Peer-reviewed article
1407. Cytomegalovirus (CMV) infection in the first year of life in a cohort of infants in rural Guatemala
Munoz F, Lamb M, Waggoner J, Paniagua-avila a, Bauer D et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined cytomegalovirus (CMV) infection in infants during their first year of life in rural Guatemala. Researchers tested 469 infants for CMV using urine samples and assessed their neurodevelopment, hearing, vision, and nutrition at one year of age. CMV infection was found in 22% of infants, but there were no differences in health outcomes between infected and uninfected children, including neurodevelopment scores, hearing, vision, and nutritional status.
Key points
- 22% (103/469) of infants in the cohort tested positive for CMV infection
- CMV infection was more common after 4 weeks of age (97% of positive cases)
- No association found between CMV infection and microcephaly (10.3% in CMV-positive vs 10.4% in CMV-negative infants)
- No CMV-positive children had abnormal vision or hearing deficits
- No correlation between CMV infection at 0-3 months and neurodevelopment scores at 1 year (RR 1.02, 95% CI 0.99-1.05)
Limitations
This is an observational cohort study without intervention, so it can only describe the epidemiology and associations of CMV infection, not establish causation. The study was not specifically designed to evaluate CMV but rather to assess effects of Zika on neurodevelopment, which may limit the depth of CMV-specific investigation.
Abstract
Abstract 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. Disclosures Molly Lamb, PhD, BioFire (Grant/Research Support)