{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:10:45Z","timestamp":1790885445730,"version":"4.1.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,11,10]],"date-time":"2019-11-10T00:00:00Z","timestamp":1573344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 MH087344"],"award-info":[{"award-number":["R01 MH087344"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 AI131928"],"award-info":[{"award-number":["K24 AI131928"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005627","name":"Thrasher Research Fund","doi-asserted-by":"publisher","award":["AWD 164515"],"award-info":[{"award-number":["AWD 164515"]}],"id":[{"id":"10.13039\/100005627","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006383","name":"Children\u2019s Hospital Colorado Research Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006383","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Human immunodeficiency virus (HIV)-exposed, uninfected (HEU) infants experience high rates of infectious morbidity. We hypothesized that early cytomegalovirus (CMV) infection was associated with increased hospitalization rates and decreased vaccine responses in HEU compared with HIV-unexposed (HUU) infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among infants enrolled in the Tshipidi study in Botswana, we determined CMV infection status by 6 months of age and compared hospitalization rates and responses to tetanus and Bacille Calmette-Gu\u00e9rin vaccines among HEU and HUU vaccinees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen of 226 (6.6%) HEU infants and 17 (19.3%) of 88 HUU infants were CMV-infected by 6 months. The HEU infants were approximately 3 times as likely to be hospitalized compared with HUU infants (P = .02). The HEU peripheral blood cells produced less interleukin (IL)-2 (P = .004), but similar amounts of interferon-\u03b3, after stimulation with tetanus toxoid. Antitetanus immunoglobulin G titers were similar between groups. Cellular responses to purified protein derivative stimulation did not differ between groups. Maternal receipt of 3-drug antiretroviral therapy compared with zidovudine was associated with increased IL-2 expression after tetanus toxoid stimulation. The infants\u2019 CMV infection status was not associated with clinical or vaccine response outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed that increased rates of hospitalization and decreased memory T-cell responses to tetanus vaccine were associated with HIV exposure and incomplete treatment of maternal HIV infection, but not early CMV infection.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiz590","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T12:10:24Z","timestamp":1573128624000},"page":"1167-1175","source":"Crossref","is-referenced-by-count":13,"title":["Human Immunodeficiency Virus Exposure but Not Early Cytomegalovirus Infection Is Associated With Increased Hospitalization and Decreased Memory T-Cell Responses to Tetanus Vaccine"],"prefix":"10.1093","volume":"221","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-6477","authenticated-orcid":false,"given":"Christiana","family":"Smith","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha O","family":"Moraka","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"},{"name":"Stellenbosch University, Stellenbosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryanne","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sikhulile","family":"Moyo","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Mayondi","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy","family":"Kammerer","sequence":"first","affiliation":[{"name":"Boston Children\u2019s Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Leidner","sequence":"first","affiliation":[{"name":"Goodtables Data Consulting, Norman, Oklahoma, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simani","family":"Gaseitsiwe","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaobing","family":"Li","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Shapiro","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Lockman","sequence":"first","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Weinberg","sequence":"first","affiliation":[{"name":"University of Colorado School of Medicine, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,11,10]]},"reference":[{"key":"2020031610473270000_CIT0001","doi-asserted-by":"crossref","first-page":"164","DOI":"10.3389\/fimmu.2016.00164","article-title":"Pattern of infectious morbidity in HIV-exposed uninfected infants and children","volume":"7","author":"Slogrove","year":"2016","journal-title":"Front Immunol"},{"key":"2020031610473270000_CIT0002","author":"National AIDS Coordinating 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