Cytomegalovirus Seroprevalence Research Articles

Area-Level Social Deprivation and Cytomegalovirus Seropositivity at the Time of Solid Organ Transplant

Cytomegalovirus (CMV) is associated with significant morbidity and mortality in solid organ transplant (SOT) recipients. The risk factors for CMV seropositivity in SOT recipients, including area-level social deprivation in the US, have not been fully characterized. To (1) evaluate CMV seroprevalence, (2) assess the recipient characteristics associated with CMV seropositivity, and (3) assess the association of area-level social deprivation index (SDI) scores with pretransplant CMV serostatus. This retrospective cross-sectional analysis of the Scientific Registry of Transplant Recipients database included all adult (aged ≥18 years) SOT recipients from January 1, 2008, to May 31, 2022. Data were analyzed from April 10 to October 25, 2023. Recipient characteristics and area-level SDI. Multivariable generalized linear models were used to evaluate the association between (1) patient characteristics and CMV and (2) social deprivation (measured by SDI scores, which were assessed in quintiles, from lowest to highest) and CMV seropositivity. In addition, differences based on patient demographics and the transplanted organ(s) were evaluated. Among the 389 288 SOT recipients included in the analysis, mean (SD) age was 53.3 (13.0) years; 63.0% were male, 21.4% were Black, 15.2% were Hispanic White, 56.2% were non-Hispanic White, and 62.7% were CMV seropositive. The mean (SD) age was higher among CMV seropositive (54.0 [12.7] years) compared with CMV seronegative (52.0 [13.5] years) patients. Seropositivity for CMV was higher among women (69.9%) than men (58.5%) and among Black (74.8%) and Hispanic White (80.2%) patients compared with non-Hispanic White patients (50.4%). Seropositivity for CMV was highest among kidney (64.5%), liver (63.6%), and kidney and liver (66.2%) recipients. Greater SDI scores were associated with greater CMV seropositivity, ranging from 51.7% for the least deprived to 75.5% for the most deprived quintiles (P < .001), independent of age, sex, or race. In this cross-sectional study, an association between SDI and CMV seropositivity was observed among SOT recipients, independent of age, sex, or race and ethnicity. To optimize posttransplant outcomes in CMV seropositive recipients, efforts targeting prevention of CMV reactivation need to be prioritized in these higher-risk populations.

Seroprevalence of cytomegalovirus among pregnant women in Singapore

BackgroundCytomegalovirus (CMV) is the most common congenital infection in pregnancy with potential long-term adverse effects on the fetus. There is limited data on CMV seroprevalence in pregnant women in Singapore, with last reported study dating back over two decades. We look at the latest CMV seroprevalence in antenatal population in Singapore.MethodsBetween January 2021 and August 2021, 385 pregnant women receiving antenatal care at Singapore General Hospital were randomly selected for CMV IgG test to be performed on their blood samples collected during the first trimester of their pregnancies. Positivity for CMV IgG represents past exposure prior to pregnancy.ResultsOverall CMV seroprevalence was 71.7% (276/385) (95% CI 067, 0.76, p value < 0.001). The trend of CMV IgG positivity increased with age, 68.3% (95% CI 0.60, 0.76, p value < 0.001) in those aged 20–29, 72.5% (95% CI 0.66, 0.78, p value < 0.001) in the 30–39 age group, and 79.0% (95% CI 0.67, 0.76, p value 0.012) in women over 40.ConclusionsThere is a declining trend in CMV seroprevalence among pregnant women in Singapore, which indicates that a substantial portion of this population faces the risk of primary maternal CMV infection during pregnancy. Emerging research suggests that prenatal treatment with valacyclovir effectively reduces the likelihood of vertical transmission. Considering this evidence, it is imperative to reevaluate the recommendations for universal maternal CMV screening during pregnancy.

Seroprevalence and molecular detection of cytomegalovirus and some viral STDs and their infection risk factors in male subjects in Onitsha, South-East, Nigeria

Viral infections including latent viruses have been known to affect semen quality of men negatively thereby affecting reproductive potentials. A cross-sectional study was done to assess the prevalence of CMV antigen/ antibody (IgG and IgM), HBV, HCV, HIV, confirm CMV molecularly and determine their risk factors for infection. Blood and semen samples were collected from 96 apparently healthy men aged between 24 – 65years in Onitsha, South-East, Nigeria. Ethical approval and informed consents were obtained. Data was collected using structured questionnaires and standard WHO tool for STDs. Method: HBV and HCV antibodies were screened immunochromatographically; HIV tested by parallel method, confirmed using Western-blot; CMV IgG and IgM were screened using ELISA, confirmed molecularly with quantitative PCR. Data was assessed using SPSS version 23 set at 0.05 at 95% confidence interval. Result: This revealed that CMV IgG had the highest prevalence of 68(70.8%) (p=0.04), HIV had 2(2.1%) (p=0.904) and HCV had 1(1.0%) (p=0.167). None of the subjects tested positive to CMV IgM and HBV. One out of 17 samples tested positive for CMV qPCR 1(5.9%). HIV was significantly associated with multiple partners (p=0.002) and unprotected anal sex (p=0.019). Conclusion: Early screening and treatment should be done for a more quality health and reproductive life.

Seroprevalence of human herpes viruses in France, 2018–2022: a multilevel regression and poststratification approach

Background Information related to herpes simplex virus 1 and 2 (HSV-1 and 2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) seroprevalence in France is either lacking, incomplete, or outdated, despite their public health burden. Method We used routinely collected serological data between 2018 and 2022 to estimate HSV-1, HSV-2, VZV, EBV, and CMV seroprevalence in France. To account for demographic differences between our analytic samples and the French population and get estimates for sparsely sampled districts and age classes, we used a multilevel regression and poststratification approach combined with Bayesian model averaging via stacking weights. Results The observed seroprevalence (number of positive tests/number of tests) were 64.6% (93,294/144,424), 16.9% (24,316/144,159), 93.0% (141,419/152,084), 83.4% (63,199/75, 781), and 49.0% (23,276/47,525), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV. Between 2018 and 2022, France had a model-based average (equal-tailed interval at 95%) expected seroprevalence equal to 61.1% (60.7,61.5), 14.5% (14.2,14.81), 89.5% (89.3,89.8), 85.6% (85.2,86.0), and 50.5% (49.3,51.7), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV infections. We found an almost certain lower expected seroprevalence in Metropolitan France than in overseas territories for all viruses but VZV, for which it was almost certainly greater. The expected seroprevalences were likely greater among females for all viruses. Limitations Our results relied on the assumption that individuals were sampled at random conditionally to variables used to build the poststratification table. Implications The analysis highlights spatial and demographic patterns in seroprevalence that should be considered for designing tailored public health policies.

Evaluation of T. gondii, rubella, and cytomegalovirus seroprevalences among female Syrian refugees in Sanliurfa, Turkiye.

Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province. A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA). The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively. A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.

Serological status for Toxoplasma gondii and cytomegalovirus in pregnant women

Background and objective. Toxoplasma gondii and CMV cause congenital defects in TORCH (Toxoplasmosis, Rubella virus, cytomegalovirus, and Herpes simplex virus) infections. The primary objective of the study was to estimate the seroprevalence of Toxoplasma gondii (TOXO) and cytomegalovirus (CMV) infections among pregnant women in Al Qurnah, Iraq, and identify the presence of specific Immunoglobulin M (IgM) antibodies indicating recent infections. Material and method. The study tested 1000 healthy pregnant women using VIDAS® TOXO and CMV IgM kits. Results. The findings revealed a significant seroprevalence, with 37.2% of samples positive for Toxoplasma IgM, 22.8% for CMV IgM, and 9.6% for mixed infections. The highest rate of abortions occurred in the first trimester, with a significant increase in abortion parameters among pregnant women infected with T. gondii and CMV. Our study comprised 372 pregnant women with Toxoplasma infection; 286 (76.9%) were rural and 86 (23.1%) urban. Our analysis identified CMV in 228 pregnant women, 159 rural (69.7%), and 69 urban (30.3%). Conclusion. The study suggests a higher prevalence of Toxoplasma IgM compared to CMV IgM infections in the region, emphasizing the importance of early detection and prevention, especially during the first trimester. The results also highlight the need for routine antenatal screening and educational measures to reduce the impact of these infections on pregnancy outcomes.

COMPARISON SEROPREVALENCE OF TOXOPLASMA GONDII, RUBELLA, AND CYTOMEGALOVIRUS IN MUŞ PROVINCE BEFORE AND DURING THE COVID-19 PANDEMİC

The aim of this study is to determine the seroprevalence of Toxoplasma gondii (T. gondii), rubella and cytomegalovirus (CMV) and the primary infection rates of these agents with avidity test in pregnant women in Muş province. Additionally, the effect of prevention and protection measures implemented during the Covid-19 pandemic on the prevalence of T. gondii, rubella and CMV in pregnant women was also investigated. Between 2018 and 2021, IgG and IgM antibodies in the serum samples of pregnant women who applied to the Department of Gynecology and Obstetrics polyclinic of Muş State Hospital were examined by enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay (CLIA). High and low avidity assays were examined by enzyme linked fluorescence assay (ELFA). Low seroprevalence of T. gondii IgG antibody (28%) and the detection of low avidity detection in 38 of 102 pregnant women indicate that this parasite may be a risk for intrauterine life. Rubella IgG (89%) and CMV IgG (99%) antibodies were found to carry a low risk due to their high seroprevalence and avidity. It was determined that Covid-19 prevention and protection measures caused a significant decrease in the prevalence of rubella and CMV, but had no effect on the prevalence of T.gondii.

Seroprevalence of Cytomegalovirus, Epstein-barr Virus and Herpes Simplex Viruses in Children Born HIV Positive at the Yaounde University Teaching Hospital, Cameroon

Background: Cameroon is a country located in sub-Saharan Africa, which is an area endemic to herpesviridae family, there is very little data on the herpes virus infections epidemiology, especially associated with HIV infection. Aims: The aim of our study was to determine the seroprevalence of four herpes viruses that are cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes Simplex virus 1 (HSV-1) and 2 (HSV-2) in HIV-positive patients in Yaoundé University Teaching Hospital. Methodology: the study was prospective cross-sectional and took place at Yaounde University Teaching Hospital and Department of Microbiology, Faculty of Sciences, University of Yaounde I, between November 2020 and April 2021. We included consecutively 74 on children living with HIV born HIV positive, on antiretroviral treatment (23 men, 51 women; age range 3-19 years), and whose medical file was complete and available within the ATC. IgG/IgM antibodies against HSV-1, HSV-2, CMV, and IgM against EBV were qualitatively determined by Rapid Diagnostic Tests, for the detection of these pathogens. The statistical analysis was done using IBM SPSS version 22.0, the Fisher exact and the Khi-sqaure tests to compare qualitative variables between groups, while on the other hand, we used the Mann-Whitney test to compare quantitative variables. All P values below 0.05 were considered significant. Results: A total of 74 participants were enrolled in the study with a female predominance of 68.92% (n=51/74). The average age of our serie was 9.05±5.09 years, and a majority of participants was under 10 years old (56.76%, n=42/74). HSV-1, HSV-2, EBV and CMV Seroprevalences were 93.24%, 93.24%, 22.97% and 12.2% respectively. Other parameters such as sex, age, stage of disease, smoking and alcohol consumption were significantly associated with the seropositivity of these herpesviridae. Conclusion: Despite the absence for most of the clinical manifestations related to HSV-1 and HSV-2, it was strong to note a high circulation of those virus in HIV infected patients, mainly in bi and tri co-infections.

Seroprevalence of cytomegalovirus (CMV) among pregnant women at a tertiary facility in southern Nigeria

Background: Cytomegalovirus (CMV) also called human cytomegalovirus (HCMV) or human herpesvirus-5 (HHV-5) is an encapsulated double-stranded deoxyribonucleic acid (DNA) virus. It is an opportunistic virus which often remains latent and only become symptomatic in immune-suppressed individuals such as pregnant women, HIV/AIDS patients and other immune weakening disease conditions. It is also estimated to have an 86% global sero-prevalence among reproductive women. Objectives: To determine the sero-prevalence of CMV infection, investigate the relationship between risk factors and CMV infection and to determine the relationship between obstetric characteristics and CMV infections among pregnant women. Method: A cross-sectional study among a cross-section of pregnant women receiving ante-natal care in the University of Port Harcourt Teaching Hospital from August 2022 to December 2022. A structured pro forma data sheet was used as interviewer-administered questionnaire by medical personnel to collect data from the study participants. 5ml of blood was collected from each participant and assessed for the presence of anti-CMV IgG using commercial Enzyme-linked Immunosorbent Assay (ELISA). The data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Descriptive statistics (mean, median, frequency percentage and standard deviation), Chi-square test and Fischer’s exact test were used appropriately. Results: Out of 101 respondents, only 24 (24%) were positive for CMV IgG, while 77 (76%) were negative. About 50% of the women were in their 3rd decade of life, while (3) were in the 4th decade of life. All the respondents were married and were Christians. Three quarters of the women [75(74.3%)] had tertiary education, 20 (19.8%) had secondary education, while 6 (5.9%) were Postgraduate students. Based on income, women with income &lt; #50,000 (53.5%) were the most common. The relationship between demographic factors such as age, religion, income, educational level, employment status, marital status and CMV results were statistically insignificant. The relationship between obstetric characteristics and CMV results were not statistically significant, while risk factors for CMV and presence of CMV infection were not statistically significant as well. Conclusion: The 24% sero-prevalence for CMV at University of Port Harcourt Teaching Hospital was quite low; however it can be reduced to the barest minimum, by encouraging intensive awareness campaigns about the virus and providing free serum testing to all categories of the population, since CMV affects all ages.

Human Cytomegalovirus Oncoprotection across Diverse Populations, Tumor Histologies, and Age Groups: The Relevance for Prospective Vaccinal Therapy.

The oncogenicity of the human cytomegalovirus (CMV) is currently being widely debated. Most recently, mounting clinical evidence suggests an anti-cancer effect via CMV-induced T cell-mediated tumor destruction. However, the data were mostly obtained from single-center studies and in vitro experiments. Broad geographic coverage is required to offer a global perspective. Our study examined the correlation between country-specific CMV seroprevalence (across 73 countries) and the age-standardized incidence rate (of 34 invasive tumors). The populations studied were stratified according to decadal age periods as the immunologic effects of CMV seropositivity may depend upon age at initial infection. The International Agency for Research on Cancer of the World Health Organization (IARC WHO) database was used. The multivariate linear regression analysis revealed a worldwide inverse correlation between CMV seroprevalence and the incidences of 62.8% tumors. Notably, this inverse link persists for all cancers combined (Spearman's ρ = -0.732, p < 0.001; β = -0.482, p < 0.001, adjusted R2 = 0.737). An antithetical and significant correlation was also observed in particular age groups for the vast majority of tumors. Our results corroborate the conclusions of previous studies and indicate that this oncopreventive phenomenon holds true on a global scale. It applies to a wide spectrum of cancer histologies, additionally supporting the idea of a common underlying mechanism-CMV-stimulated T cell tumor targeting. Although these results further advance the notion of CMV-based therapies, in-depth investigation of host-virus interactions is still warranted.

"Seroprevalence of Cytomegalovirus, Epstein-Barr Virus, and Herpes Simplex Viruses in Children Born HIV Positive at the Yaounde University Teaching Hospital, Cameroon After 12 Months of Follow-Up: A Cross Sectional Study"

"Seroprevalence of Cytomegalovirus, Epstein-Barr Virus, and Herpes Simplex Viruses in Children Born HIV Positive at the Yaounde University Teaching Hospital, Cameroon After 12 Months of Follow-Up: A Cross Sectional Study"

Seroprevalence of Human Cytomegalovirus among Aborted Women in Aden, Yemen

Human cytomegalovirus (HCMV) is one member of Herpesviridae. It can cause serious complications in pregnant women and their fetuses. So, this study aims to determine the prevalence of IgG and IgM against HCMV among aborted women and other related factors in Aden–Yemen. An analytical cross-sectional study was conducted on 88 aborted women. Blood samples were collected and serum HCMV IgG and IgM were analyzed using ELISA. The overall prevalence of IgG and IgM of HCMV infections were 77.6% and 83.3%, respectively. Neither HCMV IgG nor IgM seroprevalence had significantly influenced by age, number of abortions, education level, trimesters, and other factors. It can be concluded that the seroprevalence IgG antibodies of HCMV infections among aborted women were slightly lower than those reported globally whereas the seroprevalence IgM antibodies were higher than most of the previous studies that performed globally. Other causative factors may also contribute to abortion among aborted women. Further research is required to detect the HCMV and other causative agents of abortion in Aden and other southern governments of Yemen using adequate sample size and new advanced techniques.

Latent toxoplasmosis, Cytomegalovirus, and Herpes Simplex Virus infections and risk of motorcycle accidents: A case-control study in a county with a high rate of motorcycle injuries in Iran.

Road traffic injuries (RTIs) are among the most important issues worldwide. Several studies reported that infection with the neurotropic parasite Toxoplasma gondii (T. gondii) increased the risk of car accidents. In this study, our objective was to investigate the possible associations among latent T. gondii, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV) infections with the risk of motorcycle accidents in Jahrom (Fars Province), which is a county with a high rate of motorcycle accidents in Iran. In the setting of a case-control study; 176 motorcyclist men, including 88 survivors of motorcycle accidents and 88 motorcyclist without accidents, were considered as case and control groups, respectively. Rates of latent infections with T. gondii, CMV, and HSV were assessed by an enzyme-linked immunosorbent assay (ELISA). Eleven of 88 (12.5%) in the case group and 22 of 88 (25.0%) in controls were positive for anti-T. gondii IgG antibodies, this difference was statistically significant (OR = 0.42; CI: 0.19-0.95, p = 0.03). The general seroprevalence of CMV (94.3% in the case group vs. 87.5% in the control group, OR = 2.37; CI: 0.78-7.13, p = 0.12) and HSV (63.6% in the case group vs. 62.5% in the control group, OR = 1.05; CI: 0.57-1.94, p = 0.87) were not significantly different between the case and control groups. Although latent toxoplasmosis has been associated with traffic accidents in recent reports, we found a negative association between latent toxoplasmosis and motorcycle accidents among survivors of these accidents. As such, latent CMV and HSV infections did not differ significantly between the cases compared to the control groups.

Rapid detection of human cytomegalovirus by multienzyme isothermal rapid amplification and lateral flow dipsticks.

Human cytomegalovirus (HCMV) is the most common viral infection seen in newborns. The major route of transmission for acquired human cytomegalovirus infection is breast milk from mothers who are HCMV seropositive to the infants. Thus, a rapid, economical, and simple method to perform HCMV test in breast milk is crucial and necessary for preventing acquired HCMV infection, especially in underdeveloped regions with limited laboratory resources. In this study, an effective technique for the detection of HCMV was constructed by combining multienzyme isothermal rapid amplification (MIRA) and lateral flow chromatography strip (LFD). Primers for the conserved HCMV sequence UL83 were utilized for MIRA-LFD testing. Our results showed that the entire MIRA reaction could be completed in 12 minutes at 37°C, and LFD outcomes could be observed visibly after 10 minutes. The detection sensitivity of this method reached 50 copy/μl. Samples of breast milk were examined to compare MIRA-LFD and conventional qPCR. The accuracy of MIRA-LFD was 100%. The straightforward, rapid, economic features of the test can provide the significant advantages for the prevention of breast milk-acquired cytomegalovirus infection, particularly in resource-limited locations with high seroprevalence of cytomegalovirus.

Evidence for effect modification by serum clusterin on dendritic cells in association with dementia

AbstractBackgroundAlzheimer’s disease (AD) and AD related dementias (ADRD) are complex heterogeneous diseases with multiple pathogenic mechanisms. Previous experimental studies showed that serum clusterin has a significant role in the maturation of dendritic cells (DCs). Studies showed that myeloid DCs (mDCs) in blood were dysregulated in AD and higher levels of serum clusterin related to higher incidence of dementia. We evaluated the association of DCs in peripheral blood and serum clusterin and their interaction with AD/ADRD.MethodWe used data from 3072 participants in the Health and Retirement Study (HRS) who participated in the 2016 Venous Blood Study (VBS), and had flow cytometry, clusterin and cognition assessed. We used generalized survey logit models to evaluate the association between the DCs, clusterin, and dementia after adjusting for age, sex, race, education, comorbidity, body mass index (BMI) and Cytomegalovirus (CMV) seroprevalence. Utilizing the RNAseq data, we performed differential gene expression (DGE) analysis on DCs, clusterin and dementia to identify overlapping genes in the biological process.ResultWe found that after covariate adjustment, a higher percentage of dendritic cells was associated with lower odds of having dementia (OR = 0.61, 95% CI: [0.44, 0.86]; p = 0.005). We found that higher levels of serum clusterin was associated with higher odds of having dementia. This relationship was somewhat attenuated after covariate adjustment (OR = 1.07, 95% CI [0.99, 1.16], p = 0.09). We found a significant interaction between serum clusterin and DCs in the association with dementia (p = 0.02) with those having low DCs and high clusterin being at increased ADRD risk (OR = 1.25) and those with high DCs and low clusterin being at lower ADRD risk (OR = 0.48) as compared to those who have both low DCs and low clusterin. We identified three genes (TUBB4A, WASHC5 and GSTA4) that were dysregulated in the pathways of DCs and clusterin in association with dementia.ConclusionThis study has shown, for the first time, an interaction between serum clusterin and DCs in peripheral blood that is associated with increased risk of dementia in a large sample of older adults that needs to be validated in future studies.

Is human cytomegalovirus a potential risk factor for mood disorders? A systematic review and meta-analysis.

Mood disorders are among the common mental disorders worldwide. Because of the persistence of cytomegalovirus (CMV) in the body and nervous system, this virus can be activated when the immune system is weakened and continues to exert its destructive effects throughout life. This study aimed to investigate the seroprevalence and association of human cytomegalovirus with mood disorders. Eligible articles were extracted using online international databases Science Direct, Medline, Web of Science, Scopus, and Google Scholar between 2000 and 2023. After quality assessment and specific inclusion and exclusion criteria, a total of eight eligible articles were included in the meta-analysis. Our finding showed that the seropositivity of CMV in mood disorders was 51.6% (95% CI; 42.8-60.4). There were statistical differences between mood disorders and control groups regarding the seropositivity of CMV 1.327% (95% CI; 13.27-10.45). The results of the publication bias using the Egger test confirmed no publication bias in each sub-group. The results of this meta-analysis study demonstrated that CMV infection might have associations with the incidence of mood disorders. Furthermore, we found that there were statistical differences between mood disorders and control groups regarding the seropositivity of CMV.

Vaccine value profile for cytomegalovirus

Cytomegalovirus (CMV) is the most common infectious cause of congenital malformation and a leading cause of developmental disabilities such as sensorineural hearing loss (SNHL), motor and cognitive deficits. The significant disease burden from congenital CMV infection (cCMV) led the US National Institute of Medicine to rank CMV vaccine development as the highest priority. An average of 6.7/1000 live births are affected by cCMV, but the prevalence varies across and within countries. In contrast to other congenital infections such as rubella and toxoplasmosis, the prevalence of cCMV increases with CMV seroprevalence rates in the population. The true global burden of cCMV disease is likely underestimated because most infected infants (85–90 %) have asymptomatic infection and are not identified. However, about 7–11 % of those with asymptomatic infection will develop SNHL throughout early childhood.Although no licensed CMV vaccine exists, several candidate vaccines are in development, including one currently in phase 3 trials. Licensure of one or more vaccine candidates is feasible within the next five years. Various models of CMV vaccine strategies employing different target populations have shown to provide substantial benefit in reducing cCMV. Although CMV can cause end-organ disease with significant morbidity and mortality in immunocompromised individuals, the focus of this vaccine value profile (VVP) is on preventing or reducing the cCMV disease burden.This CMV VVP provides a high-level, comprehensive assessment of the currently available data to inform the potential public health, economic, and societal value of CMV vaccines. The CMV VVP was developed by a working group of subject matter experts from academia, public health groups, policy organizations, and non-profit organizations. All contributors have extensive expertise on various elements of the CMV VVP and have described the state of knowledge and identified the current gaps. The VVP was developed using only existing and publicly available information.

Cytomegalovirus Active Infection in Critically Ill Children.

To describe the epidemiology, clinical characteristics and outcomes of children with cytomegalovirus (CMV) active infection in the pediatric intensive care unit (PICU) and to investigate risk factors for mortality. This was a retrospective cohort study of patients who had CMV DNA detected in blood samples and/or tracheal aspirates by polymerase chain reaction (PCR) during stay at 2 PICUs of a university hospital. Suspected cases without etiological confirmation and patients with laboratory-confirmed CMV infection before PICU admission were excluded. Demographic, clinical and outcome data were collected from medical records. From January 1, 2012, to December 31, 2019, 4748 children were admitted to the PICUs. Thirty-five (0.74%; 95% CI 0.51%-1.02%) had laboratory-confirmed CMV active infection; 71.4% were immunocompromised and 11 (31.4%) died. Patients who died were older than those who survived (median age 65 vs. 5.5 months, respectively; P = 0.048), and they received antiviral therapy for a shorter time (median 12 vs. 23 days, respectively; P = 0.001). The main causa mortis was septic shock (82%) and in most deceased patients (73%) the last CMV PCR before death was positive. PELOD score >6 was a risk factor for death (RR 2.96; 95% CI 1.07-8.21). Viral load in blood had a poor ability for the prediction of death (area under the receiver operating characteristic curve 0.62; 95% CI 0.37-0.84). The incidence of CMV active infection during PICU stay was 0.74% in an upper-middle income country with a high CMV seroprevalence. PELOD score higher than 6 was a risk factor for death. No association was observed between CMV viral load and mortality.

Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study

BackgroundMaternal CMV infection during pregnancy, either primary or non-primary, may be associated with fetal infection and long-term sequelae. While guidelines recommend against it, screening for CMV in pregnant women is a prevalent clinical practice in Israel. Our aim is to provide updated, local, clinically relevant, epidemiological information about CMV seroprevalence among women at childbearing age, the incidence of maternal CMV infection during pregnancy and the prevalence of congenital CMV (cCMV), as well as to provide information about the yield of CMV serology testing.MethodsWe performed a descriptive, retrospective study of women at childbearing age who were members of Clalit Health Services in the district of Jerusalem and had at least one gestation during the study period (2013–2019). We utilized serial serology tests to determine CMV serostatus at baseline and at pre/periconception and identified temporal changes in CMV serostatus. We then conducted a sub-sample analysis integrating inpatient data on newborns of women who gave birth in a single large medical center. cCMV was defined as either positive urine CMV-PCR test in a sample collected during the first 3 weeks of life, neonatal diagnosis of cCMV in the medical records, or prescription of valganciclovir during the neonatal period.ResultsThe study population Included 45,634 women with 84,110 associated gestational events. Initial CMV serostatus was positive in 89% women, with variation across different ethno-socioeconomic subgroups. Based on consecutive serology tests, the detected incidence rate of CMV infection was 2/1000 women follow-up years, among initially seropositive women, and 80/1000 women follow-up years, among initially seronegative women. CMV infection in pregnancy was identified among 0.2% of women who were seropositive at pre/periconception and among 10% of women who were seronegative. In a subsample, which included 31,191 associated gestational events, we identified 54 newborns with cCMV (1.9/1000 live births). The prevalence of cCMV among newborns of women who were seropositive at pre/periconception was lower than among newborns of women who were seronegative (2.1 vs. 7.1/1000). Frequent serology tests among women who were seronegative at pre/periconception detected most primary CMV infections in pregnancy that resulted in cCMV (21/24). However, among women who were seropositive, serology tests prior to birth detected none of the non-primary infections that resulted in cCMV (0/30).ConclusionsIn this retrospective community-based study among women of childbearing age characterized by multiparity and high seroprevalence of CMV, we find that consecutive CMV serology testing enabled to detect most primary CMV infections in pregnancy that led to cCMV in newborns but failed to detect non-primary CMV infections in pregnancy. Conducting CMV serology tests among seropositive women, despite guidelines' recommendations, has no clinical value, while it is costly and introduces further uncertainties and distress. We thus recommend against routine CMV serology testing among women who were seropositive in a prior serology test. We recommend CMV serology testing prior to pregnancy only among women known to be seronegative or women whose serology status is unknown.

Seroprevalence of Toxoplasma Gondii, Rubella and Cytomegalovirus Among Pregnant Women in Our Clinic

To determine the rate of seropositivity in toxoplasma, rubella and cytomegalovirus infections during pregnancy. 4488 pregnants who applied to outpatient polyclinics of Gynecology and Obstetrics in Muğla Sıtkı Koçman University Training and Research Hospital for pregnancy examination in the first 10 weeks of pregnancy were included in the study. Results of anti-Toxoplasma IgM and IgG, anti-Rubella IgM and IgG, anti-CMV IgM and IgG were evaluated. Seropositivity rates of anti-Toxoplasma, anti-Rubella, anti-CMV IgG and IgM were determined respectively 21.6%, 1.6%, 92.8%, 1%; 98.5%, 1.1% in the study group. Toxoplasma, Rubella and CMV seroprevalence should be evaluated during preconceptional or antenatal screening according to regional conditions.