Postnatal cytomegalovirus exposure in infants of antiretroviral-treated and untreated HIV-infected mothers.
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HIV-1 and CMV are important pathogens transmitted via breastfeeding. Furthermore, perinatal CMV transmission may impact growth and disease progression in HIV-exposed infants. Although maternal antiretroviral therapy reduces milk HIV-1 RNA load and postnatal transmission, its impact on milk CMV load is unclear. We examined the relationship between milk CMV and HIV-1 load (4-6 weeks postpartum) and the impact of antiretroviral treatment in 69 HIV-infected, lactating Malawian women and assessed the relationship between milk CMV load and postnatal growth in HIV-exposed, breastfed infants through six months of age. Despite an association between milk HIV-1 RNA and CMV DNA load (0.39 log(10) rise CMV load per log(10) rise HIV-1 RNA load, 95% CI 0.13-0.66), milk CMV load was similar in antiretroviral-treated and untreated women. Higher milk CMV load was associated with lower length-for-age (-0.53, 95% CI: -0.96, -0.10) and weight-for-age (-0.40, 95% CI: -0.67, -0.13) Z-score at six months in exposed, uninfected infants. As the impact of maternal antiretroviral therapy on the magnitude of postnatal CMV exposure may be limited, our findings of an inverse relationship between infant growth and milk CMV load highlight the importance of defining the role of perinatal CMV exposure on growth faltering of HIV-exposed infants.
Infectious Disease Transmission, Vertical
Published Version (Please cite this version)10.1155/2014/989721
Publication InfoDenny, Thomas Norton; Ehlinger, EP; Kalilani, L; Lovingood, RV; Meyer, SA; Patel, Emily; ... Westreich, Daniel J (2014). Postnatal cytomegalovirus exposure in infants of antiretroviral-treated and untreated HIV-infected mothers. Infect Dis Obstet Gynecol, 2014. pp. 989721. 10.1155/2014/989721. Retrieved from http://hdl.handle.net/10161/13925.
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Professor in Medicine
Thomas N. Denny, MSc, M.Phil, is the Chief Operating Officer of the Duke Human Vaccine Institute (DHVI) and the Center for HIV/AIDS Vaccine Immunology (CHAVI), and a Professor of Medicine in the Department of Medicine at Duke University Medical Center. He is also an Affiliate Member of the Duke Global Health Institute. He has recently been appointed to the Duke University Fuqua School of Business Health Sector Advisory Council. Previously, he was an Associate Professor of Pathology, Laboratory M
Assistant Professor of Obstetrics and Gynecology
Professor of Pediatrics
Dr. Permar's work focuses on the development of vaccines to prevent vertical transmission of neonatal viral pathogens. She has utilized the nonhuman primate model of HIV/AIDS to characterize the virus-specific immune responses and virus evolution in breast milk and develop a maternal vaccine regimen for protection against breast milk transmission of HIV. In addition, Dr. Permar's lab has advanced the understanding of HIV-specific immune responses and virus evolution in vertically-transmitting an
Associate Professor of Obstetrics and Gynecology
Dr. Geeta Swamy, MD, became Vice Chair for Research and Faculty Development in the Department of Obstetrics and Gynecology on March 1, 2018. In this dual role, Dr. Swamy oversees strategic development and administration of the Department’s basic, translational and clinical research programs, as well as implements and oversees programs to support development and mentorship for all faculty at all levels. Dr. Swamy has dedicated her career to advancing research in women’s he
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