*[1]Bamisaye, O. E., [2],[3],[4]Omoruyi, E. C., 1Badmus, M. M., 1Osuide, M. E., and 5Salami, O. L.
1Department of Biomedical Laboratory Science, College of Medicine, University of Ibadan, Nigeria
2Institute of Child Health, College of Medicine, University of Ibadan, Nigeria 3Clinical Virology Laboratory, College of Medicine, University of Ibadan, Nigeria
4Department of Medical Laboratory Sciences, Edo University, Iyamho, Nigeria 5Infectious Disease Institute, College of Medicine, University of Ibadan, Nigeria
*Correspondence to: bamisayeseyi@gmail.com
Abstract:
Background: Cytomegalovirus (CMV) co-infection with human immunodeficiency virus (HIV) poses significant global challenges with possible complications of disease progression in children and adolescents, especially in resource-limited settings. This study investigates the prevalence of CMV among children living with HIV as well as their viral load dynamics and immunological status correlates.
Methodology: A total of 169 HIV infected participants, including 37 children (2 months to 10 years) and 132 adolescents (11–19 years) on antiretroviral therapy (ARTs), were enrolled from the State Hospital HIV Clinic, Ibadan, Nigeria. The CMV-DNA cycle threshold (Ct) and HIV viral loads were determined using real-time polymerase chain reaction (rt PCR) assay while CD4+ cell counts were assessed with CyFlow method. Sociodemographic and clinical data of participants were analyzed using SPSS (version 25.0) and statistical compari- sons and correlations between variables were evaluated at significant level of p<0.05.
Results: The mean age of all HIV-infected participants was 11.89±3.16 years, and were predominantly males (65.1%, n=110). The overall prevalence of CMV was 13.0%, with higher rates among males (20.9%) compared to females (5.4%) (OR=3.897, 95% CI=1.103-13.776, p=0.03). The prevalence of low and high CMV DNA Ct were 8.9% and 4.1% respectively. Most of the participants had low HIV loads (<19 copies/µL) (n=102, 60.4%) and high CD4+ counts (>500 cells/µL) (n=134, 79.3%). However, a subset of the participants (n=12, 7.1%) had high CMV DNA levels despite their low HIV loads. A negative correlation between CMV DNA Ct values and age (r<0) suggested increased CMV loads in older participants.
Conclusion: Cytomegalovirus co-infecting with HIV is present at a prevalence of 13.0% in this study, and significantly higher in males and older age groups, depicting a significant concern among male children and adolescents living with HIV. These findings highlight the need for routine CMV screening among children and adolescents living with HIV, age- and gender-sensitive interventions, as well as enhanced ART adherence, to mitigate the risks associated with co-infection in this vulnerable population.
Keywords: CMV, HIV, co-infection, real time PCR, cycle threshold, CD4+ T cell