PD147 - CONGENITAL CYTOMEGALOVIRUS SCREENING IN HIV-EXPOSED NEWBORNS (ID 438)
Abstract
Backgrounds:
Congenital Cytomegalovirus-infections (cCMV) are a leading cause for hearing and neurological impairment. In retroviral exposed neonates, the incidence of cCMV is reported to be 2.7-6.5% worldwide. HIV-exposed newborns seems to have a higher risk of cCMV-infection than unexposed newborns with an estimated incidence of 0.2–0.5% in Germany.
Methods
In this prospective multicentre study, screening for cCMV-infection was performed in a German cohort of HIV-exposed newborns. Saliva specimen was tested for CMV-DNA by real-time PCR within the first three weeks of life. Additional urine and blood samples were analysed for CMV-DNA to verify positive saliva results. Further diagnostics were performed to detect cCMV-related symptoms: Detailed physical-neurological examination, blood analysis, ultrasound of the head and abdomen, hearing test (AABR) and visual examination.
Results:
122/184 (66.3%) HIV-exposed neonates born from 121 mothers during the study period from 24/11/2017 to 31/03/2021 were eligible for enrolment. There was no mother-to-child transmission of HIV. 74/77 HIV-infected mothers with known CMV-serostatus were CMV-IgG positive (96.1%). A cCMV-infection was detected in one of 122 HIV-exposed neonates, corresponding to a cCMV incidence of 0,82% in our cohort. This cCMV infected newborn suffered from CNS disease with subependymal cysts on both sides and thalamostriatal vasculopathy on the right. Antiviral therapy with Antiviral therapy with valganciclovir was offered and started on day 20 of life.
Conclusions/Learning Points:
This study shows a higher incidence of cCMV in HIV-exposed neonates than the estimated value for non-HIV-exposed newborns in Germany. Thanks to our cCMV-screening protocol, a symptomatic cCMV-infected newborn was identified and treated in time, which would have been missed in regular standard care. These results needs to be verified in further prospective studies with greater cohorts. CCMV-screening in HIV-exposed newborns should be considered.
