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Clinical Trial
. 2023 Nov 28;228(11):1491-1495.
doi: 10.1093/infdis/jiad182.

Incidence of Cytomegalovirus Primary and Secondary Infection in Adolescent Girls: Results From a Prospective Study

Robert Paris  1 , Dan Apter  2 , Suresh Boppana  3 , Maria D'Aloia  4 , Nathalie De Schrevel  4 , Jean-Marc Delroisse  5 , Luca Grassano  6 , Adrienne Guignard  5 , Anil A Panackal  1 , Francois Roman  5 , Jing Yu  1 , Elsa M Yunes  7 , Ilse Dieussaert  5
Affiliations
Clinical Trial

Incidence of Cytomegalovirus Primary and Secondary Infection in Adolescent Girls: Results From a Prospective Study

Robert Paris et al. J Infect Dis. .

Abstract

Developing a vaccine to prevent congenital cytomegalovirus (CMV) infection and newborn disability requires an understanding of infection incidence. In a prospective cohort study of 363 adolescent girls (NCT01691820), CMV serostatus, primary infection, and secondary infection were determined in blood and urine samples collected at enrollment and every 4 months for 3 years. Baseline CMV seroprevalence was 58%. Primary infection occurred in 14.8% of seronegative girls. Among seropositive girls, 5.9% had ≥4-fold increase in anti-CMV antibody, and 23.9% shed CMV DNA in urine. Our findings provide insights on infection epidemiology and highlight the need for more standardized markers of secondary infection.

Keywords: CMV pp65 qPCR; anti-CMV tegument IgG ELISA; cytomegalovirus; primary infection; secondary infection.

Plain language summary

Cytomegalovirus (CMV) can be passed from a woman to her unborn baby during pregnancy, which can result in disabilities in the baby. This can happen after a first infection with the virus during pregnancy, after a subsequent infection with a different strain (“reinfection”), or after “reactivation”, which means that a virus present from a previous infection becomes active again. Vaccinating adolescent girls against CMV may be a future strategy to help prevent CMV infection during pregnancy. To provide information to design trials evaluating a CMV vaccine, it is important to know how common primary/secondary CMV infection is in adolescent girls and if this can be measured with available tools. We followed adolescent girls living in Finland, Mexico or the United States for three years. At study start, 58% of these girls showed evidence of previous CMV infection. During the three-year follow-up, a first CMV infection occurred in 15% of girls, and reinfection or reactivation in 6% to 24% of girls (depending on the method used). The obtained estimates of CMV infection rates in adolescent girls provide valuable information for future studies to evaluate CMV vaccines, but standardized markers for secondary infection are needed.

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Conflict of interest statement

Potential conflicts of interest. M. D., N. D. S., A. G., A. A. P., F. R., J. Y., and I. D. are employed by and hold shares of GSK. J.-M. D. and L. G. are employees of GSK. R. P. was an employee of GSK at the time of the study; he holds shares of GSK, is currently an employee of Moderna Inc, and holds shares of Moderna Inc. D. A. and S. B. received a grant from GSK for this study. S. B. is a member of advisory committees for Merck, Moderna Therapeutics, and Sanofi, and received grants from Pfizer and Moderna outside the submitted work. E. M. Y. reports no potential conflicts. The authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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