Deepti Suri1, Ankur K Jindal1, Aman Gupta1, Anju Gupta1, Priya Bajgai2, Ramandeep Singh2, Mini P Singh3, Ranjana W Minz4, Sunil Arora4, Surjit Singh1. 1. Pediatric Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. 2. Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. 3. Department Virology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. 4. Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Abstract
BACKGROUND: Cytomegalovirus (CMV) results in significant morbidity and mortality in Human Immunodeficiency Virus (HIV)-infected individuals. There is paucity of literature on paediatric CMV disease, especially from developing countries. METHODS: A retrospective review of records of all HIV-infected children with evidence of CMV disease was done. RESULTS: A total of 15 children were found to have CMV disease (retinitis in all, pneumonia in two and invasive gastrointestinal disease in one). Median CD4+ T cell count and percentage at diagnosis of CMV disease was 64.5 cells/µl and 3.6%, respectively. Intravenous ganciclovir was used in patients with active CMV disease. Of the 15 children, three died while two were lost to follow-up. Symptomatic patients had poor visual outcome and almost all children who were diagnosed on active screening attained normal vision. CONCLUSION: Retinitis is the most common CMV disease in HIV-infected children. Early detection by active screening and initiation of systemic ganciclovir reduces the morbidity.
BACKGROUND: Cytomegalovirus (CMV) results in significant morbidity and mortality in Human Immunodeficiency Virus (HIV)-infected individuals. There is paucity of literature on paediatric CMV disease, especially from developing countries. METHODS: A retrospective review of records of all HIV-infected children with evidence of CMV disease was done. RESULTS: A total of 15 children were found to have CMV disease (retinitis in all, pneumonia in two and invasive gastrointestinal disease in one). Median CD4+ T cell count and percentage at diagnosis of CMV disease was 64.5 cells/µl and 3.6%, respectively. Intravenous ganciclovir was used in patients with active CMV disease. Of the 15 children, three died while two were lost to follow-up. Symptomatic patients had poor visual outcome and almost all children who were diagnosed on active screening attained normal vision. CONCLUSION: Retinitis is the most common CMV disease in HIV-infected children. Early detection by active screening and initiation of systemic ganciclovir reduces the morbidity.
Authors: Meriem Attaf; Julia Roider; Amna Malik; Cristina Rius Rafael; Garry Dolton; Andrew J Predergast; Alasdair Leslie; Thumbi Ndung'u; Henrik N Kløverpris; Andrew K Sewell; Philip J Goulder Journal: Front Immunol Date: 2020-09-30 Impact factor: 7.561