Seroprevalence of Cytomegalovirus (CMV) and Risk Factors for Infection in Adolescent Males

Department of Pediatrics, Division of Infectious Diseases, University of Kentucky, Lexington, KY 40536-0284, USA.
Clinical Infectious Diseases (Impact Factor: 9.42). 10/2010; 51(10):e76-81. DOI: 10.1086/656918
Source: PubMed

ABSTRACT Congenital cytomegalovirus (CMV) is a leading cause of disability, including sensorineural hearing loss, developmental delay, and mental retardation. Although the seroprevalence of CMV and associated exposure and behavioral risk factors have been reported in adolescent females, few data exist about males.
Serum samples were obtained from males aged 12-17 years from June 2006 through July 2007 in Cincinnati, Ohio; Galveston, Texas; and Nashville, Tennessee. The samples were tested for CMV immunoglobulin G antibody with a commercial assay. Participants completed a computer-assisted screening interview to assess 7 risk categories.
A total of 397 adolescent males were screened, and 165 (47%) were seropositive. African American race, older age, and exposure to children ≤ 3 years of age in the home were significant predictors of CMV infection in the univariate analysis. Hispanic ethnicity, group living situations, saliva-sharing behaviors, and intimate sexual contact were not associated with CMV infection. However, among those with a history of sexual contact, the number of life-time partners was associated with CMV. In the final multivariate model, CMV seroprevalence was significantly higher in African American subjects (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.27-2.95) and subjects ≥ 14 years of age (OR, 1.1; 95% CI, 1.0-1.28). With each additional risk factor, males had a 1.6 times increased risk of CMV.
CMV infections are common in adolescent males and are associated with African American race and increasing age. Further study is needed to understand these risk factors in preparation for a CMV vaccine targeted at both adolescent males and females.


Available from: Laura Patricia Stadler, Apr 13, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: With increasing age, the ability of the adaptive immune system to respond to vaccines and to protect from infection declines. In parallel, the production of inflammatory mediators increases. While cross-sectional studies have been successful in defining age-dependent immunological phenotypes, studies of accelerated immune aging in human subpopulations have been instrumental in obtaining mechanistic insights. The immune system depends on its regenerative capacity; however, the T cell repertoire, once established, is relatively robust to aging and only decompensates when additionally stressed. Such stressors include chronic infections such as CMV and HIV, even when viral replication is controlled, and autoimmune diseases. Reduced regenerative capacity, chronic immune activation in the absence of cell exhaustion, T cell memory inflation, and accumulation of highly potent effector T cells in these patients synergize to develop an immune phenotype that is characteristic of the elderly. Studies of accelerated immune aging in autoimmune diseases have identified an unexpected link to chronic DNA damage responses that are known to be important in aging, but so far had not been implicated in immune aging.
    Annals of the New York Academy of Sciences 01/2012; 1247:69-82. DOI:10.1111/j.1749-6632.2011.06297.x · 4.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Xerostomia is a common complaint of nearly half of the elderly population and about one-fifth of younger adults. It causes several signs and symptoms, and compromise oral functions and health-related quality-of-life. Multiple reasons are proposed to describe the etiology of xerostomia such as local factors, psychogenic factors, and systemic diseases. In order to manage xerostomia effectively, identification of the main causality is mandatory. The aim of this review was to present systemic diseases leading to xerostomia with their mechanisms of action. We used various general search engines and specialized databases such as Google, Google Scholar, Yahoo, PubMed, PubMed Central, MedLine Plus, Medknow, EBSCO, ScienceDirect, Scopus, WebMD, EMBASE, and authorized textbooks to find relevant topics by means of Medical Subject Headings keywords such as "xerostomia," "hyposalivations," "mouth dryness," "disease," and "systemic." We appraised 97 English-language articles published over the last 40 years in both medical and dental journals including reviews, meta-analysis, original papers, and case reports. Upon compilation of relevant data, it was concluded that autoimmune diseases most frequently involve salivary glands and cause xerostomia followed by diabetes mellitus, renal failure, and graft-versus-host disease. Moreover, the underlying mechanisms of systemic disease-related xerostomia are: autoimmunity, infiltration of immunocompetent cells, granuloma formation, fibrosis and dehydration, deposition of proteinaceous substances, bacterial infection, and side-effects of medications.
    07/2014; 4(4):503-10. DOI:10.4103/2141-9248.139284
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Cytomegalovirus (CMV) retinitis is an important cause of morbidity in patients with HIV/AIDS and iatrogenic or local (ocular) immunosuppression. No new drugs have been approved for the treatment of CMV retinitis since 2001, and several have been taken off the market. This paper reviews currently available anti-CMV drugs, their side effects, and investigational drugs that may be useful in patients with intolerance or resistance to approved therapy.Areas covered: In this review, the epidemiology, clinical features, and treatment of CMV retinitis is summarized. Limitations of current therapy as a result of drug toxicity and resistance are reviewed, with an emphasis on the lack of new drug development in this field. The limitations of current anti-CMV therapy in patients who are iatrogenically immunosuppressed are highlighted. Investigational drugs with potential to treat CMV retinitis are discussed.Expert opinion: Currently therapy for the treatment of CMV retinitis is limited by drug toxicity, antiviral resistance, and a failure to develop new drugs with more favorable side effect profile and a different mechanism of activity. The marked reduction in the incidence of CMV retinitis is patients with AIDS in the era of combination antiretroviral therapy (ART) has resulted in the removal of several FDA-approved drugs by manufacturers due to poor sales and created a disincentive for new drug development.
    08/2014; 2(10). DOI:10.1517/21678707.2014.945906