) infection is one of the most frequently causes of mental retardation and congenital deafness. Seroepidemiological studies are necessary to understand the transmission dynamics of the disease. The purpose of the study was to quantify the transmission rate of CMV disease in a community in the state of São Paulo, Brazil. METHODS: Using ELISA test (IgG), a retrospective serological survey looking for CMV antibodies was performed in an non-immunized community. Frozen sera from 443 individuals, randomly selected by cluster sampling technique in the town of Caieiras, São Paulo, were collected from November 1990 to January 1991. Seroprevalence was stratified by age (0-40 years). Mathematical techniques were applied to determine the age-dependent decay function of maternal antibodies during the first year of life, the age-dependent seroprevalence function and the force of infection for CMV in this community. RESULTS: It was observed a descending phase of seropositivity in the first 9 months, but changes in antibody titration were observed between 8 months old and one year of age. The average age of the first infection was 5.02 months of age and 19.84 years, when the age-dependent seroprevalence and the force of infection were analyzed between 10 months of age and 10 years of age and from 10 to 40 years old, respectively. CONCLUSION: CMV infection is highly prevalent among the population studied and infection occurs in the first year of life. This study shows that most women at reproductive age are vulnerable to the first infection, increasing the risk for congenital infection.

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Melanotic Neuroectodermal Tumor of Infancy: Presentation of a Case Affecting the Mandible

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i2.1772 ◽

2019 ◽

Author(s):

Souhir Khemiri ◽

Jihene Feki ◽

Afef Khanfir ◽

Mohamed Abdelmoula ◽

Mounir Frikha

Keyword(s):

Neoadjuvant Chemotherapy ◽

Surgical Excision ◽

Neuroectodermal Tumor ◽

Early Infancy ◽

High Rate ◽

Diagnosis And Treatment ◽

First Year ◽

Treatment Methods ◽

First Year Of Life ◽

Anterior Mandible

Abstract- Melanotic neuroectodermal tumor of infancy (MNTI) is a rare and distinctive neoplasm of early infancy with rapid expansile growth and a high rate of recurrences. Most commonly the lesion affects the maxilla of infants during the first year of life, but it may also occur in the mandible, skull, brain, epididymis, and other rare locations. Common treatment methods’ include surgical excision and resection of the tumor. The aim of this article was to show the diagnosis and treatment of a 7-month-old patient with melanotic neuroectodermal tumor occurred in the anterior mandible and to demonstrate the effectiveness of the neoadjuvant chemotherapy.

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Prevalence of Cytomegalovirus Infection in Hospitalized Infants

Folia Medica ◽

10.2478/v10153-012-0005-5 ◽

2012 ◽

Vol 54 (4) ◽

pp. 45-52 ◽

Cited By ~ 2

Author(s):

Ivan S. Ivanov ◽

Nikolay I. Popov ◽

Rumyana I. Moshe ◽

Dora D. Terzieva ◽

Rumen S. Stefanov ◽

...

Keyword(s):

Cytomegalovirus Infection ◽

Clinical Manifestations ◽

Tertiary Hospital ◽

High Rate ◽

Cmv Infection ◽

Predictive Capacity ◽

Entire Study ◽

One Year ◽

Duration Of Breastfeeding ◽

First Year Of Life

Abstract Data on cytomegalovirus infection (CMV) prevalence and course in hospitalized infants are rather scarce, obsolete and considerably inconsistent. AIM: to determine the prevalence, rate of clinical manifestations, risk factors and predictive capacity of clinical manifestations of CMV infection in hospitalized infants during their first year of life. PATIENTS AND METHODS: All 163 infants hospitalized in the Pediatric Ward for Nonrespiratory Pathology in a tertiary hospital were serologically screened for cytomegalovirus infection for 10 months. In infants up to 6 months old that were CMV IgG (+) and CMV IgM (-) we followed up the CMV IgG concentration or compared it with that of their mothers. RESULTS: The CMV prevalence for the entire study sample was 33.1 ± 3.7% (54 seropositive out of 163 examined infants); in newborns it was 19.4 ± 6.7% (7 of 36), in infants aged 1-3 months - 23.8 ± 5.4% (15 of 63), in 4-6-month olds - 28.1 ± 8.1% (9 of 32), and in 7-12-month old - 71.9 ± 8.1% (23 of 32). The rates of clinically apparent infections in the respective groups was 33.3 ± 6.5%, 57.01 ± 20.2%, 53.3 ± 13.3%, 33.3 ± 16.6%, and 13.0 ± 7.17%. The overall rate of clinically apparent CMV infection in all 163 children was between 11.0 ± 2.5% and 17.2 ± 2.9%. The probability of CMV infection increased with age and duration of breastfeeding. Hepatitis, cerebral vasculopathy and pneumonia (alone or combined) turned out to be predictors of CMV infection, but none of these symptoms had a frequency greater than 22%. CONCLUSIONS: We found a high rate of cytomegalovirus infections in hospitalized infants less than one year of age. This infection is the reason why at least 10% of the newborns and 12% of the children aged 1 to 3 months were hospitalised. The course was clinically apparent in over half of the infected children of up to 3 months of age.

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Immune Activation and Microbial Translocation Markers in HIV-Exposed Uninfected Malawian Infants in the First Year of Life

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmz022 ◽

2019 ◽

Vol 65 (6) ◽

pp. 617-625 ◽

Cited By ~ 1

Author(s):

Silvia Baroncelli ◽

Clementina Maria Galluzzo ◽

Giuseppe Liotta ◽

Mauro Andreotti ◽

Sandro Mancinelli ◽

...

Keyword(s):

Immune Activation ◽

Binding Protein ◽

Microbial Translocation ◽

First Year ◽

Gastrointestinal Infections ◽

Fatty Acid Binding ◽

Hiv Exposed ◽

First Year Of Life ◽

The Impact ◽

Exposed Uninfected

Abstract Background HIV-exposed uninfected (HEU) infants show a high rate of morbidity. We aimed to investigate on biomarkers of immune activation/microbial translocation in HEU infants, evaluating the impact that infections/malnutrition can have on biomarker levels during the first year of life. Methods Clinical data of 72 Malawian infants were recorded monthly and correlated with levels of soluble CD14 (sCD14), lipopolysaccharide-binding protein (LBP) and intestinal fatty acid-binding protein (I-FABP), analyzed longitudinally. Results Levels of sCD14 and LBP showed a significant age-related increase. Higher levels of LBP (19.4 vs. 15.2 μg/ml) were associated with stunting, affecting 30% of the infants. The association remained statistically significant after adjusting for cytomegalovirus acquisition, malaria and respiratory infections (p = 0.031). I-FABP levels were significantly increased in infants experiencing gastrointestinal infections (1442.8 vs. 860.0 pg/ml, p = 0.018). Conclusion We provide evidence that stunting is associated with an enhanced inflammatory response to microbial products in HEU children, suggesting that malnutrition status should be taken into consideration to better understand the alteration of the immune profile of HEU infants living in poor socioeconomic settings.

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Long-Term Pertussis-Specific Immunity after Primary Vaccination with a Combined Diphtheria, Tetanus, Tricomponent Acellular Pertussis, and Hepatitis B Vaccine in Comparison with That after Natural Infection

Infection and Immunity ◽

10.1128/iai.69.7.4516-4520.2001 ◽

2001 ◽

Vol 69 (7) ◽

pp. 4516-4520 ◽

Cited By ~ 27

Author(s):

Susanna Esposito ◽

Tiziano Agliardi ◽

Anna Giammanco ◽

Giacomo Faldella ◽

Antonio Cascio ◽

...

Keyword(s):

Hepatitis B ◽

Natural Infection ◽

Primary Vaccination ◽

Hepatitis B Vaccine ◽

First Year ◽

Igg Antibody ◽

Peripheral Blood Mononuclear ◽

Booster Immunization ◽

Humoral And Cellular Immunity ◽

First Year Of Life

ABSTRACT The aim of this study was to compare pertussis-specific humoral and cellular immunity in children 5 years after a primary vaccination with a combined diphtheria, tetanus, tricomponent acellular pertussis, and hepatitis B vaccine (DTaP-HBV; InfanrixHepB; SmithKline Beecham) with immunity after natural infection. The subjects were 38 children aged 5 to 6 years who received DTaP-HBV at 3, 5, and 11 months of life and 21 subjects of similar ages and sex who acquired pertussis in the first year of life. Immunoglobulin G (IgG) antibody titers againstBordetella pertussis antigens, peripheral blood mononuclear cell-specific proliferation, and the secretion of cytokines were evaluated. After 5 years, only a small proportion of vaccinated and infected children had significant specific concentrations of IgG in serum against all three B. pertussis antigens, and T-cell responses persisted in a minority of subjects. A preferential type 1 cytokine response with the secretion of gamma interferon was observed in the pertussis group, whereas a type 2 skewed response was observed in the vaccinated children; however, the quantitative differences in the cytokines produced by DTaP-HBV and natural infection were minimal. In conclusion, our results show that the immune responses induced by primary pertussis vaccination are qualitatively and quantitatively similar to those seen in children who recovered from natural infection and highlight the need for booster immunization with pertussis vaccines in order to maintain adequate levels of a specific immune response to B. pertussis.

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1407. Cytomegalovirus (CMV) infection in the first year of life in a cohort of infants in rural Guatemala

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1589 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S711-S712

Author(s):

Flor M Munoz ◽

Molly Lamb ◽

Jesse Waggoner ◽

alejandra Paniagua-avila ◽

Desiree Bauer ◽

...

Keyword(s):

Cohort Study ◽

Relative Risk ◽

Early Life ◽

Neonatal Period ◽

Early Learning ◽

First Year ◽

Cmv Infection ◽

Research Support ◽

Culturally Adapted ◽

First Year Of Life

Abstract Background Little is known about the epidemiology of Cytomegalovirus (CMV) infection in low resource countries. We evaluated the frequency and effects of post-natal CMV infection in infants from a prospective cohort study designed to assess the effects of post-natal Zika on neurodevelopment (ND) in rural Guatemala. Infants with CMV infection (blue bars) were older compared CMV-negative (red bars) infants. Methods Infants were evaluated for CMV infection by PCR using urine samples collected at 0-3 months of age. ND testing was conducted by local psychologists using a culturally adapted Mullen Scales of Early Learning (MSEL). We explored associations between CMV infection and microcephaly, neurological, visual and hearing deficits, malnutrition and ND outcomes at 1 year of age. Results The infant cohort (N = 469) had a mean age at enrollment of 1.5 (SD 0.75) months; 47% were female and 71% were breastfeeding at 1 year. A total of 103 (22%) were CMV positive and the majority of these (97%) were > 4 weeks of age at testing. Infants > 4 weeks of age were more likely to be CMV positive (P < 0.0001) (Figure). Gender was not correlated with CMV positivity. Among children with head circumference (HC) measurements, microcephaly (HC < 2 SD) was present in 9/87 (10.3%) CMV positive and 35/338 (10.4%) CMV negative infants at 0-3 months of age (p =0.99). Among 438 infants who underwent screening for hearing deficits and a complete ophthalmologic evaluation, none of the CMV positive children had abnormal vision or hearing. Abnormal neurological exams in the first year of life occurred in 50/100 (50%) CMV positive and 166/365 (45.5%) CMV negative infants (p =0.56). There was no association between CMV infection at 0-3 months and MSEL overall or subdomain scores at 1 year (overall Relative risk (RR) 1.02, 95% CI 0.99-1.05, p=0.16). Malnutrition at 0-3 months (RR: 1.53, 95% CI 0.89-2.66, p = 0.13) and 1 year (RR: 1.10, 95% CI 0.77-1.58, p=0.59) was not associated with CMV infection at 0-3 months. Conclusion In a cohort of Guatemalan infants, postnatal CMV infection was common (22%) and more likely to occur after the neonatal period. There was no correlation between CMV infection and microcephaly at 0-3 months or at 1 year of age, nor with abnormal nutritional, neurologic, ophthalmologic, hearing or ND deficits at 1 year of age. This is the first epidemiologic report on CMV infection in early life in rural Guatemala. Disclosures Molly Lamb, PhD, BioFire (Grant/Research Support)

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Immunologic and Virologic Factors Associated with Hospitalization in HIV-Exposed, Uninfected Infants in the United States

Clinical Infectious Diseases ◽

10.1093/cid/ciab272 ◽

2021 ◽

Author(s):

Christiana Smith ◽

Yanling Huo ◽

Kunjal Patel ◽

Kirk Fetters ◽

Shannon Hegemann ◽

...

Keyword(s):

United States ◽

Regression Models ◽

The United States ◽

Pediatric Hiv ◽

First Year ◽

Virus Family ◽

Vaccine Antigens ◽

Hiv Exposed ◽

First Year Of Life ◽

Exposed Uninfected

Abstract Background HIV-exposed, uninfected (HEU) infants experience higher rates of morbidity and mortality than HIV-unexposed uninfected (HUU) infants. Few studies have examined whether particular infections and/or immune responses are associated with hospitalization among HEU infants born in the United States. Methods We evaluated a subset of HEU infants enrolled in the International Maternal Pediatric Adolescent AIDS Clinical Trials Group P1025 and/or Pediatric HIV/AIDS Cohort Study Surveillance Monitoring for ART Toxicities studies. We determined seroconversion to 6 respiratory viruses and measured antibody concentrations to 9 vaccine antigens using quantitative ELISA or electrochemiluminesence. Multivariable modified Poisson regression models were fit to evaluate the associations of seroconversion to each respiratory virus/family and antibody concentrations to vaccine antigens with the risk of hospitalization in the first year of life. Antibody concentrations to vaccine antigens were compared between HEU infants and HUU infants from a single site using multivariable linear regression models. Results Among 556 HEU infants, seroconversion to respiratory syncytial virus (RSV) and parainfluenza were associated with hospitalization [adjusted risk ratio: 1.95 (95% CI 1.21-3.15); 2.30 (1.42-3.73), respectively]. Antibody concentrations to tetanus toxoid, pertussis, and pneumococcal vaccine antigens were higher among 525 HEU compared with 100 HUU infants. No associations were observed between antibody concentrations to any vaccine and hospitalization among HEU infants. Conclusions RSV and parainfluenza contribute to hospitalization among HEU infants in the first year of life. HEU infants demonstrate robust antibody responses to vaccine antigens; therefore, humoral immune defects likely do not explain the increased susceptibility to infection observed in this population.

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Quality of Caregiving is Positively Associated With Neurodevelopment During the First Year of Life Among HIV-Exposed Uninfected Children in Uganda

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001599 ◽

2018 ◽

Vol 77 (3) ◽

pp. 235-242 ◽

Cited By ~ 7

Author(s):

Itziar Familiar ◽

Shalean M. Collins ◽

Alla Sikorskii ◽

Horacio Ruisenor-Escudero ◽

Barnabas Natamba ◽

...

Keyword(s):

First Year ◽

Hiv Exposed ◽

First Year Of Life ◽

Exposed Uninfected

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Mitochondrial DNA Parameters in Blood of Infants Receiving Lopinavir/Ritonavir or Lamivudine Prophylaxis to Prevent Breastfeeding Transmission of HIV-1

Journal of Clinical Medicine ◽

10.3390/jcm9092972 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2972 ◽

Cited By ~ 1

Author(s):

Audrey Monnin ◽

Nicolas Nagot ◽

Marianne Periès ◽

Roselyne Vallo ◽

Nicolas Meda ◽

...

Keyword(s):

Mitochondrial Dna ◽

Control Group ◽

First Year ◽

Mtdna Depletion ◽

Immunodeficiency Virus ◽

Maternal Hiv ◽

Lamivudine Prophylaxis ◽

Hiv Exposed ◽

Exposure Prophylaxis ◽

First Year Of Life

Children who are human immunodeficiency virus (HIV)-exposed but uninfected (CHEU) accumulate maternal HIV and antiretroviral exposures through pregnancy, postnatal prophylaxis, and breastfeeding. Here, we compared the dynamics of mitochondrial DNA (mtDNA) parameters in African breastfed CHEU receiving lopinavir/ritonavir (LPV/r) or lamivudine (3TC) pre-exposure prophylaxis during the first year of life. The number of mtDNA copies per cell (MCN) and the proportion of deleted mtDNA (MDD) were assessed at day 7 and at week 50 post-delivery (PrEP group). mtDNA depletion was defined as a 50% or more decrease from the initial value, and mtDNA deletions was the detection of mtDNA molecules with large DNA fragment loss. We also performed a sub-analysis with CHEU who did not receive a prophylactic treatment in South Africa (control group). From day seven to week 50, MCN decreased with a median of 41.7% (interquartile range, IQR: 12.1; 64.4) in the PrEP group. The proportion of children with mtDNA depletion was not significantly different between the two prophylactic regimens. Poisson regressions showed that LPV/r and 3TC were associated with mtDNA depletion (reference: control group; LPV/r: PR = 1.75 (CI95%: 1.15–2.68), p < 0.01; 3TC: PR = 1.54 (CI95%: 1.00–2.37), p = 0.05). Moreover, the proportion of children with MDD was unexpectedly high before randomisation in both groups. Long-term health impacts of these mitochondrial DNA parameters should be investigated further for both CHEU and HIV-infected children receiving LPV/r- or 3TC- based regimens.

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