Zhao Z F, Liu Z J, Wang Y, Sun Y Q, Xu L P, Zhang X H, Huang X J, Pei X Y
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Nov 14;45(11):986-990. doi: 10.3760/cma.j.cn121090-20240910-00342.
This study aimed to assess the infection status of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in healthy populations in China over the past decade and analyze the differences in CMV and EBV infection and related risk factors in healthy populations before and after the lifting of coronavirus disease 2019 (COVID-19) pandemic control measures. This study retrospectively analyzes the CMV and EBV infection status of 8 827 healthy donors who underwent prehematopoietic stem cell transplantation screening at Peking University People's Hospital from January 2014 to December 2023. Logistic regression analysis was conducted to determine the risk factors for CMV and EBV infection. The CMV and EBV IgG positivity rates were 94.52% and 95.40% among the healthy donors, respectively, with no significant differences before and after the lifting of pandemic control measures (all value>0.05). However, IgG antibody titers increased [CMV: (100.44±36.50) U/ml (109.98±36.31) U/ml, <0.001; EBV: (281.57±226.79) U/ml (361.08±268.58) U/ml, <0.001] after lifting the COVID-19 restrictions. However, the CMV IgM positivity rate remained unchanged. The EBV IgM positivity rate significantly increased after lifting measures (2.77% 6.29%, <0.001), reaching 8.10% within 3 months. Further analysis of the factors affecting EBV IgM positivity revealed that gender (=1.479, 95% 1.169-1.872, =0.001), age[compared with the group younger than 18 years, the 18-50-year age group (=0.584, 95% 0.421-0.820, =0.002), the >50-year age group (=0.389, 95% 0.248-0.610, <0.001) ], and the lifting of COVID-19 restrictions (=2.360, 95% 1.287-3.047, <0.001) were independent factors influencing EBV IgM positivity in the general population. The EBV IgM positivity rate in individuals under 18 years old was not affected by gender or the lifting of COVID-19 restrictions when stratified by age group. Both genders (=1.499, 95% 1.138 - 1.975, =0.004) and the lifting of COVID-19 restrictions (=2.608, 95% 1.940-3.507, <0.001) were independent factors affecting EBV IgM positivity in the 18-50-year age group. The lifting of COVID-19 restrictions (=2.222, 95% 1.101-4.484, =0.026) was the sole independent factor affecting EBV IgM positivity in individuals over 50 years old. Previous infection rates of CMV and EBV are high in healthy populations in China, which increase with age. COVID-19 infection may increase EBV reactivation rates in healthy individuals, with a more pronounced effect on those aged >18 years.
本研究旨在评估过去十年中国健康人群中巨细胞病毒（CMV）和EB病毒（EBV）的感染状况，并分析2019冠状病毒病（COVID-19）大流行防控措施解除前后健康人群中CMV和EBV感染的差异及相关危险因素。本研究回顾性分析了2014年1月至2023年12月在北京大学人民医院接受造血干细胞移植前筛查的8827名健康供者的CMV和EBV感染状况。进行逻辑回归分析以确定CMV和EBV感染的危险因素。健康供者中CMV和EBV IgG阳性率分别为94.52%和95.40%，大流行防控措施解除前后无显著差异（所有P值>0.05）。然而，COVID-19限制措施解除后，IgG抗体滴度升高[CMV：（100.44±36.50）U/ml对（109.98±36.31）U/ml，P<0.001；EBV：（281.57±226.79）U/ml对（361.08±268.58）U/ml，P<0.001]。然而，CMV IgM阳性率保持不变。措施解除后EBV IgM阳性率显著升高（2.77%对6.29%，P<0.001），在3个月内达到8.10%。对影响EBV IgM阳性的因素进一步分析发现，性别（β=1.479，95%CI 1.169 - 1.872，P=0.001）、年龄[与18岁以下组相比，18 - 50岁年龄组（β=0.584，95%CI 0.421 - 0.820，P=0.002），>50岁年龄组（β=0.389，95%CI 0.248 - 0.610，P<0.001）]以及COVID-19限制措施的解除（β=2.360，95%CI 1.287 - 3.047，P<0.001）是影响一般人群中EBV IgM阳性的独立因素。按年龄组分层时，18岁以下个体的EBV IgM阳性率不受性别或COVID-19限制措施解除的影响。性别（β=1.499，95%CI 1.138 - 1.975，P=0.004）和COVID-19限制措施的解除（β=2.608，95%CI 1.940 - 3.507，P<0.001）都是影响18 - 50岁年龄组EBV IgM阳性的独立因素。COVID-19限制措施的解除（β=2.222，95%CI 1.101 - 4.484，P=0.026）是影响50岁以上个体EBV IgM阳性的唯一独立因素。中国健康人群中CMV和EBV既往感染率较高，且随年龄增长而增加。COVID-19感染可能增加健康个体中EBV的再激活率，对18岁以上人群的影响更为明显。
