Associations of Cytomegalovirus Infection With All-Cause and Cardiovascular Mortality in Multiple Observational Cohort Studies of Older Adults

J Infect Dis. 2021 Feb 3;223(2):238-246. doi: 10.1093/infdis/jiaa480.

Abstract

Background: Whether latent cytomegalovirus (CMV) infection in older adults has any substantial health consequences is unclear. Here, we sought associations between CMV-seropositivity and IgG titer with all-cause and cardiovascular mortality in 5 longitudinal cohorts.

Methods: Leiden Longevity Study, Prospective Study of Pravastatin in the Elderly at Risk, Longitudinal Study of Aging Danish Twins, and Leiden 85-plus Study were assessed at median (2.8-11.4 years) follow-up . Cox regression and random effects meta-analysis were used to estimate mortality risk dependent on CMV serostatus and/or IgG antibody titer, in quartiles after adjusting for confounders.

Results: CMV-seropositivity was seen in 47%-79% of 10 122 white community-dwelling adults aged 59-93 years. Of these, 3519 had died on follow-up (579 from cardiovascular disease). CMV seropositivity was not associated with all-cause (hazard ratio [HR], 1.05; 95% confidence interval [CI], .97-1.14) or cardiovascular mortality (HR, 0.97; 95% CI, .83-1.13). Subjects in the highest CMV IgG quartile group had increased all-cause mortality relative to CMV-seronegatives (HR, 1.16; 95% CI, 1.04-1.29) but this association lost significance after adjustment for confounders (HR, 1.13; 95% CI, .99-1.29). The lack of increased mortality risk was confirmed in subanalyses.

Conclusions: CMV infection is not associated with all-cause or cardiovascular mortality in white community-dwelling older adults.

Trial registration: ClinicalTrials.gov NCT03070600.

Keywords: Herpesviridae; aged; cardiovascular; cytomegalovirus; immunoglobulin G; mortality; seroepidemiologic studies.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / immunology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Cohort Studies
  • Comorbidity
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / mortality*
  • Cytomegalovirus* / immunology
  • Female
  • Geriatric Assessment
  • Humans
  • Immunoglobulin G / immunology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Public Health Surveillance
  • Seroepidemiologic Studies

Substances

  • Antibodies, Viral
  • Immunoglobulin G

Associated data

  • ClinicalTrials.gov/NCT03070600