Severe cytomegalovirus-triggered autoimmune hemolytic anemia complicating vertically acquired HIV infection

The association of acute cytomegalovirus infection with severe autoimmune hemolysis has not yet been reported in patients with HIV infection. The case is described of a 9-month-old infant with congenital HIV-1 infection who presented with severe autoimmune hemolysis and a high cytomegalovirus viral plasma load. Alternative causes of the hemolysis, such as drugs or other infections, were ruled out. After birth and after successful therapy of hemolysis, cytomegalovirus was not detected in the plasma, strongly suggesting a causal relationship between the hemolysis and cytomegalovirus infection. Severe autoimmune hemolysis should thus be considered as a cytomegalovirus-associated complication in HIV infection.