Laura Patricia Stadler1, David I Bernstein2, S Todd Callahan3, Christine B Turley4, Flor M Munoz5, Jennifer Ferreira6, Mekhala Acharya6, Gina A Gorgone Simone6, Shital M Patel7, Kathryn M Edwards8, Susan L Rosenthal9. 1. Department of Pediatrics, Division of Infectious Diseases, University of Kentucky, Lexington. 2. Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Ohio. 3. Department of Adolescent and Young Adult Medicine, Vanderbilt University, and. 4. Department of Pediatrics, University of Texas Medical Branch at Galveston. 5. Departments of Pediatrics. 6. EMMES Corporation, Rockville, Maryland. 7. Medicine, and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas. 8. Department of Pediatrics, Division of Pediatric Infectious Disease, Vanderbilt Vaccine Research Program, Nashville, Tennessee. 9. Department of Pediatrics, Columbia University Medical Center New York-Presbyterian Hospital Morgan Stanley Children's Hospital, New York, New York.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: By age 12, evidence of CMV infection was common. Multiple factors regarding race and personal behaviors likely contribute to seroconversion earlier in life.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: By age 12, evidence of CMV infection was common. Multiple factors regarding race and personal behaviors likely contribute to seroconversion earlier in life.
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