Category: Pediatric Viral Studies (natural history and therapeutic)

Poster Session: Pediatric Viral Studies (natural history and therapeutic)

1407 - Cytomegalovirus (CMV) infection in the first year of life in a cohort of infants in rural Guatemala

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Presenting Author(s)

Flor M. Munoz

Associate Professor of Pediatrics
Baylor College of Medicine
Houston, TX
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

ML

Molly Lamb

Assistant Professor
Colorado School of Public Health
Aurora, Colorado
Disclosure: BioFire (Grant/Research Support)
JW

Jesse Waggoner

Assistant Professor
Emory University School of Medicine
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
aP

alejandra Paniagua-avila

Investigator
Fundacion para la Salud Integral de los Guatemaltecos
Guatemala City, Sacatepequez, Guatemala
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DB

Desiree Bauer

Mrs.
Center for Human Development, Fundacion para la Salud de los Guatemaltecos, Retalhuleu, Guatemala
Denver, Colorado
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AC

Amy Connery

Assistant Professor
University of Colorado
Denver, CO
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Daniel Olson

Associate Professor
CU School of Medicine
Denver, Colorado
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MN

Muktha Natrajan

Investigator
Emory University Vaccine Center
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Evan J. Anderson

Professor
Emory University School of Medicine
Atlanta, Georgia
Disclosure: Sanofi Pasteur (Scientific Research Study Investigator)
MC

Mirella Calvimontes

Investigator
Fundacion para la Salud Integral de los Guatemaltecos
Aurora, CO
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GB

Guillermo Bolanos

Investigator
Fundacion para la Salud Integral de los Guatemaltecos
Denver, CO
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
FM

Flor Munoz

Associate Professor of Pediatrics
Baylor College of Medicine
Houston, Texas
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EA

Edwin J. Asturias

Professor
CU School of Medicine
Aurora, Colorado
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Little is known about the epidemiology of Cytomegalovirus (CMV) infection in low resource countries. We evaluated the frequency and effects of post-natal CMV infection in infants from a prospective cohort study designed to assess the effects of post-natal Zika on neurodevelopment (ND) in rural Guatemala.Infants with CMV infection (blue bars) were older compared CMV-negative (red bars) infants.

Methods: Infants were evaluated for CMV infection by PCR using urine samples collected at 0-3 months of age. ND testing was conducted by local psychologists using a culturally adapted Mullen Scales of Early Learning (MSEL). We explored associations between CMV infection and microcephaly, neurological, visual and hearing deficits, malnutrition and ND outcomes at 1 year of age.

Results: The infant cohort (N = 469) had a mean age at enrollment of 1.5 (SD 0.75) months; 47% were female and 71% were breastfeeding at 1 year. A total of 103 (22%) were CMV positive and the majority of these (97%) were > 4 weeks of age at testing. Infants > 4 weeks of age were more likely to be CMV positive (P < 0.0001) (Figure). Gender was not correlated with CMV positivity. Among children with head circumference (HC) measurements, microcephaly (HC < 2 SD) was present in 9/87 (10.3%) CMV positive and 35/338 (10.4%) CMV negative infants at 0-3 months of age (p =0.99). Among 438 infants who underwent screening for hearing deficits and a complete ophthalmologic evaluation, none of the CMV positive children had abnormal vision or hearing. Abnormal neurological exams in the first year of life occurred in 50/100 (50%) CMV positive and 166/365 (45.5%) CMV negative infants (p =0.56). There was no association between CMV infection at 0-3 months and MSEL overall or subdomain scores at 1 year (overall Relative risk (RR) 1.02, 95% CI 0.99-1.05, p=0.16). Malnutrition at 0-3 months (RR: 1.53, 95% CI 0.89-2.66, p = 0.13) and 1 year (RR: 1.10, 95% CI 0.77-1.58, p=0.59) was not associated with CMV infection at 0-3 months.

Conclusion: In a cohort of Guatemalan infants, postnatal CMV infection was common (22%) and more likely to occur after the neonatal period. There was no correlation between CMV infection and microcephaly at 0-3 months or at 1 year of age, nor with abnormal nutritional, neurologic, ophthalmologic, hearing or ND deficits at 1 year of age. This is the first epidemiologic report on CMV infection in early life in rural Guatemala.