Epidemiological survey of human cytomegalovirus antibody levels in children from Southeastern China

Virology Journal

Xiao-Qun Zheng²  Jian Yu³  Qiu-Ju Zhou²  Yan-Qing Liu²  Miao Fu⁴  Ying Peng¹  Yan Gao²  Qi Zhang² 

[1] Present adress: University of Missouri, Columbia, MO 65211, USA;Key Laboratory of Laboratory Medicine, Ministry of Education, Wenzhou, China;Department of Laboratory Medicine, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;Department of Laboratory Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China

关键词: Child;    Southeastern China;    Chemiluminescence immunoassay;    Human cytomegalovirus;   

Others  :  1148897
DOI  :  10.1186/1743-422X-11-123

 received in 2014-04-13, accepted in 2014-06-30,  发布年份 2014

【 摘 要 】

Background

This study investigated infection status and distribution of human cytomegalovirus (HCMV) serum markers in hospitalized children from the Wenzhou region.

Methods

This survey was performed on 10,147 hospitalized children from birth to 14 years of age in Southeastern China (Wenzhou region) from March 2010 to March 2013. IgM and IgG antibodies to HCMV were quantitatively detected by chemiluminescence immunoassay (CLIA). HCMV IgM or IgG detection rates, concentration, and distribution in various age groups were retrospectively analyzed.

Results

In this study of hospitalized children, the overall rates of HCMV IgM⁺ and IgG⁺ were 10.8% (1,099/10,147) and 83.0% (8,425/10,147), respectively. The lowest HCMV IgM⁺ rate (1.0%, P < 0.001) was observed in the group of patients <28 days of age whereas the highest HCMV IgM⁺ rate (19.9%, P < 0.001) occurred in the 28 days ~ 5 months old group. However, the concentrations of HCMV specific IgM in all age groups were not significantly different (P > 0.05). The HCMV IgG⁺ rate was highest in the <28 days group (98.1%, P < 0.001). The 28 days ~ 5 months old group had the lowest HCMV specific IgG concentrations (median, 133.9 AU/mL, P < 0.001). Among 1,099 HCMV IgM⁺ children, 405 (36.9%) were diagnosed with respiratory infections which pneumonia accounted for 18.2% (200/1,099) of the total population. However, children with respiratory infections had the lowest HCMV IgG concentrations (median, 161.1 AU/mL, P < 0.05).

Conclusions

HCMV specific antibody responses are very common in hospitalized children with respiratory infection in Wenzhou region. Protection against HCMV airway infection needs greater emphasis and further studies will be helpful to reveal the role of HCMV in children respiratory disease.

【 授权许可】

   
2014 Zhang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Chen J, Hu L, Wu M, Zhong T, Zhou YH, Hu Y: Kinetics of IgG antibody to cytomegalovirus (CMV) after birth and seroprevalence of anti-CMV IgG in Chinese children. Virol J 2012, 9:304. BioMed Central Full Text
• [2]Lazzarotto T, Galli C, Pulvirenti R, Rescaldani R, Vezzo R, La Gioia A, Martinelli C, La Rocca S, Agresti G, Grillner L, Nordin M, Van Ranst M, Combs B, Maine GT, Landini MP: Evaluation of the Abbott AxSYM cytomegalovirus (CMV) immunoglobulin M (IgM) assay in conjunction with other CMV IgM tests and a CMV IgG avidity assay. Clin Diagn Lab Immunol 2001, 8:196-198.
• [3]De Paschale M, Agrappi C, Manco MT, Clerici P: Positive predictive value of anti-HCMV IgM as an index of primary infection. J Virol Methods 2010, 168:121-125.
• [4]Swanson EC, Schleiss MR: Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North Am 2013, 60:335-349.
• [5]Doerr HW: Cytomegalovirus infection in pregnancy. J Virol Methods 1987, 17:127-132.
• [6]Cannon MJ, Davis KF: Washing our hands of the congenital cytomegalovirus disease epidemic. BMC Public Health 2005, 5:70. BioMed Central Full Text
• [7]Boppana SB, Pass RF, Britt WJ, Stagno S, Alford CA: Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J 1992, 11:93-99.
• [8]Conboy TJ, Pass RF, Stagno S, Alford CA, Myers GJ, Britt WJ, McCollister FP, Summers MN, McFarland CE, Boll TJ: Early clinical manifestations and intellectual outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr 1987, 111:343-348.
• [9]Lazzarotto T, Varani S, Guerra B, Nicolosi A, Lanari M, Landini MP: Prenatal indicators of congenital cytomegalovirus infection. J Pediatr 2000, 137:90-95.
• [10]Yow MD, Williamson DW, Leeds LJ, Thompson P, Woodward RM, Walmus BF, Lester JW, Six HR, Griffiths PD: Epidemiologic characteristics of cytomegalovirus infection in mothers and their infants. Am J Obstet Gynecol 1988, 158:1189-1195.
• [11]Griffiths PD: Strategies to prevent CMV infection in the neonate. Semin Neonatol 2002, 7:293-299.
• [12]Boppana SB, Rivera LB, Fowler KB, Mach M, Britt WJ: Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N Engl J Med 2001, 344:1366-1371.
• [13]Burny W, Liesnard C, Donner C, Marchant A: Epidemiology, pathogenesis and prevention of congenital cytomegalovirus infection. Expert Rev Anti Infect Ther 2004, 2:881-894.
• [14]Revello MG, Gerna G: Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant. Clin Microbiol Rev 2002, 15:680-715.
• [15]Maine GT, Stricker R, Schuler M, Spesard J, Brojanac S, Iriarte B, Herwig K, Gramins T, Combs B, Wise J, Simmons H, Gram T, Lonze J, Ruzicki D, Byrne B, Clifton JD, Chovan LE, Wachta D, Holas C, Wang D, Wilson T, Tomazic-Allen S, Clements MA, Wright GL Jr, Lazzarotto T, Ripalti A, Landini MP: Development and clinical evaluation of a recombinant-antigen-based cytomegalovirus immunoglobulin M automated immunoassay using the Abbott AxSYM analyzer. J Clin Microbiol 2000, 38:1476-1481.
• [16]Lazzarotto T, Dalla Casa B, Campisi B, Landini MP: Enzyme-linked immunoadsorbent assay for the detection of cytomegalovirus-IgM: comparison between eight commercial kits, immunofluorescence, and immunoblotting. J Clin Lab Anal 1992, 6:216-218.
• [17]Almeida LN, Azevedo RS, Amaku M, Massad E: Cytomegalovirus seroepidemiology in an urban community of Sao Paulo, Brazil. Rev Saude Publica 2001, 35:124-129.
• [18]Huang LM, Lee CY, Chang MH, Wang JD, Hsu CY: Primary infections of Epstein-Barr virus, cytomegalovirus, and human herpesvirus-6. Arch Dis Child 1993, 68:408-411.
• [19]Stagno S, Cloud GA: Changes in the epidemiology of cytomegalovirus. Adv Exp Med Biol 1990, 278:93-104.
• [20]Fang FQ, Fan QS, Yang ZJ, Peng YB, Zhang L, Mao KZ, Zhang Y, Ji YH: Incidence of cytomegalovirus infection in Shanghai, China. Clin Vaccine Immunol 2009, 16:1700-1703.
• [21]Zhao P, Ma DX, Xue FZ, Ji CY, Wang SK, Zhang XM, Zhou YB, Yu XP: Seroprevalence and risk factors of human cytomegalovirus infection in the eastern Chinese population. Arch Virol 2009, 154:561-564.
• [22]Sun XN, Liu ZJ, Wang B, Shi LH, Liang RW, Li L, Qian DM, Song XX: Sero-epidemiological survey of human cytomegalovirus-infected children in Weifang (Eastern China) between 2009 and 2012. Virol J 2013, 10:42. BioMed Central Full Text
• [23]Dworsky M, Yow M, Stagno S, Pass RF, Alford C: Cytomegalovirus infection of breast milk and transmission in infancy. Pediatrics 1983, 72:295-299.
• [24]Vochem M, Hamprecht K, Jahn G, Speer CP: Transmission of cytomegalovirus to preterm infants through breast milk. Pediatr Infect Dis J 1998, 17:53-58.
• [25]Stagno S, Reynolds DW, Pass RF, Alford CA: Breast milk and the risk of cytomegalovirus infection. N Engl J Med 1980, 302:1073-1076.
• [26]Meier J, Lienicke U, Tschirch E, Kruger DH, Wauer RR, Prosch S: Human cytomegalovirus reactivation during lactation and mother-to-child transmission in preterm infants. J Clin Microbiol 2005, 43:1318-1324.
• [27]Numazaki K: Human cytomegalovirus infection of breast milk. FEMS Immunol Med Microbiol 1997, 18:91-98.
• [28]Munoz FM, Piedra PA, Glezen WP: Safety and immunogenicity of respiratory syncytial virus purified fusion protein-2 vaccine in pregnant women. Vaccine 2003, 21:3465-3467.
• [29]Watanaveeradej V, Endy TP, Samakoses R, Kerdpanich A, Simasathien S, Polprasert N, Aree C, Vaughn DW, Ho C, Nisalak A: Transplacentally transferred maternal-infant antibodies to dengue virus. Am J Trop Med Hyg 2003, 69:123-128.
• [30]Sinzger C, Digel M, Jahn G: Cytomegalovirus cell tropism. Curr Top Microbiol Immunol 2008, 325:63-83.
• [31]Bissinger AL, Sinzger C, Kaiserling E, Jahn G: Human cytomegalovirus as a direct pathogen: correlation of multiorgan involvement and cell distribution with clinical and pathological findings in a case of congenital inclusion disease. J Med Virol 2002, 67:200-206.
• [32]Gabrielli L, Bonasoni MP, Lazzarotto T, Lega S, Santini D, Foschini MP, Guerra B, Baccolini F, Piccirilli G, Chiereghin A, Petrisli E, Gardini G, Lanari M, Landini MP: Histological findings in foetuses congenitally infected by cytomegalovirus. J Clin Virol 2009, 46(Suppl 4):S16-S21.
• [33]Jiwa NM, Raap AK, van de Rijke FM, Mulder A, Weening JJ, Zwaan FE, The TH, van der Ploeg M: Detection of cytomegalovirus antigens and DNA in tissues fixed in formaldehyde. J Clin Pathol 1989, 42:749-754.
• [34]Liu Z, Tian Y, Wang B, Yan Z, Qian D, Ding S, Song X, Bai Z, Li L: Serum proteomics with SELDI-TOF-MS in congenital human cytomegalovirus hepatitis. J Med Virol 2007, 79:1500-1505.