Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom.
Clin Infect Dis. 2013 May;56(10):1421-7. doi: 10.1093/cid/cit083. Epub 2013 Feb 26.
The relationship between cytomegalovirus (CMV) infection and mortality among immunocompetent individuals is uncertain. We aimed to examine whether seropositivity for CMV and the level of CMV immunoglobulin G (IgG) antibody are associated with all-cause and cause-specific mortality.
We used data from a random sample of 13 090 participants aged 40-79 years at recruitment in 1993-1997 to the European Prospective Investigation of Cancer-Norfolk population-based cohort study. We measured baseline IgG antibody levels against CMV. Death certificates were obtained for all participants who died before 31 March 2011. Codes for the underlying cause of death were used to investigate cause-specific mortality.
A total of 2514 deaths occurred during a mean follow-up of 14.3 years (SD, 3.3 years). Compared to seronegative participants (age- and sex-adjusted mortality rate, 12.4 [95% confidence interval {CI}, 11.3-13.2] per 1000 person-years at risk), rates increased across thirds of IgG antibody levels (score test of trend P < .0001). CMV seropositivity (prevalence 59%) was associated with increased all-cause mortality (age- and sex-adjusted hazard ratio [HR], 1.16 [95% CI, 1.07-1.26]), similarly in men and women (P for interaction = .52). The association persisted after additionally adjusting for measures of socioeconomic status and possible confounders. Cause-specific analyses suggested that increased mortality from cardiovascular disease (HR, 1.06 [95% CI, .91-1.24]), cancer (HR, 1.13 [95% CI, .98-1.31]), and other causes (HR, 1.23 [95% CI, 1.04-1.47) all appeared to contribute to the overall associations.
Seropositivity and higher IgG antibody levels against CMV are associated with increased mortality and after adjustment for a range of potential confounders in the general population.
巨细胞病毒（CMV）感染与免疫功能正常个体的死亡率之间的关系尚不确定。本研究旨在探究 CMV 血清阳性和 CMV 免疫球蛋白 G（IgG）抗体水平是否与全因和死因特异性死亡率相关。
我们使用了 1993-1997 年在欧洲癌症前瞻性调查-诺福克人群队列研究中招募的 13090 名年龄在 40-79 岁的随机参与者的数据。我们测量了基线时针对 CMV 的 IgG 抗体水平。所有在 2011 年 3 月 31 日前死亡的参与者都获得了死亡证明。死因代码用于调查死因特异性死亡率。
在平均 14.3 年（SD，3.3 年）的随访期间，共发生了 2514 例死亡。与血清阴性的参与者相比（年龄和性别调整后的死亡率，每 1000 人年风险为 12.4 [95%置信区间 {CI}，11.3-13.2]），IgG 抗体水平逐三分位数增加（趋势得分检验 P<0.0001）。CMV 血清阳性（流行率为 59%）与全因死亡率增加相关（年龄和性别调整的风险比 [HR]，1.16 [95% CI，1.07-1.26]），男性和女性之间相似（P 交互作用=0.52）。在进一步调整社会经济地位和可能的混杂因素的措施后，这种关联仍然存在。病因特异性分析表明，心血管疾病（HR，1.06 [95% CI，0.91-1.24]）、癌症（HR，1.13 [95% CI，0.98-1.31]）和其他原因（HR，1.23 [95% CI，1.04-1.47]）的死亡率增加似乎都促成了总体关联。
CMV 血清阳性和更高的 IgG 抗体水平与全因死亡率增加相关，在一般人群中调整了一系列潜在混杂因素后仍然如此。
