Human Cytomegalovirus (HCMV) Infection in Sub-Saharan Africa

Abstract

. HCMV seroprevalenceThere have been over published studies which present HCMV IgG seroprevalence data for sub-Saharan Africa patient groups and cohorts of healthy blood donors Table . Up to eight different serology assays were used and older pre-ELISA methods might have slightly underestimated prevalence [ ]. Antibodies to HCMV are generally present in high titres in seropositive individuals, so the use of different assays is unlikely to have had a major effect [ ]. Hence, comparing these studies is primarily confounded by the diverse range of patient groups tested. Few studies stratify by age, or they do so using different groupings. Most of the studies use convenience samples, which do not provide accurate population-based estimates of prevalence.The most striking observation is that HCMV primary infection appears to be endemic in young infants. A population-based study in Zambia of healthy infants showed % HCMV seroprevalence by months of age [ ] Table . This backs up much older studies from the Gambia [ ] and Nigeria [ ]. This differs from the results of larger studies in the USA n = , where HCMV seroprevalence ranges from % in -year-olds to % in those over years old. The cumulative incidence of HCMV primary infection was ~ % per year from adolescence [ ]. In the USA, non-white ethnicity and lower socioeconomic status SES were linked with -percentage point increases in seroprevalence [ ]. A study of over , women in the U.K attending antenatal clinics found similar results, with increasing parity also being linked with increased HCMV seroprevalence. This supports the notion that seronegative adult women contract primary HCMV infection from children who are shedding virus [ ]. Figure presents a model for cumulative HCMV seroprevalence by age with respect to SES, showing more rapid uptake in low SES communities, and delayed uptake in high SES communities. Conversely an Israeli study found the effect of ethnicity persisted even when corrected for gender, education and SES [ ], and high HCMV seroprevalence has been described in populations with high SES groups [ , ].

HIV Infection Is Associated with Shortened Telomere Length in Ugandans with Suspected Tuberculosis

“…[ 56 , 57 ] One review that included over 25 studies from sub-Saharan African countries found weighted average CMV IgG seroprevalence rates in HIV-infected and HIV-uninfected adult patients to be 80.0% (range 59%-100%) and 79.3% (range 55%-97%), respectively. [ 58 ] Thus, the absence of CMV data in our study remains a limitation, but we do not believe that CMV infection is significantly affecting our finding that HIV infection is an independent predictor associated with shorter telomere length due to the similar rates of CMV infection found in numerous studies from sub-Saharan Africa.…”

Prevalence and Risk Factors for Betaherpesvirus DNAemia in Children >3 Weeks and <2 Years of Age Admitted to a Large Referral Hospital in Sub-Saharan Africa

“…Recent prospective studies and careful review of some older but overlooked studies, has lead to a growing awareness of the importance of HCMV infections in high seroprevalence settings [11][12][13], as a major cause of mortality in HIV-infected children [14,15] and as a cause of developmental delay [5] and hearing loss [16][17][18] in children through either congenital or early infant infections, with maternal HIV infection and lower CD4 count associated with higher prevalence of congenital infection [15,19]. Human herpesvirus 6A (HHV-6A), Human herpesvirus 6B (HHV-6B) and Human herpesvirus 7 (HHV-7)) have been less well studied in sub-Saharan Africa.…”

Seroprevalence of Rubella virus and cytomegalovirus infections in infertile women in Baghdad city

“…Determination of positive and negative samples for the presence of specific antibodies (IgM and IgG) for CMV and rubella was done by ELISA system depending on the cut-off values of standard positive and negative controls as shown in table (1).Equivocal CMV IgM or IgG results may occur during acute infection or may be due to non-specific binding reactions (12), thus, Samples showed equivocal titers were considered negative for the presence of specific antibody. (14).…”