Cytomegalovirus Disease in HIV-infected Children-A Single-Centre Clinical Experience over 23 Years

• Published in: Journal of tropical pediatrics (1980) Vol. 64; no. 3; p. 215
• Main Authors: Suri, Deepti, Jindal, Ankur K, Gupta, Aman, Gupta, Anju, Bajgai, Priya, Singh, Ramandeep, Singh, Mini P, Minz, Ranjana W, Arora, Sunil, Singh, Surjit
• Format: Journal Article
• Language: English
• Published: England 01.06.2018
• Subjects: Administration, Intravenous; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - drug therapy; AIDS-Related Opportunistic Infections - mortality; Antiretroviral Therapy, Highly Active; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; CD4 Lymphocyte Count; Child; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - drug therapy; Cytomegalovirus Infections - mortality; Cytomegalovirus Infections - virology; Cytomegalovirus Retinitis - diagnosis; Cytomegalovirus Retinitis - drug therapy; Cytomegalovirus Retinitis - mortality; Cytomegalovirus Retinitis - virology; Female; Ganciclovir - administration & dosage; Ganciclovir - therapeutic use; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Humans; India - epidemiology; Male; Pneumonia, Pneumocystis - drug therapy; Survival Rate; India
• ISSN: 1465-3664
• DOI: 10.1093/tropej/fmx052

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. A retrospective review of records of all HIV-infected children with evidence of CMV disease was done. 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. Retinitis is the most common CMV disease in HIV-infected children. Early detection by active screening and initiation of systemic ganciclovir reduces the morbidity.