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Seroepidemiology of cytomegalovirus infections in Croatia

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Summary

Background

Cytomegalovirus (CMV) is endemic worldwide, with marked differences in the seroprevalence rates between countries. The aim of this study was to analyze the seroprevalence of CMV infections in Croatia.

Methods

During a 3-year period (2013–2015) 2438 consecutive serum samples collected from Croatian residents were tested for the presence of CMV IgM and IgG antibodies using enzyme-linked immunoassay. The IgM/IgG positive samples were further tested for IgG avidity.

Results

The overall seroprevalence rates for CMV IgG and IgM antibodies were 74.4 % and 4.3 %, respectively. The IgG seroprevalence showed significant differences between population groups: children/adolescents 54.6 %, general adult population 77.2 %, hemodialysis patients 91.4 % (p < 0.001). Seropositivity of CMV was strongly age-dependent with prevalences ranging from 53.0 % in children less than 10 years old to 93.8 % in persons above 60 years (p < 0.001). There was no difference in the prevalence rate between women with normal pregnancy and women with poor obstetric history. Gender and place of residence were not associated with CMV seropositivity. Using IgG avidity, current/recent primary CMV infection was confirmed by a low/borderline avidity index (AI) in 46.7 % participants, while in 53.3 % a high AI indicated CMV reactivation or reinfection. Primary infections were detected mainly in children and adolescents (83.2 % and 70.5 %, respectively), while reactivation/reinfection was common in persons older than 40 (77.0–100 %). Reactivation/reinfection was most commonly detected in hemodialysis patients (92.3 %). Logistic regression showed that older age and being on hemodialysis were significant predictors of CMV seropositivity.

Conclusion

Infections with CMV are widespread in the Croatian population. Older age and being on hemodialysis appear to be the main risk factors for CMV infection.

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Acknowledgements

This research was supported by the Ministry of Science, Education, and Sports of the Republic of Croatia, Grant No 005-0053443-3447 (to GMG). The authors thank Ljiljana Milasincic, Snjezana Artl, Vesna Cupic, Dubravka Landripet and Ana Pesut for technical assistance. Izabela Vrtar was project associate.

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Authors and Affiliations

  1. Department of Virology, Croatian National Institute of Public Health, Rockefellerova 12, 10000, Zagreb, Croatia

    Tatjana Vilibic-Cavlek MD, PhD, Izabela Vrtar, Irena Tabain & Gordana Mlinaric-Galinovic

  2. School of Medicine University of Zagreb, Zagreb, Croatia

    Tatjana Vilibic-Cavlek MD, PhD, Natasa Beader & Gordana Mlinaric-Galinovic

  3. Department of Epidemiology, Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia

    Branko Kolaric

  4. School of Medicine University of Rijeka, Rijeka, Croatia

    Branko Kolaric

  5. Clinical Hospital Centre, Zagreb, Croatia

    Natasa Beader

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  1. Tatjana Vilibic-Cavlek MD, PhD
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Corresponding author

Correspondence to Tatjana Vilibic-Cavlek MD, PhD.

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Conflict of interest

T. Vilibic-Cavlek, B. Kolaric, N. Beader, I. Vrtar, I. Tabain, and G. Mlinaric-Galinovic declare that they have no competing interests.

Ethical standards

All studies on humans described in this manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). Informed consent was obtained from all participants included in the study. In the case of underage patients consent was obtained from a parent of legal guardian.

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Vilibic-Cavlek, T., Kolaric, B., Beader, N. et al. Seroepidemiology of cytomegalovirus infections in Croatia. Wien Klin Wochenschr 129, 129–135 (2017). https://doi.org/10.1007/s00508-016-1069-7

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