Wilms Isca R, Best Al M, Adler Stuart P
Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia, USA.
BMC Infect Dis. 2008 Aug 1;8:107. doi: 10.1186/1471-2334-8-107.
Since African-Americans have twice the prevalence of cytomegalovirus (CMV) infections as age-matched Caucasians we sought to determine the ages and possible sources of infection of African-American children.
Subjects were 157 African-American healthy children and adolescents and their 113 household adults in Richmond VA. Families completed a questionnaire, provided saliva for antibody testing, and adolescents were interviewed regarding sexual activity.
Regardless of age CMV seropositivity was not associated with gender, breast feeding, health insurance, sexual activity, or household income, education, or size. In the final regression model, prior CMV infection in adults was over two-fold higher than in children (chi-square = 18.8, p < 0.0001). At one year of age the CMV seropositivity rate was 11% (95%CI = 4% - 24%) and increased 1.8% each year until age 13 years. Between ages 13 and 20 years the CMV seropositivity rate remained between 22% and 33%. For adults, the CMV seropositivity rate was 84% in 21 year olds (95%CI = 69%-.92%). There was no association between CMV infections of the children and their mothers but CMV infections among siblings were associated.
We observed that African-American children had CMV seroprevalence rates by age 20 years at less than one-half of that of their adult mothers and caregivers. Sibling-to-sibling transmission was a likely source of CMV infections for the children. The next generation of African-American women may be highly susceptible to a primary CMV infection during pregnancy and may benefit from a CMV vaccine.
由于非裔美国人巨细胞病毒(CMV)感染的患病率是年龄匹配的白种人的两倍,我们试图确定非裔美国儿童的感染年龄和可能的感染源。
研究对象为弗吉尼亚州里士满的157名非裔美国健康儿童和青少年及其113名家庭成年人。家庭完成了一份问卷,提供唾液进行抗体检测,并对青少年进行了关于性活动的访谈。
无论年龄大小,CMV血清阳性与性别、母乳喂养、健康保险、性活动或家庭收入、教育程度或家庭规模均无关联。在最终回归模型中,成年人既往CMV感染率比儿童高出两倍多(卡方 = 18.8,p < 0.0001)。一岁时CMV血清阳性率为11%(95%置信区间 = 4% - 24%),到13岁前每年增加1.8%。13至20岁之间,CMV血清阳性率保持在22%至33%之间。对于成年人,21岁时CMV血清阳性率为84%(95%置信区间 = 69% - 92%)。儿童与其母亲的CMV感染之间无关联,但兄弟姐妹之间的CMV感染有关联。
我们观察到,20岁时非裔美国儿童的CMV血清阳性率不到其成年母亲和照顾者的一半。兄弟姐妹之间的传播可能是儿童CMV感染的一个来源。下一代非裔美国女性在怀孕期间可能极易发生原发性CMV感染,可能会从CMV疫苗中受益。