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. 2020 Sep 17;15(9):e0238102.
doi: 10.1371/journal.pone.0238102. eCollection 2020.

Neurological and growth outcomes in South African children with congenital cytomegalovirus: A cohort study

Jayani Pathirana  1   2 , Leanne Texeira  3 , Hannah Munian  3 , Firdose Nakwa  4 , Ismail Mayet  5 , Innocent Maposa  6 , Michelle J Groome  1   2 , Suresh Boppana  7   8 , Shabir A Madhi  1   2
Affiliations

Neurological and growth outcomes in South African children with congenital cytomegalovirus: A cohort study

Jayani Pathirana et al. PLoS One. .

Abstract

Objectives: To assess neurological sequelae and growth in the first 12 months of life in a cohort of congenital cytomegalovirus (cCMV) infected infants compared to cCMV uninfected infants.

Study design: This was a prospective matched cohort study conducted in Soweto, South Africa where forty-six confirmed cCMV cases were matched on HIV-exposure, gender and gestational age (±two weeks) to 84 cCMV-uninfected controls in a 1:2 ratio. Cases and controls were followed up until 12 months of age to assess anthropometry, hearing and neurodevelopmental outcomes.

Results: Thirty-four (73.9%) cCMV cases and 74 (88.1%) controls, completed all assessments at 12 months age. At 12 months, one cCMV case had died, none of the children in either group had SNHL and neurodevelopmental delay was present in a similar percentage of cCMV cases (n = 2; 6%) and controls (n = 1, 4%; OR 1.09, 95% CI 0.04-27.84, p = 0.958). Anthropometry did not differ between cases and controls overall throughout the follow up period. HIV-exposed cases had smaller head circumference for age at 6 and 12 months when compared with HIV-exposed controls.

Conclusion: By 12 months of age, there was no evidence of a difference in neurological sequelae between cCMV infected South African children and cCMV uninfected children in this study. Further follow-up is warranted to detect late-onset hearing loss and neurodevelopmental delay beyond 12 months of age.

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Conflict of interest statement

I have read the journal's policy and the authors of this manuscript have the following competing interests: Shabir Madhi reports grants from the National Research Foundation, South Africa during the conduct of the study and grants and personal fees from the Bill and Melinda Gates Foundation, grants from Pfizer, GlaxoSmithKline, Sanofi and Mivervax outside the submitted work. Suresh Boppana reports personal fees from Merck and grants from Meridian Biosciences outside the submitted work. All other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials outside the submitted work. All other authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart representing numbers of cases and controls enrolled and assessments at each study visit.
Fig 2
Fig 2. Trend in difference of mean anthropometry Z-scores between HIV-exposed congenital cytomegalovirus infected and uninfected children over 12 months.
cCMV (congenital cytomegalovirus), WAZ (weight for age), LAZ (length for age), BMIZ (Body mass index for age), ACZ (arm circumference for age), Head circumference for age (HCZ).
Fig 3
Fig 3. Trend in difference of mean anthropometry Z-scores between HIV-unexposed congenital cytomegalovirus infected and uninfected children over 12 months.
cCMV (congenital cytomegalovirus), WAZ (weight for age), LAZ (length for age), BMIZ (Body mass index for age), ACZ (arm circumference for age), Head circumference for age (HCZ).
See this image and copyright information in PMC

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