Factors associated with cytomegalovirus serostatus in young people in England: a cross-sectional study

Abstract

Background Human cytomegalovirus (CMV) is a common herpesvirus which is estimated to infect 83% of the global population. Whilst many infections are asymptomatic, it is an important cause of morbidity and mortality, particularly for immunocompromised people and for infants who are congenitally infected. A vaccine against CMV has been stated as a public health priority, but there are gaps in our understanding of CMV epidemiology. To guide potential future vaccination strategies, our aim was to examine risk factors for CMV seropositivity in young people in England. Methods The Health Survey for England (HSE) is an annual, cross-sectional representative survey of households in England during which data are collected through questionnaires, and blood samples are taken. We randomly selected individuals who participated in the HSE 2002, aiming for 25 participants of each sex in each single year age group from 11 to 24 years. Stored samples were tested for CMV antibodies. We undertook descriptive and regression analyses of CMV seroprevalence and risk factors for infection. Results Demographic data and serostatus were available for 732 individuals, of whom 175 (23.7%) were CMV-seropositive. CMV seroprevalence was associated with age, with 18.3% seropositive at 11–14 years compared to 28.3% at 22–24 years. CMV serostatus was also higher in people of non-white ethnicity (adjusted odds ratio [aOR] 6.22, 95% confidence interval [CI] 3.47–11.14), and in adults who were seropositive for EBV (aOR 2.08 [1.06–4.09]). There was no evidence that smoking status, occupation, body mass index and region of England were associated with CMV serostatus. Conclusions CMV seroprevalence is strongly associated with ethnicity, and modestly increases with age in 11–24-year-olds. A greater understanding of the transmission dynamics of CMV, and the impact of this on CMV-associated morbidity and mortality, is necessary to inform effective vaccination strategies when a vaccine for CMV becomes available.

Epidemiological and Liver Biomarkers Profile of Epstein-Barr Virus Infection and Its Coinfection with Cytomegalovirus in Patients with Hematological Diseases

“…Similar results were found among patients carriers of infectious mononucleosis in the United Kingdom and healthy individuals from the Brazilian state of Espirito Santo [5,18]. However, it is important to point out that the children of our study population were often absent from school owing to their health condition, which could directly influence the prevalent rates, considering that daycare and school attendance are important factors implicated in the mechanism of EBV and CMV transmission among children [4,19].…”

Cytomegalovirus infection may be oncoprotective against neoplasms of B-lymphocyte lineage: single-institution experience and survey of global evidence

“…Global disease burden reports [36,52,53,[55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] suggest a significant inverse correlation between overall estimates of CMV seropositivity and the age-standardized and population-based incidence rate of B-cell cancers (Tables 4 and 6, Fig. 1A-D).…”

Association Between Cytomegalovirus Infection and Tuberculosis Disease: A Systematic Review and Meta-Analysis of Epidemiological Studies

“…The infection typically occurs later in high-income industrialized countries, with an estimated prevalence of 60%–70% at the age of 60 years [ 3 ]. Notwithstanding, a study among young people in the United Kingdom reveals that nearly a quarter of individuals aged 11–24 years are infected with cytomegalovirus and the seroprevalence modestly increases with age [ 5 ].…”