Stadler Laura Patricia, Bernstein David I, Callahan S Todd, Turley Christine B, Munoz Flor M, Ferreira Jennifer, Acharya Mekhala, Simone Gina A Gorgone, Patel Shital M, Edwards Kathryn M, Rosenthal Susan L
Department of Pediatrics, Division of Infectious Diseases, University of Kentucky, Lexington.
Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Ohio.
J Pediatric Infect Dis Soc. 2013 Mar;2(1):7-14. doi: 10.1093/jpids/pis076. Epub 2012 Aug 3.
Congenital cytomegalovirus (CMV) is a leading cause of disability, including sensorineural hearing loss, developmental delay, and mental retardation. Understanding risk factors for acquisition of CMV infection in adolescent females will help determine vaccine strategies.
Females (12-17 years) were recruited from primary care settings in Cincinnati, Galveston, Houston, and Nashville from June 2006 to July 2010 for a seroepidemiologic study, from which seronegative participants were recruited for a CMV vaccine trial. Participants (n = 1585) responded to questions regarding potential exposures. For those with young children in the home (n = 859), additional questions were asked about feeding and changing diapers, and for those > 14 years of age (n = 1162), questions regarding sexual activity were asked. Serum was evaluated for CMV antibody using a commercial immunoglobulin G assay.
Cytomegalovirus antibody was detected in 49% of participants. In the univariate analyses, CMV seroprevalence was significantly higher among African Americans, those with children < 3 years of age in the home, and those with a history of oral, anal, or vaginal intercourse. Among those with young children in the home, feeding children and changing diapers further increased the association with CMV infection. However, in the final multivariate analysis, only African Americans and household contact with young children were associated with CMV infection.
By age 12, evidence of CMV infection was common. Multiple factors regarding race and personal behaviors likely contribute to seroconversion earlier in life.
先天性巨细胞病毒（CMV）是导致残疾的主要原因之一，包括感音神经性听力损失、发育迟缓以及智力障碍。了解青春期女性感染CMV的风险因素将有助于确定疫苗策略。
2006年6月至2010年7月，从辛辛那提、加尔维斯顿、休斯顿和纳什维尔的初级保健机构招募了年龄在12 - 17岁的女性进行血清流行病学研究，从血清学阴性的参与者中招募进行CMV疫苗试验。参与者（n = 1585）回答了有关潜在暴露的问题。对于家中有幼儿的参与者（n = 859），还询问了有关喂养和换尿布的额外问题，对于年龄大于14岁的参与者（n = 1162），询问了有关性活动的问题。使用商业免疫球蛋白G检测法评估血清中的CMV抗体。
49%的参与者检测到CMV抗体。在单因素分析中，非裔美国人、家中有3岁以下儿童的人以及有口交、肛交或阴道性交史的人CMV血清阳性率显著更高。在那些家中有幼儿的人中，喂养孩子和换尿布进一步增加了与CMV感染的关联。然而，在最终的多因素分析中，只有非裔美国人和与幼儿的家庭接触与CMV感染有关。
到12岁时，CMV感染的证据很常见。种族和个人行为的多种因素可能导致在生命早期发生血清转化。
