Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Sociodemographic factors associated with IgG and IgM seroprevalence for human cytomegalovirus infection in adult populations of Pakistan: a seroprevalence survey

Authors: Saira Ibrahim, Anwar A. Siddiqui, Amna R. Siddiqui, Waquaruddin Ahmed, Paul A. H. Moss, El-Nasir M. A. Lalani

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

The seroprevalence of human cytomegalovirus (HCMV) infection ranges from 30 to 90 % in developed countries. Reliable estimates of HCMV seroprevalence are not available for Pakistan. This study determined the seroprevalence and sociodemographic factors associated with HCMV infection in adult populations of Karachi, Pakistan.

Methods

A seroprevalence survey was conducted on 1000 adults, including residents of two semi-urban communities, and visitors to a government and a private hospital. Questionnaire-based interviews were conducted. Sera were analysed for HCMV-specific IgG and IgM. Chi-square or Fisher’s exact test was used for comparing sociodemographic variables against seropositivity of HCMV-IgG or IgM. Multiple logistic regression modeling was performed for IgG seroprevalence and adjusted odds ratios were computed.

Results

The seroprevalence of HCMV-IgG and IgM was 93.2 and 4.3 % respectively. 95.3 % of individuals who were IgM seropositive were also seropositive for IgG. Around 6 % (15/250) of women of childbearing age remained uninfected and were therefore susceptible to primary infection. HCMV-IgG seroprevalence was associated with being female (p = 0.001), increasing age (p = 0.002) and crowding index (p = 0.003) and also with lower levels of both education (p < 0.001) and income (p = 0.008). Seroprevalence also differed significantly by marital status (p = 0.008) and sampling location (p < 0.001). A logistic regression model for HCMV-IgG seroprevalence showed associations with being female (OR = 1.89; 95 % CI: 1.10–3.25), increasing age (OR = 3.95; 95 % CI: 1.79–8.71) and decreasing income (OR = 0.72; 95 % CI: 0.54–0.96). A strong association was observed between increased seroprevalence of HCMV-IgM and decreasing household size (p = 0.008).

Conclusions

Seroprevalence of HCMV is very high in Pakistan, although 6 % of women of childbearing age remain at risk of primary infection. The IgM seropositivity observed in some individuals living in small household size (1–3 individuals) with persistent HCMV infection could have resulted from a recurrent HCMV infection. Future longitudinal research in pregnant women and neonates is required to study the trends in HCMV seroprevalence over time in Pakistan for the development of a potential HCMV prevention and vaccination programme.
Literature
1.
2.
Landolfo S, Gariglio M, Gribaudo G, Lembo D. The human cytomegalovirus. Pharmacol Ther. 2003;98(3):269–97.CrossRefPubMed
3.
Harari A, Zimmerli SC, Pantaleo G. Cytomegalovirus (CMV)-specific cellular immune responses. Hum Immunol. 2004;65(5):500–6.CrossRefPubMed
4.
Gandhi MK, Khanna R. Human cytomegalovirus: clinical aspects, immune regulation, and emerging treatments. Lancet Infect Dis. 2004;4(12):725–38.CrossRefPubMed
5.
Rowshani AT, Bemelman FJ, van Leeuwen EM, van Lier RA, ten Berge IJ. Clinical and immunologic aspects of cytomegalovirus infection in solid organ transplant recipients. Transplantation. 2005;79(4):381–6.CrossRefPubMed
6.
Hummel M, Abecassis MM. A model for reactivation of CMV from latency. J Clin Virol. 2002;25 Suppl 2:S123–36.CrossRefPubMed
7.
Staras SA, Dollard SC, Radford KW, Flanders WD, Pass RF, Cannon MJ. Seroprevalence of cytomegalovirus infection in the United States, 1988-1994. Clin Infect Dis. 2006;43(9):1143–51.CrossRefPubMed
8.
Adjei AA, Armah HB, Gbagbo F, Boamah I, Adu-Gyamfi C, Asare I. Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa. BMC Infect Dis. 2008;8:111.CrossRefPubMedPubMedCentral
9.
Kothari A, Ramachandran VG, Gupta P, Singh B, Talwar V. Seroprevalence of cytomegalovirus among voluntary blood donors in Delhi, India. J Health Popul Nutr. 2002;20(4):348–51.PubMed
10.
Fang FQ, Fan QS, Yang ZJ, Peng YB, Zhang L, Mao KZ, et al. Incidence of cytomegalovirus infection in Shanghai, China. Clin Vaccine Immunol. 2009;16(11):1700–3.CrossRefPubMedPubMedCentral
11.
Tagawa M, Minematsu T, Masuzaki H, Ishimaru T, Moriuchi H. Seroepidemiological survey of cytomegalovirus infection among pregnant women in Nagasaki, Japan. Pediatr Int. 2010;52(3):459–62.CrossRefPubMed
12.
Souza MA, Passos AM, Treitinger A, Spada C. Seroprevalence of cytomegalovirus antibodies in blood donors in southern, Brazil. Rev Soc Bras Med Trop. 2010;43(4):359–61.CrossRefPubMed
13.
Spano LC, Gatti J, Nascimento JP, Leite JP. Prevalence of human cytomegalovirus infection in pregnant and non-pregnant women. J Infect. 2004;48(3):213–20.CrossRefPubMed
14.
de Ory F, Ramirez R, Garcia Comas L, Leon P, Sagues MJ, Sanz JC. Is there a change in cytomegalovirus seroepidemiology in Spain? Eur J Epidemiol. 2004;19(1):85–9.CrossRefPubMed
15.
Lubeck PR, Doerr HW, Rabenau HF. Epidemiology of human cytomegalovirus (HCMV) in an urban region of Germany: what has changed? Med Microbiol Immunol. 2010;199(1):53–60.CrossRefPubMed
16.
Lopo S, Vinagre E, Palminha P, Paixao MT, Nogueira P, Freitas MG. Seroprevalence to cytomegalovirus in the Portuguese population, 2002-2003. Euro Surveill. 2011;16(25):1–6.
17.
Dowd JB, Aiello AE, Alley DE. Socioeconomic disparities in the seroprevalence of cytomegalovirus infection in the US population: NHANES III. Epidemiol Infect. 2009;137(1):58–65.CrossRefPubMed
18.
Zajacova A, Dowd JB, Aiello AE. Socioeconomic and race/ethnic patterns in persistent infection burden among U.S. adults. J Gerontol A Biol Sci Med Sci. 2009;64(2):272–9.CrossRefPubMed
19.
N’Diaye DS, Yazdanpanah Y, Krivine A, Andrieu T, Rozenberg F, Picone O, et al. Predictive factors of cytomegalovirus seropositivity among pregnant women in Paris, France. PLoS One. 2014;9(2):e89857.CrossRefPubMedPubMedCentral
20.
Zhang Q, Gao Y, Peng Y, Fu M, Liu YQ, Zhou QJ, et al. Epidemiological survey of human cytomegalovirus antibody levels in children from Southeastern China. Virol J. 2014;11:123.CrossRefPubMedPubMedCentral
21.
Rizvi CB, Raza A, Siddiqui MF, Alam R. Sero-prevalence of human cytomegalovirus among blood donors in Lahore, Pakistan. Adv Life Sci. 2015;2(4):171–5.
22.
23.
24.
Correa CB, Kouri V, Verdasquera D, Martinez PA, Alvarez A, Aleman Y, et al. HCMV seroprevalence and associated risk factors in pregnant women, Havana City, 2007 to 2008. Prenat Diagn. 2010;30(9):888–92.CrossRefPubMed
25.
Seale H, MacIntyre CR, Gidding HF, Backhouse JL, Dwyer DE, Gilbert L. National serosurvey of cytomegalovirus in Australia. Clin Vaccine Immunol. 2006;13(11):1181–4.CrossRefPubMedPubMedCentral
26.
Mustakangas P, Sarna S, Ammala P, Muttilainen M, Koskela P, Koskiniemi M. Human cytomegalovirus seroprevalence in three socioeconomically different urban areas during the first trimester: a population-based cohort study. Int J Epidemiol. 2000;29(3):587–91.CrossRefPubMed
27.
De Paschale M, Agrappi C, Manco MT, Paganini A, Clerici P. Incidence and risk of cytomegalovirus infection during pregnancy in an urban area of Northern Italy. Infect Dis Obstet Gynecol. 2009;2009:206505.CrossRefPubMedPubMedCentral
28.
Dollard SC, Staras SA, Amin MM, Schmid DS, Cannon MJ. National prevalence estimates for cytomegalovirus IgM and IgG avidity and association between high IgM antibody titer and low IgG avidity. Clin Vaccine Immunol. 2011;18(11):1895–9.CrossRefPubMedPubMedCentral
29.
Uyar Y, Balci A, Akcali A, Cabar C. Prevalence of rubella and cytomegalovirus antibodies among pregnant women in northern Turkey. New Microbiol. 2008;31(4):451–5.PubMed
30.
Bagheri L, Mokhtarian H, Sarshar N, Ghahramani M. Seroepidemiology of cytomegalovirus infection during pregnancy in Gonabad, east of Iran: a cross-sectional study. J Res Health Sci. 2012;12(1):38–44.PubMed
31.
Akinbami AA, Akanmu AS, Adeyemo TA, Wright KO, Dada MO, Dosunmu AO. Cytomegalovirus antibodies among healthy blood donors at Lagos University Teaching Hospital. S Afr Med J. 2009;99(7):528–30.
32.
Wang C, Dollard SC, Amin MM, Bialek SR. Cytomegalovirus IgM Seroprevalence among Women of Reproductive Age in the United States. PLoS One. 2016;11(3):e0151996.CrossRefPubMedPubMedCentral
33.
Seo S, Cho Y, Park J. Serologic screening of pregnant Korean women for primary human cytomegalovirus infection using IgG avidity test. Korean J Lab Med. 2009;29(6):557–62.CrossRefPubMed
34.
Uysal A, Taner CE, Cuce M, Atalay S, Gol B, Kose S, et al. Cytomegalovirus and rubella seroprevalence in pregnant women in Izmir/Turkey: follow-up and results of pregnancy outcome. Arch Gynecol Obstet. 2012;286(3):605–8.CrossRefPubMed
35.
Revello MG, Tibaldi C, Masuelli G, Frisina V, Sacchi A, Furione M, et al. Prevention of Primary Cytomegalovirus Infection in Pregnancy. EBioMedicine. 2015;2(9):1205–10.CrossRefPubMedPubMedCentral
36.
Zhao P, Ma D, Xue F, Ji C, Wang S, Zhang X, et al. Seroprevalence and risk factors of human cytomegalovirus infection in the eastern Chinese population. Arch Virol. 2009;154(4):561–4.CrossRefPubMed
37.
Revello MG, Campanini G, Piralla A, Furione M, Percivalle E, Zavattoni M, et al. Molecular epidemiology of primary human cytomegalovirus infection in pregnant women and their families. J Med Virol. 2008;80(8):1415–25.CrossRefPubMed
38.
Sheevani JN, Aggarwal A. A pilot seroepidemiological study of cytomegalovirus infection in women of child bearing age. Indian J Med Microbiol. 2005;23(1):34–6.CrossRefPubMed
39.
Colugnati FA, Staras SA, Dollard SC, Cannon MJ. Incidence of cytomegalovirus infection among the general population and pregnant women in the United States. BMC Infect Dis. 2007;7:71.CrossRefPubMedPubMedCentral
40.
Lanzieri TM, Dollard SC, Bialek SR, Grosse SD. Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries. Int J Infect Dis. 2014;22:44–8.CrossRefPubMedPubMedCentral
41.
Bodurtha J, Adler SP, Nance WE. Seroepidemiology of cytomegalovirus and herpes simplex virus in twins and their families. Am J Epidemiol. 1988;128(2):268–76.CrossRefPubMed
42.
Pass RF, Griffiths PD, August AM. Antibody response to cytomegalovirus after renal transplantation: comparison of patients with primary and recurrent infections. J Infect Dis. 1983;147(1):40–6.CrossRefPubMed
Metadata
Title
Sociodemographic factors associated with IgG and IgM seroprevalence for human cytomegalovirus infection in adult populations of Pakistan: a seroprevalence survey
Authors
Saira Ibrahim
Anwar A. Siddiqui
Amna R. Siddiqui
Waquaruddin Ahmed
Paul A. H. Moss
El-Nasir M. A. Lalani
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3772-8

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue

Study protocol

Psycho-social resilience, vulnerability and suicide prevention: impact evaluation of a mentoring approach to modify suicide risk for remote Indigenous Australian students at boarding school

Research article

HIV/AIDS-related knowledge awareness and risk behaviors among injection drug users in Maanshan, China: a cross-sectional study

Research article

Physical activity, body mass index and heart rate variability-based stress and recovery in 16 275 Finnish employees: a cross-sectional study

Research article

Precarious employment is a risk factor for poor mental health in young individuals in Sweden: a cohort study with multiple follow-ups

Research article

An examination of the effectiveness of health warning labels on smokeless tobacco products in four states in India: findings from the TCP India cohort survey

Research article

Occurrence of multiple mental health or substance use outcomes among bisexuals: a respondent-driven sampling study