Molecular and Cell Biology Research Center (MCBRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Sana Institute of Higher Education, Sari, Iran.
Medical Sciences Technologies, Molecular and Cell Biology Research Center (MCBRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Molecular and Cell Biology Research Center (MCBRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Transpl Immunol. 2022 Jun;72:101587. doi: 10.1016/j.trim.2022.101587. Epub 2022 Mar 23.
Patients with end-stage renal failure (ESRD) require hemodialysis. According to this point that CMV infection is related to mortality in immunocompromised, and damages in hemodialysis, this study is designed to survey the seroprevalence of CMV and primary infection in hemodialysis (HD) patients.
Current cross-sectional studies were found by online reviewing the national and international databases (Web of Science, Pubmed, Scopus, Science Direct, Google scholar), and suitable studies were selected. NOS checklist were used for evaluation of the qualities of all papers. Assessment of heterogeneity among the studies of primary studies was performed using Chi-squared test (Cochran's Q) and I2 index (significance level of 50%). The statistical analysis were performed using Comprehensive Meta-Analysis (CMA) V.2. For assessing publication bias, the Egger test was used by subjective judgment in each study. Also the effect of potential factor on heterogeneity of studies was performed by Meta-regression test and the impact of each study on the overall estimate was assessed by sensitivity analysis.
This meta- analysis included 23 primary studies investigating seroprevalence of Cytomegalovirus antibodies and primary infection among hemodialysis patients. Finding showed that seroprevalence of CMV IgG and IgM antibodies in hemodialysis patients at 95% confidence interval using random effect model was 88.7% (81.7-93.2%) and 10.9% (5.9-19.2%) respectively. Also the frequency of CMV infection among these studies were reported 41% (18.8-67.6%).
We found that frequency of CMV IgG was higher and it was detected in HD patients. The result of our study showed that most patients were exposure to CMV during dialysis may reactivate by various stimulation, including immunosuppression and inflammation, so screening of patients should be performed to prevent future consequences such as kidney transplant rejection during of dialysis.
终末期肾衰竭（ESRD）患者需要进行血液透析。根据巨细胞病毒（CMV）感染与免疫功能低下患者的死亡率相关，以及其对血液透析的损害，本研究旨在调查血液透析（HD）患者的 CMV 血清流行率和原发感染。
通过在线检索国家和国际数据库（Web of Science、Pubmed、Scopus、Science Direct、Google scholar），进行当前的横断面研究，并选择合适的研究。使用 NOS 清单评估所有论文的质量。使用卡方检验（Cochran's Q）和 I2 指数（50%显著性水平）评估初级研究之间的异质性。使用综合荟萃分析（CMA）V.2 进行统计分析。使用 Egger 检验进行主观判断，评估发表偏倚在每个研究中的存在情况。还通过 Meta 回归检验研究异质性的潜在因素，并通过敏感性分析评估每个研究对总体估计的影响。
这项荟萃分析纳入了 23 项研究，调查了血液透析患者的 CMV 抗体血清流行率和原发感染。结果显示，使用随机效应模型，血液透析患者 CMV IgG 和 IgM 抗体的血清流行率在 95%置信区间分别为 88.7%（81.7-93.2%）和 10.9%（5.9-19.2%）。此外，这些研究报告的 CMV 感染频率为 41%（18.8-67.6%）。
我们发现 CMV IgG 的频率更高，且在 HD 患者中检测到。我们的研究结果表明，大多数患者在透析期间接触到 CMV，可能会因各种刺激而重新激活，包括免疫抑制和炎症，因此应进行患者筛查，以防止在透析期间发生肾移植排斥等未来后果。
