Why Has the High CMV Seroprevalence Been Increasing in Turkey? Cross-Sectional Analysis of 20 Year Data?

Abstract

Background: Seroprevalence of CMV is associated with substantial protection against congenital primary CMV infection. Geography, socioeconomic status (SES), hygienic conditions, breast feeding, age, gender, and parity are all factors that influence CMV IgG and thus indirectly the rate of congenital CMV infection.

Objectives: The aim of this study was to estimate the CMV seropositivity rate/trend in Turkey and to identify the factors such as age, gender, geography, socioeconomic status through educational and health insurance status, breast-feeding, and parity influencing CMV seroprevalence

Methods: 112,737 individuals participated in primary, secondary, and tertiary care at 54 different healthcare centers in all 7 geographic regions of Turkey. The 146,830 serology tests (87,947 CMV IgM and 58,883 CMV IgG) that were collected between 2002 and 2021 were retrospectively reviewed. Age, gender, country, educational level, health insurance parity and breast feeding period were noted as factors influencing CMV seroprevalence.

Results: The overall CMV IgG prevalence rate was 94.04%. CMV IgM seropositivity was 1.13%. From 2002 to 2021, CMV IgG was increasing and the CMV IgM positivity rate was decreasing.

Turkish, older, females with government health insurance, low level of education, high parity number, and long breast feeding period had significantly higher CMV IgG seroprevalence and significantly lower CMV IgM positivity than foreign, younger, male, private health insurance, high level of education, low parity number, and short breast feeding period.

Conclusions: : High CMV prevalence has been increasing in Turkey. Age, gender, country, economic status (through health insurance, educational level), parity and breast feeding period influenced CMV seroprevalence.