Low CD4 Counts and Early Sexual Debut Predict Genital CytomegalovirusInfection among HIV Infected Women in Mwanza, Tanzania

Fridolin Mujuni, M. Mirambo, Müller Andreas, Korn Klaus, D. Matovelo, M. Mushi, M. Majigo, S. Mshana
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Abstract

Objective: Here we report the prevalence and predictors of genital CMV infection among HIV infected women in Mwanza, Tanzania. Methods: A total of 255 HIV seropositive women were investigated between August and October, 2014. Demographic and clinical data were collected using standardized data collection tool. Exfoliated cells from endocervix were obtained and detection of CMV DNA was done using real-time polymerase chain reaction (RTPCR). Results: A total number of 255 HIV infected women were enrolled with the mean age of 39.2 ± 9.1.The overall prevalence of genital CMV among HIV infected women was 43(16.7%, 95% CI: 12-21). Inflammatory changes and dysplasia did not show any association with genital CMV infection (p>0.05). Only good socio-economic status (OR=2.36, 95% CI; 1.1-5.02, p=.0.027), young age at first sexual intercourse (OR=2.18, 95% CI; 1.04-4.62, p=0.04) and lower CD4+ counts (OR=2.07, 95% CI; 1.23-3.48, p=.0.027) were found to be independent predictors of genital CMV infection among HIV infected women. Conclusion: A significant proportion of HIV infected women are genitally infected with CMV in the genital tract. More studies to ascertain the clinical role of this virus in the female genital tract are recommended especially in HIV infected women.
低CD4计数和早期性行为预示着坦桑尼亚姆万扎HIV感染妇女的生殖器巨细胞病毒感染
目的:在此,我们报告了坦桑尼亚姆万扎艾滋病毒感染妇女生殖器巨细胞病毒感染的患病率和预测因素。方法:2014年8 - 10月对255名HIV血清阳性妇女进行调查。采用标准化数据收集工具收集人口学和临床资料。取宫颈内脱落细胞,采用实时聚合酶链反应(RTPCR)检测巨细胞病毒DNA。结果:共纳入255例HIV感染妇女,平均年龄39.2±9.1岁。艾滋病毒感染妇女中生殖器巨细胞病毒的总体流行率为43(16.7%,95% CI: 12-21)。炎性改变和发育不良与生殖器巨细胞病毒感染无相关性(p < 0.05)。只有良好的社会经济地位(OR=2.36, 95% CI;1.1-5.02, p=.0.027),初次性交年龄较小(OR=2.18, 95% CI;1.04-4.62, p=0.04), CD4+计数较低(OR=2.07, 95% CI;1.23-3.48, p=.0.027)是HIV感染妇女生殖器巨细胞病毒感染的独立预测因子。结论:在感染HIV的妇女中,生殖道中有相当大比例的巨细胞病毒感染。建议进行更多的研究,以确定这种病毒在女性生殖道中的临床作用,特别是在感染艾滋病毒的妇女中。
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