Program Schedule

1128
Association between Cytomegalovirus Seropositivity or Titres and Cardiovascular Disease: Systematic Review and Meta-Analysis of Prospective Evidence

Session: Poster Abstract Session: Viral Infections: Epidemiology
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Poster (2014-10-08).pdf (362.3 kB)
  • Background:

    Established risk factors for cardiovascular disease (CVD) do not fully explain CVD risk. Cytomegalovirus (CMV) has been linked to development of CVD among transplant recipients, but its association with CVD in immunocompetent adults is not established.

    Methods:

    Embase®, Medline® and Web of Science® were searched in April 2014. Titles, abstracts and full-text articles were screened and meta-analysed using a priori criteria.

    Results:

    Of 2,658 titles screened, 25 prospective studies met criteria for synthesis. All included studies defined CMV exposure using serological tests with a clinically important CVD outcome, but varied substantially regarding potential bias, confounding, and sample size. Random-effects meta-analysis of studies examining CMV seropositivity and CVD revealed a null association in both 13 population-based studies (effect estimate, 0.99; 95% CI, 0.87–1.12) and in 10 studies of patients with previous history of CVD (1.13; 1.00–1.27). However, in the three population-based studies that examined CMV antibody levels and CVD, there was an indication of increased risk in CVD among participants with higher titres, with the most methodologically robust study reporting an adjusted hazard ratio (95% CI) of 1.21 (1.04–1.41) for participants in the highest tertile of titres versus seronegative subjects.

    Conclusion:

    There appears to be a modest increased risk in CVD associated with higher CMV antibody levels. Given high burden of CVD and high seroprevelance of CMV among adults worldwide, this association is of potential public health relevance. Further research examining this association in other cohorts, and prospective studies correlating CMV antibody levels with direct measurements of active infection are necessary.

    Mohsin Ali, University of Cambridge, Cambridge, United Kingdom, Eddy Malouf, University College Dublin, Dublin, Ireland and Effrossyni Gkrania-Klotsas, MD, MPH, FRCP, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom

    Disclosures:

    M. Ali, None

    E. Malouf, None

    E. Gkrania-Klotsas, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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