Sero-prevalence of human cytomegalovirus infection and predisposing factors among HIV infected patients attending comprehensive care clinic at Kenyatta National Hospital, Kenya

Abstract

Background: Human Cytomegalovirus (hCMV) is one of the opportunistic infections in HIV patients. During an active infection it's a common cause of Pneumonia, retinitis, gastro-intestinal disease, and hepatitis. It is significantly associated as a HIV disease co-factor. It does quicken HIV acquisition, disease progression and high mortality and morbidity in HIV patients. Currently there is scanty data on this disease in Kenya leading to lack of recognition on the magnitude especially in HIV patients. Objective:To determine the sero-prevalence and predisposing factors associated with hCMV infection among HIV infected individuals attending comprehensive care clinic (CCC) at Kenyatta National Hospital, Nairobi County, Kenya. Design: A cross sectional study. Setting: Kenyatta National Hospital. Subjects: A total of 400 consenting patients were systematically sampled from HIV comprehensive clinic of Kenyatta National Hospital between July and August 2015 Results: A total of 400 HIV-infected individuals who were 18 years and above with an average age of 42.73 (SD, 9.5) years were screened for CMV infections. Of these, 246(61.5%) were female and 154(38.5%) were male. Of 400,398 (99.0%) were hCMV IgG sero-positive, 32 (8.0%) were hCMV IgM sero-positive. Age group between 19 and 28 years [OR= 4.8 95% CI: (1.4-16.4); P=0.012], never been married [OR= 4.3 95% CI: (1.3-14.5); p=0.020], never had children [OR=3.2 95% CI: (1.2-8.5); p=0.022] and use of highly active anti-retroviral therapy (HAARn [OR=3.5 95% CI: (1.2-10.3); p=0.031]were found to be significantly associated with CMV sero-positivity in bivariate analysis. In multivariate analysis, bothCD4 (p <0.001) and viral loads (p <0.001) were found to be significantly associated with CMV sero-positivity. Conclusion: The 99.0% sero-prevalence of hCMV in the HIV patient's calls for routine screening for hCMV infections in order to prevent neurological clinical manifestations associated with CMV in HIV patients. Human cytomegalovirus preventive measures may be necessary to decrease mortality and morbidity associated with hCMV infections.