South African Journal of Child Health
On-line version ISSN 1999-7671
Print version ISSN 1994-3032
DIAR, H A and VELAPHI, S. Characteristics and mortality rate of neonates with congenital cytomegalovirus infection. S. Afr. j. child health [online]. 2014, vol.8, n.4, pp.133-137. ISSN 1999-7671. http://dx.doi.org/10.7196/SAJCH.752.
BACKGROUND: Cytomegalovirus (CMV) infection is a common congenital infection in neonates. Clinical presentation and laboratory findings in CMV-infected infants in a setting where HIV is prevalent are not well characterised. OBJECTIVE: To determine the characteristics and survival to hospital discharge of neonates with congenital CMV infection. METHODS: In this retrospective, case-control study, hospital records of neonates, tested for CMV in the first 3 weeks of life from January 2004 to December 2008, were reviewed for maternal and neonatal characteristics, clinical presentation, laboratory findings and inpatient mortality. Comparisons were made between CMV-infected and CMV-uninfected neonates in those infants who were tested for CMV. RESULTS: Among the CMV-infected, 91% were of low birth weight, 83% were preterm and 29% were small for gestational age. The CMV-infected neonates were more likely to present with hepato/splenomegaly compared with uninfected neonates (p=0.02). Thrombocytopenia was more severe in CMV-infected neonates (p=0.004). Congenital CMV-infected neonates were more likely to be HIV-exposed (p=0.003) and HIV-infected (p=0.02). Mortality before hospital discharge was significantly higher in congenital CMV-infected neonates (p=0.01) and in those with HIV co-infection (p=0.02). The male gender was a significant independent predictor of inpatient mortality (odds ratio: 23, 95% confidence interval 1.19 - 445.698; p=0.04). CONCLUSION: Neonates presenting with hepato/splenomegaly and severe thrombocytopenia are most likely to be CMV-infected. Neonates with congenital CMV are more likely to be co-infected with HIV. The co-infection of CMV and HIV is associated with a high mortality rate, especially in male neonates.