Factors associated with cytomegalovirus infection among human immunodeficiency virus type 1-seronegative and -seropositive women from an urban minority community.

Abstract

Cytomegalovirus (CMV) seroprevalence and genital tract shedding in human immunodeficiency virus (HIV)-seronegative and HIV-seropositive women from an urban minority community were investigated. CMV seropositivity was high in both groups: 181 (95.2%) of 190 HIV-negative and 158 (90.3%) of 175 HIV-positive subjects. Cervicovaginal shedding was detected in 8 (4.4%) CMV-positive HIV-negative subjects and 31 (19.6%) HIV-positive subjects (odds ratio [OR], 5.28; P < .001). Multiple logistic regression analysis revealed that CMV shedding was independently associated with younger age (OR = 0.90; P < .001) and concurrent Chlamydia trachomatis or Neisseria gonorrhoeae infection (OR = 3.60; P = .08). However, shedding was observed over a broad age range in HIV-positive subjects, with 54.8% of shedders being > or = 30 years old. Among HIV-positive subjects, CMV shedding was also associated with decreased CD4 cell counts (P = .04) and, compared with HIV-negative subjects, was significantly higher (P < .001) among subjects with CD4 cell counts < 500 x 10(6)/L (26.5% in subjects with counts < or = 200 and 22.1% in subjects with counts of 201-499 x 10(6)/L).