title: Cytomegalovirus seropositivity is associated with herpes zoster.
abstract: Herpes zoster (HZ) is caused by VZV reactivation that is facilitated by a declined immunity against varicella-zoster virus (VZV), but also occurs in immunocompetent individuals. Cytomegalovirus (CMV) infection is associated with immunosenescence meaning that VZV-specific T-cells could be less responsive. This study aimed to determine whether CMV infection could be a risk factor for the development of HZ. CMV IgG serostatus was determined in stored serum samples from previously prospectively recruited ambulatory adult HZ patients in the UK (N = 223) in order to compare the results with those from UK population samples (N = 1545) by means of a logistic regression (controlling for age and gender). Furthermore, we compared the UK population CMV seroprevalence with those from population samples from other countries (from Belgium (N1 = 1741, N2 = 576), USA (N = 5572) and Australia (N = 2080)). Furthermore, CMV IgG titers could be compared between UK HZ patients and Belgium N2 population samples because the same experimental set-up for analysis was used. We found UK ambulatory HZ patients to have a higher CMV seroprevalence than UK population samples (OR 1.56 [1.11 2.19]). CMV IgG seropositivity was a significant risk factor for HZ in the UK (OR 3.06 [1.32 7.04]. Furthermore, high CMV IgG titers (exceeding the upper threshold) were less abundant in CMV-seropositive Belgian N2 population samples than in CMV-seropositive UK HZ patients (OR 0.51 [0.31 0.82]. We found CMV-seroprevalence to increase faster with age in the UK than in other countries (P < 0.05). We conclude that CMV IgG seropositivity is associated with HZ. This finding could add to the growing list of risk factors for HZ.
authors.affiliation: a Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID); Vaccine & Infectious Disease Institute (VAXINFECTIO); University of Antwerp ; Antwerp , Belgium.
authors.forename: Benson
authors.initials: B
authors.lastname: Ogunjimi
authors.forename: Niel
authors.initials: N
authors.lastname: Hens
authors.forename: Richard
authors.initials: R
authors.lastname: Pebody
authors.forename: Hilde
authors.initials: H
authors.lastname: Jansens
authors.forename: Holly
authors.initials: H
authors.lastname: Seale
authors.forename: Mark
authors.initials: M
authors.lastname: Quinlivan
authors.forename: Heidi
authors.initials: H
authors.lastname: Theeten
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.forename: Judy
authors.initials: J
authors.lastname: Breuer
authors.forename: Philippe
authors.initials: P
authors.lastname: Beutels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D001315:Australia / Q000453:epidemiology; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000150:complications*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006562:Herpes Zoster / Q000453:epidemiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G
keywords: CMV; immunosenescence; reactivation; shingles; susceptibility; zoster