Abstract
This study aimed to investigate the seroprevalence of cytomegalovirus (CMV) infection and risk factors associated with CMV acquisition among pregnant women in Zimbabwe. In a cross-sectional study, pregnant women were recruited in late gestation, seeking antenatal care at council clinics in three high-density suburbs in Harare, Zimbabwe. Anti-CMV IgM and IgG antibodies were quantified in serum using an enzyme-linked immunosorbent assay. Antibody avidity tests were used to distinguish active infection from viral reactivation in anti-CMV IgM-positive cases. Five hundred and twenty four women were recruited: 278 HIV infected and 246 HIV uninfected. Current or active CMV infection defined as IgM positive+low avidity was detected in 4.6% (24/524), 95% confidence interval (CI): 3–6.9 in all women, 5.8% (16/278) in the HIV infected and 3.3% (8/246), 95% CI: 1.4–6.3 in the HIV uninfected. IgG seroprevalence was 99.6% (522/524), 95% CI: 98.6–99.9 in all women. Notably, the difference in the prevalence of active CMV infection between the HIV-infected and HIV-uninfected women was not statistically significant (p = 0.173). The study shows a low prevalence of primary or active CMV infection among the pregnant women, but the IgG seroprevalence suggests high previous CMV exposure. Importantly, CMV seroprevalence was not associated with the HIV status of the women, perhaps due to the ubiquitous exposure of the population to CMV.
Highlights
Cytomegalovirus (CMV) infection is endemic worldwide, with a 30–61% seroprevalence in developed countries [1,24] and 60–100% seroprevalence in developing countries [26,31,38]
This study aimed to investigate the seroprevalence of cytomegalovirus (CMV) infection and risk factors associated with CMV acquisition among pregnant women in Zimbabwe
Current or active CMV infection defined as IgM positive+low avidity was detected in 4.6% (24/524), 95% confidence interval (CI): 3–6.9 in all women, 5.8% (16/278) in the HIV infected and 3.3% (8/ 246), 95% CI: 1.4–6.3 in the HIV uninfected
Summary
Cytomegalovirus (CMV) infection is endemic worldwide, with a 30–61% seroprevalence in developed countries [1,24] and 60–100% seroprevalence in developing countries [26,31,38]. CMV infection is usually acquired early in life resulting in an asymptomatic, subclinical, and mostly latent infection in immune-competent persons. In the context of immune dysregulation or immune compromise such as pregnancy and HIV infection, latent CMV virus can be reactivated to cause symptomatic infection [21]. Reactivation of CMV predisposes to transmission of the virus from the mother to the developing fetus, leading to congenital CMV (cCMV) infection [35]. The consequences of cCMV can be severe and include cerebral disability, psychomotor delay, speech and language disabilities, interactive disorders, visual damage, cerebral palsy, and sensorineural hearing loss for which CMV is the leading nongenetic cause [9,25]
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