The prevalence of cytomegalovirus antibody in women: an epidemiological study from South Wales

Cytomegalovirus seropositivity and incident ischaemic heart disease in the Caerphilly prospective heart disease study

OBJECTIVE

To assess the role of cytomegalovirus (CMV) infection in primary ischaemic heart disease.

METHODS

Plasma specimens collected during 1979-83 from men in Caerphilly, south Wales, were analysed for IgG antibodies to CMV by enzyme linked immunosorbent assay and latex tests. Incident ischaemic heart disease events were ascertained after five and 10 years from death certificates, hospital records, and ECG changes; 195 incident ischaemic heart disease cases were compared with 216 controls of a similar age drawn from the rest of the cohort.

RESULTS

164 cases (84%) and 180 controls (83%) were seropositive for CMV. Optical density, an indicator of CMV antibody titre, was similar for cases and controls. Among controls, seropositivity was not associated with age, socioeconomic status currently or in childhood, smoking, height, body mass index, blood pressure, total cholesterol, fibrinogen, plasma viscosity, or leucocyte count. The unadjusted odds ratio relating CMV seropositivity to incident ischaemic heart disease was 1.06 (95% confidence interval 0.63 to 1.79) and was little changed (1.11, 0.63 to 1.97) after adjustment for age, smoking, body mass index, systolic blood pressure, total cholesterol, and socioeconomic status currently and in childhood.

CONCLUSIONS

CMV infection is unlikely to be a strong risk factor for development of myocardial infarction in middle aged men.

Methods for estimating the incidence of primary infection in pregnancy: a reappraisal of toxoplasmosis and cytomegalovirus data

Accurate incidence information is required to plan and evaluate screening programmes which have been proposed for the detection of primary toxoplasmosis and cytomegalovirus infection in pregnancy. Appropriate statistical methods are described for deriving incidence rates and their confidence intervals from three types of data: change in age-specific seroprevalence, seroconversion, and IgM studies. These methods are applied to seven published studies on toxoplasmosis and cytomegalovirus carried out in the UK. In these publications only one estimate of the infection rate per pregnancy was correctly derived, and none were accompanied by confidence intervals. Using the proposed methods, most estimates of the primary toxoplasmosis rate in these studies were between 2.5 and 5.5 per 1000 pregnancies, compared to the 2 per 1000 usually cited. Most cytomegalovirus incidence estimates were between 4 and 10 per 1000 pregnancies.