Cytomegalovirus Viremia and Clinical Outcomes in Kenyan Children Diagnosed With Human Immunodeficiency Virus (HIV) in Hospital

• Published in: Clinical infectious diseases 2022-04, Vol.74 (7), p.1237-1246
• Main Authors: Wamalwa, Dalton, Njuguna, Irene, Maleche-Obimbo, Elizabeth, Begnel, Emily, Chebet, Daisy J, Onyango, Judith A, Cranmer, Lisa Marie, Huang, Meei-Li, Richardson, Barbra A, Boeckh, Michael, John-Stewart, Grace, Slyker, Jennifer
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; Cytomegalovirus - genetics; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - epidemiology; HIV - genetics; HIV Infections - complications; HIV Infections - epidemiology; Hospitals; Humans; Kenya - epidemiology; Major and Commentaries; RNA; Viremia - epidemiology
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1093/cid/ciab604

Abstract Background Cytomegalovirus (CMV) viremia is common in human immunodeficiency virus (HIV) infection and is associated with worse long-term outcomes. To date, no studies have assessed CMV viremia in children diagnosed with HIV in hospital. Methods We studied CMV viremia and clinical outcomes in 163 Kenyan children aged 2 months to 12 years, diagnosed with HIV in hospital. CMV DNA levels in plasma were measured using quantitative polymerase chain reaction (PCR). Regression models were used to assess associations between CMV viremia ≥1000 IU/mL and the risk of continued hospitalization or death at 15 days, duration of hospitalization, and 6-month mortality. Results At enrollment, 62/114 (54%) children had CMV viremia, and 20 (32%) were ≥1000 IU/mL. Eleven CMV reactivations were observed after admission. The prevalence and level of CMV viremia were highest in children