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Nelfinavir (NFV), an antiretroviral drug that is safe during pregnancy, inhibits CMV replication in vitro at concentrations that standard doses achieve in plasma. We hypothesized that infants born to women receiving NFV for prevention of mother\u2010to\u2010child transmission of HIV (PMTCT) would have a reduced prevalence of cCMV infection. Methods: The prevalence of cCMV infection was compared among HIV\u2010uninfected infants whose HIV\u2010infected mothers either received NFV for <jats:styled-content>&gt;<\/jats:styled-content>4 weeks during pregnancy (NFV\u2010exposed) or did not receive any NFV in pregnancy (NFV\u2010unexposed). CMV PCR was performed on infant blood samples collected at &lt;3 weeks from birth. Results: Of the 1,255 women included, 314 received NFV for <jats:styled-content>&gt;<\/jats:styled-content>4 weeks during pregnancy and 941 did not receive any NFV during pregnancy. The overall prevalence of cCMV infection in the infants was 2.2%, which did not differ by maternal NFV use. Maternal CD4 T cell counts were inversely correlated with risk of cCMV infection, independent of the time NFV was initiated during gestation. Infants with cCMV infection were born 0.7 weeks earlier (<jats:italic>P<\/jats:italic>\u2009=\u20090.010) and weighed 170\u2009g less (<jats:italic>P<\/jats:italic>\u2009=\u20090.009) than uninfected infants. Conclusion: Among HIV\u2010exposed uninfected infants, cCMV infection was associated with adverse perinatal outcomes. NFV use in pregnancy was not associated with protection against cCMV. Safe and effective strategies to prevent cCMV infection are needed. <jats:bold><jats:italic>J. Med. Virol. 88:1051\u20131058, 2016<\/jats:italic><\/jats:bold>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.24420","type":"journal-article","created":{"date-parts":[[2015,10,31]],"date-time":"2015-10-31T23:08:42Z","timestamp":1446332922000},"page":"1051-1058","source":"Crossref","is-referenced-by-count":24,"title":["Risk of congenital cytomegalovirus infection among HIV\u2010exposed uninfected infants is not decreased by maternal nelfinavir use during pregnancy"],"prefix":"10.1002","volume":"88","author":[{"given":"Soren","family":"Gantt","sequence":"first","affiliation":[{"name":"Child and Family Research Institute University of British Columbia Vancouver British Columbia Canada"},{"name":"Fred Hutchinson Cancer Research Center Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Leister","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research The Harvard T. H. Chan School of Public Health Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise L.","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research The Harvard T. H. Chan School of Public Health Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Boucoiran","sequence":"additional","affiliation":[{"name":"Sainte\u2010Justine University Health Centre Montreal Qu\u00e9bec Canada"},{"name":"University of Montreal Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meei\u2010Li","family":"Huang","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle Washington"},{"name":"University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith R.","family":"Jerome","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center Seattle Washington"},{"name":"University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzague","family":"Jourdain","sequence":"additional","affiliation":[{"name":"Institute for Development Research Marseille France"},{"name":"The Harvard T. 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