Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
Cancer Causes Control. 2020 Jun;31(6):541-547. doi: 10.1007/s10552-020-01296-y. Epub 2020 Mar 28.
Cytomegalovirus (HCMV) is a common viral infection that shapes lifelong immunity. A history of infection with HCMV has been associated with many chronic diseases, including cancer. In addition, prospective cohort studies have established that HCMV is associated with all-cause mortality. However, there are limited data regarding HCMV and cancer mortality.
Data were obtained from the National Health and Nutrition Examination Survey (NHANES) III study (1988-1994): subjects aged 18 to 98, who had HCMV serology results, did not report having cancer at baseline, and were eligible for mortality follow-up (n = 14,498). Mortality was ascertained until December 2011 using National Death Index (NDI) linkage.
The unadjusted risk of all-cancer mortality was higher in HCMV seropositive individuals (HR 2.74, 95% CI 2.05-3.64). This association was attenuated after adjusting for age (HR 1.39, 95% CI 1.02-1.92), and other covariates (age, sex, race/ethnicity, smoking status, BMI, education, and C-reactive protein (CRP); HR 1.21, 95% CI 0.91-1.81). There was a statistically significant interaction between HCMV and sex (p = 0.01): HCMV seropositivity was associated with increased cancer mortality in men (HR 1.65, 95% CI 0.99-2.73) but not in women (HR 0.95, 95% CI 0.59-1.54).
CONCLUSION(S): Consistent with prior reports, HCMV seropositivity may be associated with an increased risk of cancer-related mortality but the association is partially driven by socioeconomic status and other risk factors. Future research is needed to determine whether HCMV is a risk factor for cancer, as well as identify the specific cancer types where HCMV increases mortality.
巨细胞病毒（HCMV）是一种常见的病毒感染，可形成终身免疫。HCMV 感染史与许多慢性疾病有关，包括癌症。此外，前瞻性队列研究已经证实 HCMV 与全因死亡率相关。然而，关于 HCMV 和癌症死亡率的数据有限。
数据来自国家健康和营养检查调查（NHANES）III 研究（1988-1994 年）：年龄在 18 至 98 岁之间、具有 HCMV 血清学结果、基线时未报告患有癌症且有资格进行死亡率随访的受试者（n=14498）。使用国家死亡指数（NDI）链接确定截至 2011 年 12 月的死亡率。
HCMV 血清阳性个体的全癌症死亡率风险较高（HR 2.74，95%CI 2.05-3.64）。调整年龄（HR 1.39，95%CI 1.02-1.92）和其他协变量（年龄、性别、种族/民族、吸烟状况、BMI、教育程度和 C 反应蛋白（CRP））后，这种关联减弱；HR 1.21，95%CI 0.91-1.81）。HCMV 和性别之间存在统计学显著的交互作用（p=0.01）：HCMV 血清阳性与男性癌症死亡率升高相关（HR 1.65，95%CI 0.99-2.73），但与女性无关（HR 0.95，95%CI 0.59-1.54）。
与先前的报告一致，HCMV 血清阳性可能与癌症相关死亡率增加相关，但这种关联部分是由社会经济地位和其他危险因素驱动的。需要进一步研究以确定 HCMV 是否是癌症的危险因素，以及确定 HCMV 增加死亡率的具体癌症类型。
