title: Prevalence and dynamics of cytomegalovirus infection among patients undergoing chronic hemodialysis.
abstract: Cytomegalovirus (CMV) is an important pathogen in immunocompromised individuals. The aim of this study was to analyze prevalence and dynamics of CMV infection among patients undergoing chronic hemodialysis. From 2010 to 2012, a total of 162 patients and 160 control subjects were tested for the presence of CMV IgM and IgG antibodies using enzyme-linked immunosorbent assay. IgM/IgG reactive samples were further evaluated for IgG avidity to confirm or rule out recent primary CMV infection. The overall IgG seropositivity was higher in hemodialysis patients compared to controls (90.7% vs. 81.9%; crude odds ratio [OR] =2.02, 95% confidence interval [CI] =1.05-3.89; OR adjusted for age and gender = 2.18, 95% CI = 1.05-4.55). CMV IgG antibody titers were similar in both groups. There was no difference in CMV prevalence between males (87.9%) and females (96.3%). According to age, a progressive increase in seropositivity was observed in both hemodialysis patients and the control group. Three hemodialysis patients (1.9%) developed recurrent CMV infection (positive IgM with high avidity IgG antibodies). In one patient (2.9%), seroconversion was documented during the second year of the follow-up period indicating primary infection. In contrast, in the control group, recent primary CMV infection (positive IgM with low/borderline IgG avidity) was demonstrated in three subjects (1.9%), whereas one (0.6%) developed recurrent infection. On multivariate logistic regression, hemodialysis and older age were significant predictors for CMV seropositivity.
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia ; Department of Microbiology, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: T
authors.initials: T
authors.lastname: Vilibic-Cavlek
authors.affiliation: Department of Social Medicine and Gerontology, Zagreb County Institute of Public Health, Zagreb, Croatia ; Department of Epidemiology, Medical School University of Rijeka, Rijeka, Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Kolaric
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia ; Department of Microbiology, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: S
authors.initials: S
authors.lastname: Ljubin-Sternak
authors.affiliation: Department of Microbiology, University of Applied Health Studies, Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Kos
authors.affiliation: Department of Epidemiology, Croatian National Institute of Public Health, Zagreb, Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Kaic
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia ; Department of Microbiology, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: G
authors.initials: G
authors.lastname: Mlinaric-Galinovic
keywords: Cytomegalovirus; hemodialysis; seroprevalence
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