Longitudinal Risk of Herpes Simplex Virus (HSV) Type 1, HSV Type 2, and Cytomegalovirus Infections among Young Adolescent Girls

Stanberry, Lawrence R.; Rosenthal, Susan L.; Mills, Lisa; Succop, Paul; Biro, Frank M.; Morrow, Rhoda Ashley; Bernstein, David I.

doi:10.1086/425307

Cited by 63 publications

(43 citation statements)

References 28 publications

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“…This result is comparable to previously published US estimates in this age group (41%-89%) [5,6,23,[25][26]. The fact that roughly half of this population is already infected with CMV should be taken into account when determining the optimal target age for a CMV vaccine.…”

Section: Discussionsupporting

confidence: 87%

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Seroprevalence and Risk Factors for Cytomegalovirus Infections in Adolescent Females

Stadler

Bernstein

Callahan

et al. 2012

Journal of the Pediatric Infectious Diseases Society

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Background. Congenital cytomegalovirus (CMV) is a leading cause of disability, including sensorineural hearing loss, developmental delay, and mental retardation. Understanding risk factors for acquisition of CMV infection in adolescent females will help determine vaccine strategies. Methods. Females (12-17 years) were recruited from primary care settings in Cincinnati, Galveston, Houston, and Nashville from June 2006 to July 2010 for a seroepidemiologic study, from which seronegative participants were recruited for a CMV vaccine trial. Participants (n = 1585) responded to questions regarding potential exposures. For those with young children in the home (n = 859), additional questions were asked about feeding and changing diapers, and for those > 14 years of age (n = 1162), questions regarding sexual activity were asked. Serum was evaluated for CMV antibody using a commercial immunoglobulin G assay. Results. Cytomegalovirus antibody was detected in 49% of participants. In the univariate analyses, CMV seroprevalence was significantly higher among African Americans, those with children < 3 years of age in the home, and those with a history of oral, anal, or vaginal intercourse. Among those with young children in the home, feeding children and changing diapers further increased the association with CMV infection. However, in the final multivariate analysis, only African Americans and household contact with young children were associated with CMV infection. Conclusions. By age 12, evidence of CMV infection was common. Multiple factors regarding race and personal behaviors likely contribute to seroconversion earlier in life.

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Section: Discussionsupporting

confidence: 87%

“…Previous studies indicate that CMV may be transmitted via saliva, urine (or handling of diapers), blood, cervical secretions, and semen [2,[17][18][19][20][21][22][23]. Because young women frequently engage in behaviors with children at the peak age of CMV shedding (1-2 year olds), they are at risk for coming into contact with body fluids containing CMV.…”

mentioning

confidence: 99%

Seroprevalence and Risk Factors for Cytomegalovirus Infections in Adolescent Females

Stadler

Bernstein

Callahan

et al. 2012

Journal of the Pediatric Infectious Diseases Society

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“…In addition to the fact that these viruses represent a cross-section of human herpes-virus families, we also chose these herpesviruses because good latently infected cell line model systems exist for them and because they cause close to universal infections in humans by an early age (14)(15)(16)(17), making the clinical and translational implications of the studies more compelling. These viruses have been associated with significant adverse clinical outcomes in clinical situations in which substantial numbers of cells may be undergoing apoptosis, such as treatment with cytotoxic cancer chemotherapeutic agents, solid organ and bone marrow transplantation (18,19), and severe hypersensitivity and autoimmune disorders (20)(21)(22)(23)(24), and in patients critically ill from a variety of causes (25).…”

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confidence: 99%

Activation of Human Herpesvirus Replication by Apoptosis

Prasad

Remick

Zeichner

2013

J Virol

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A central feature of herpesvirus biology is the ability of herpesviruses to remain latent within host cells. Classically, exposure to inducing agents, like activating cytokines or phorbol esters that stimulate host cell signal transduction events, and epigenetic agents (e.g., butyrate) was thought to end latency. We recently showed that Kaposi's sarcoma-associated herpesvirus (KSHV, or human herpesvirus-8 [HHV-8]) has another, alternative emergency escape replication pathway that is triggered when KSHV's host cell undergoes apoptosis, characterized by the lack of a requirement for the replication and transcription activator (RTA) protein, accelerated late gene kinetics, and production of virus with decreased infectivity. Caspase-3 is necessary and sufficient to initiate the alternative replication program. HSV-1 was also recently shown to initiate replication in response to host cell apoptosis. These observations suggested that an alternative apoptosis-triggered replication program might be a general feature of herpesvirus biology and that apoptosis-initiated herpesvirus replication may have clinical implications, particularly for herpesviruses that almost universally infect humans. To explore whether an alternative apoptosis-initiated replication program is a common feature of herpesvirus biology, we studied cell lines latently infected with Epstein-Barr virus/HHV-4, HHV-6A, HHV-6B, HHV-7, and KSHV. We found that apoptosis triggers replication for each HHV studied, with caspase-3 being necessary and sufficient for HHV replication. An alternative apoptosis-initiated replication program appears to be a common feature of HHV biology. We also found that commonly used cytotoxic chemotherapeutic agents activate HHV replication, which suggests that treatments that promote apoptosis may lead to activation of latent herpesviruses, with potential clinical significance.

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“…The main findings from limited studies of CMV seroconversion among miscellaneous populations (Table 4) include (1) rates among blood donors were similar to rates among pregnant women and healthcare workers [24,25]; (2) adolescent minority females have high rates of seroconversion (Figure 1), although study populations were relatively small and so may not be representative [26,27]; (3) women attending STD clinics also have higher seroconversion rates than pregnant women and healthcare workers [28,29]; (4) children have higher seroconversion rates than are typical among adults, especially the youngest children [30] and (5) families with a CMV-infected member have an annual CMV conversion rate of approximately 10% [72] (Table 4).…”

Section: Results In Miscellaneous Study Populationsmentioning

confidence: 99%

Cytomegalovirus seroconversion rates and risk factors: implications for congenital CMV

Hyde

Schmid

Cannon

2010

Reviews in Medical Virology

239

159

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Congenital CMV infection is caused by in utero mother-to-fetus transmission and is a leading cause of birth defects and developmental disabilities. The highest risk of disability is to children born to women who have a primary infection during pregnancy, which can be detected by measuring seroconversion. We reviewed studies that reported rates of CMV seroconversion in different populations. Among pregnant women, annual seroconversion rates typically ranged from 1 to 7% (summary annual rate = 2.3%, 95% CI = 2.1-2.4%). Healthcare workers, including those caring for infants and children, had seroconversion rates similar to pregnant women (summary annual rate = 2.3%, 95% CI = 1.9-2.9%). Among day-care providers, seroconversion rates ranged from 0 to 12.5% (summary annual rate = 8.5%, 95% CI = 6.1-11.6%). Parents whose child was not shedding CMV were much less likely to seroconvert (summary annual rate = 2.1%, 95% CI = 0.3-6.8%) than were parents who had a child shedding CMV (summary annual rate = 24%, 95% CI = 18-30%). Nevertheless, over the course of a year, most parents exposed to a CMV-shedding child do not become infected. Other groups with elevated risk included families with a CMV-shedding member, female minority adolescents and women attending sexually transmitted disease clinics. The relatively low rate of CMV seroconversion in most populations is encouraging for behavioural interventions and for vaccine strategies attempting to prevent infection during pregnancy.

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Longitudinal Risk of Herpes Simplex Virus (HSV) Type 1, HSV Type 2, and Cytomegalovirus Infections among Young Adolescent Girls

Abstract: This longitudinal study of adolescent girls found high baseline CMV and HSV-1 seroprevalence rates and substantial attack rates for all 3 pathogens.

Cited by 63 publications

References 28 publications

Seroprevalence and Risk Factors for Cytomegalovirus Infections in Adolescent Females

Seroprevalence and Risk Factors for Cytomegalovirus Infections in Adolescent Females

Activation of Human Herpesvirus Replication by Apoptosis

Cytomegalovirus seroconversion rates and risk factors: implications for congenital CMV

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