title: Determinants of Ethnic Differences in Cytomegalovirus, Epstein-Barr Virus, and Herpes Simplex Virus Type 1 Seroprevalence in Childhood.
abstract: OBJECTIVE
  To identify whether there are ethnic differences in cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus type 1 (HSV-1) seroprevalence rates in children at 6 years of age, and when present, to evaluate how these differences can be explained by sociodemographic and environmental factors.
  
  
  METHODS
  This study was embedded within a multi-ethnic population-based prospective cohort study. Serum IgG levels against CMV, EBV, and HSV-1 were measured by enzyme-linked immunosorbent assay in 4464 children (median age 6.0 years). Information on demographics and characteristics were assessed by questionnaires. Herpesvirus seroprevalences between Surinamese-Creole, Surinamese-Hindustani, Turkish, Moroccan, Cape Verdean Antillean, and Native Dutch children were compared.
  
  
  RESULTS
  Non-Western ethnicity was an independent risk factor for CMV (aOR, 2.16; 95% CI 1.81-2.57), EBV (1.76; 1.48-2.09), and HSV-1 seropositivity (1.52; 1.39-1.66). Among the ethnic groups, CMV seroprevalences ranged between 29% and 65%, EBV between 43% and 69%, and HSV-1 between 13% and 39%. Low family net household income, low maternal educational level, crowding, and lifestyle factors explained up to 48% of the ethnic differences in HSV-1 seroprevalences, and up to 39% of the ethnic differences in EBV seroprevalences. These factors did not explain ethnic differences in CMV seroprevalences.
  
  
  CONCLUSIONS
  Socioeconomic position and factors related to lifestyle explain only a part of the large ethnic differences in EBV and HSV-1 seroprevalences, whereas they do not explain ethnic differences in CMV seroprevalences in childhood.
authors.affiliation: The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Michelle A E
authors.initials: MA
authors.lastname: Jansen
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Diana
authors.initials: D
authors.lastname: van den Heuvel
authors.affiliation: The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Selma H
authors.initials: SH
authors.lastname: Bouthoorn
authors.affiliation: The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Herbert
authors.initials: H
authors.lastname: Hooijkaas
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.affiliation: Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Viroscience, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Pieter L A
authors.initials: PL
authors.lastname: Fraaij
authors.affiliation: Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Menno C
authors.initials: MC
authors.lastname: van Zelm
authors.affiliation: Department of Pediatrics, Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: h.a.moll@erasmusmc.nl.
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Moll
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002648:Child; D015331:Cohort Studies; D003441:Crowding; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000208:ethnology; D004522:Educational Status; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology* / Q000208:ethnology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology* / Q000208:ethnology; D018259:Herpesvirus 1, Human; D006801:Humans; D007182:Income; D008019:Life Style; D009426:Netherlands / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D016036:Seroepidemiologic Studies