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津巴布韦哈拉雷产前门诊中 HIV 感染者和 HIV 阴性孕妇的巨细胞病毒感染血清流行率。

Seroprevalence of Cytomegalovirus Infection Among HIV-Infected and HIV-Uninfected Pregnant Women Attending Antenatal Clinic in Harare, Zimbabwe.

机构信息

Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.

出版信息

Viral Immunol. 2019 Sep;32(7):289-295. doi: 10.1089/vim.2019.0024. Epub 2019 Jul 26.

Abstract

This study aimed to investigate the seroprevalence of cytomegalovirus (CMV) infection and risk factors associated with CMV acquisition among pregnant women in Zimbabwe. In a cross-sectional study, pregnant women were recruited in late gestation, seeking antenatal care at council clinics in three high-density suburbs in Harare, Zimbabwe. Anti-CMV IgM and IgG antibodies were quantified in serum using an enzyme-linked immunosorbent assay. Antibody avidity tests were used to distinguish active infection from viral reactivation in anti-CMV IgM-positive cases. Five hundred and twenty four women were recruited: 278 HIV infected and 246 HIV uninfected. Current or active CMV infection defined as IgM positive+low avidity was detected in 4.6% (24/524), 95% confidence interval (CI): 3-6.9 in all women, 5.8% (16/278) in the HIV infected and 3.3% (8/246), 95% CI: 1.4-6.3 in the HIV uninfected. IgG seroprevalence was 99.6% (522/524), 95% CI: 98.6-99.9 in all women. Notably, the difference in the prevalence of active CMV infection between the HIV-infected and HIV-uninfected women was not statistically significant ( = 0.173). The study shows a low prevalence of primary or active CMV infection among the pregnant women, but the IgG seroprevalence suggests high previous CMV exposure. Importantly, CMV seroprevalence was not associated with the HIV status of the women, perhaps due to the ubiquitous exposure of the population to CMV.

摘要

本研究旨在调查津巴布韦孕妇巨细胞病毒(CMV)感染的血清流行率和获得 CMV 的相关危险因素。在一项横断面研究中,招募了妊娠晚期在津巴布韦哈拉雷三个高密度郊区的理事会诊所寻求产前护理的孕妇。使用酶联免疫吸附试验定量检测血清中的抗 CMV IgM 和 IgG 抗体。抗体亲和性试验用于区分抗 CMV IgM 阳性病例中的活动性感染和病毒再激活。共招募了 524 名妇女:278 名 HIV 感染和 246 名 HIV 未感染。当前或活动性 CMV 感染定义为 IgM 阳性+低亲和力,在所有妇女中的检出率为 4.6%(24/524),95%置信区间(CI):3-6.9;在 HIV 感染妇女中的检出率为 5.8%(16/278),在 HIV 未感染妇女中的检出率为 3.3%(8/246),95%CI:1.4-6.3。IgG 血清阳性率为 99.6%(522/524),95%CI:所有妇女均为 98.6-99.9。值得注意的是,HIV 感染和 HIV 未感染妇女之间活动性 CMV 感染的流行率差异无统计学意义( = 0.173)。研究表明,孕妇中原发性或活动性 CMV 感染的发生率较低,但 IgG 血清阳性率表明以前有过较高的 CMV 暴露。重要的是,CMV 血清阳性率与妇女的 HIV 状况无关,这可能是由于人群普遍接触 CMV 所致。

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