Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America.
PLoS Negl Trop Dis. 2011 Apr 26;5(4):e1140. doi: 10.1371/journal.pntd.0001140.
Congenital cytomegalovirus (CMV) infection is the most common intrauterine infection in the United States disproportionately affecting minority races and those of lower socio-economic class. Despite its importance there is little information on the burden of congenital CMV-related mortality in the US. To measure congenital CMV-associated mortality in the US and assess possible racial/ethnic disparities, we reviewed national death certificate data for a 17-year period.
Congenital CMV-associated deaths from 1990 through 2006 were identified from multiple-cause-coded death records and were combined with US census data to calculate mortality rates.
A total of 777 congenital CMV-associated deaths occurred over the 17-year study period resulting in 56,355 years of age-adjusted years of potential life lost. 71.7% (557) of congenital CMV-associated deaths occurred in infants (age less than 1 year). Age-adjusted mortality rates stratified by race/ethnicity revealed mortality disparities. Age-adjusted rate ratios were calculated for each racial/ethnic group using whites as the reference. Native Americans and African Americans were 2.34 (95% CI, 2.11-2.59) and 1.89 (95% CI, 1.70-2.11) times respectively, more likely to die from congenital CMV than whites. Asians and Hispanics were 0.54 (95% CI, 0.44-0.66) and 0.96 (95% CI, 0.83-1.10) times respectively, less likely to die from congenital CMV than whites.
CONCLUSIONS/SIGNIFICANCE: Congenital CMV infection causes appreciable mortality in the US exacting a particular burden among African Americans and Native Americans. Enhanced surveillance and increased screening are necessary to better understand the epidemiology of congenital CMV infection in addition to acceleration of vaccine development efforts.
先天性巨细胞病毒（CMV）感染是美国最常见的宫内感染，不成比例地影响少数族裔和社会经济地位较低的人群。尽管它很重要，但美国先天性 CMV 相关死亡率的信息很少。为了衡量美国先天性 CMV 相关死亡率，并评估可能存在的种族/民族差异，我们回顾了 17 年的国家死亡证明数据。
从多病因编码死亡记录中确定了 1990 年至 2006 年期间与先天性 CMV 相关的死亡，并结合美国人口普查数据计算死亡率。
在 17 年的研究期间，共发生 777 例与先天性 CMV 相关的死亡，导致 56,355 年的潜在寿命损失。71.7%（557 例）的与先天性 CMV 相关的死亡发生在婴儿（年龄小于 1 岁）中。按种族/民族分层的年龄调整死亡率显示出死亡率的差异。使用白人作为参考，计算了每个种族/民族群体的年龄调整率比值。与白人相比，美国原住民和非裔美国人的死亡率分别高出 2.34 倍（95%可信区间，2.11-2.59）和 1.89 倍（95%可信区间，1.70-2.11）。亚洲人和西班牙裔美国人的死亡率分别低 0.54 倍（95%可信区间，0.44-0.66）和 0.96 倍（95%可信区间，0.83-1.10）。
结论/意义：先天性 CMV 感染在美国造成相当大的死亡率，特别是对非裔美国人和美国原住民造成特别的负担。需要加强监测和增加筛查，以更好地了解先天性 CMV 感染的流行病学，除了加速疫苗开发工作外。
