A systematic review and meta-analysis of the prevalence of human cytomegalovirus shedding in seropositive pregnant women
A systematic review and meta-analysis of the prevalence of human cytomegalovirus shedding in seropositive pregnant women
The detection of human cytomegalovirus (HCMV) in an individual's bodily fluid by culture techniques or through HCMV DNA detection by polymerase chain reaction, is known as HCMV shedding. Human cytomegalovirus shedding has the potential to transmit HCMV infection, where an individual can become infected with HCMV through contact with the bodily fluid of another individual containing HCMV. Human cytomegalovirus shedding can occur in primary infection and in non-primary infection for individuals with prior infection (HCMV seropositive). Human cytomegalovirus infection causes few or no symptoms in a pregnant woman, but can cause significant harm to her foetus if congenital CMV (cCMV) infection occurs. The association between HCMV shedding in HCMV seropositive pregnant women and the vertical transmission of HCMV to result in cCMV infection is poorly investigated, challenged by a limited understanding of the distribution of HCMV shedding in HCMV seropositive pregnant women. We systematically reviewed the published literature to describe the prevalence of HCMV shedding in HCMV seropositive women during pregnancy up to delivery. This analysis identified nine studies that met our eligibility criteria. In these studies, the prevalence of HCMV shedding in any bodily fluid of HCMV seropositive women during pregnancy and at delivery ranged from 0% to 42.5%. A meta-analysis, performed on six of the nine studies with suitable sample sizes, estimated a pooled prevalence of 21.5% [95% CI 12.7%,30.3%]. To our knowledge, this is the first review to systematically search the literature to summarise the prevalence of HCMV shedding in HCMV seropositive pregnant women. These estimates can help in the development of disease burden models and therapeutic or preventative strategies against cCMV infection in the context of non-primary maternal HCMV infection.
cytomegalovirus, pregnant, prevalence, seropositive, shedding
Sapuan, Shari
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Theodosiou, Anastasia
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Strang, Blair L.
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Heath, Paul T.
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Jones, Christine E.
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November 2022
Sapuan, Shari
a6a2745e-63a5-42b5-9c89-96531fc65042
Theodosiou, Anastasia
d0f2d7b5-6664-4b86-b738-25815681829b
Strang, Blair L.
f56f150d-d0a5-46f8-871e-9dfda8f83668
Heath, Paul T.
f730891f-46cc-45ea-b7d2-18c9b068a3cf
Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Sapuan, Shari, Theodosiou, Anastasia, Strang, Blair L., Heath, Paul T. and Jones, Christine E.
(2022)
A systematic review and meta-analysis of the prevalence of human cytomegalovirus shedding in seropositive pregnant women.
Reviews in Medical Virology, 32 (6), [e2399].
(doi:10.1002/rmv.2399).
Abstract
The detection of human cytomegalovirus (HCMV) in an individual's bodily fluid by culture techniques or through HCMV DNA detection by polymerase chain reaction, is known as HCMV shedding. Human cytomegalovirus shedding has the potential to transmit HCMV infection, where an individual can become infected with HCMV through contact with the bodily fluid of another individual containing HCMV. Human cytomegalovirus shedding can occur in primary infection and in non-primary infection for individuals with prior infection (HCMV seropositive). Human cytomegalovirus infection causes few or no symptoms in a pregnant woman, but can cause significant harm to her foetus if congenital CMV (cCMV) infection occurs. The association between HCMV shedding in HCMV seropositive pregnant women and the vertical transmission of HCMV to result in cCMV infection is poorly investigated, challenged by a limited understanding of the distribution of HCMV shedding in HCMV seropositive pregnant women. We systematically reviewed the published literature to describe the prevalence of HCMV shedding in HCMV seropositive women during pregnancy up to delivery. This analysis identified nine studies that met our eligibility criteria. In these studies, the prevalence of HCMV shedding in any bodily fluid of HCMV seropositive women during pregnancy and at delivery ranged from 0% to 42.5%. A meta-analysis, performed on six of the nine studies with suitable sample sizes, estimated a pooled prevalence of 21.5% [95% CI 12.7%,30.3%]. To our knowledge, this is the first review to systematically search the literature to summarise the prevalence of HCMV shedding in HCMV seropositive pregnant women. These estimates can help in the development of disease burden models and therapeutic or preventative strategies against cCMV infection in the context of non-primary maternal HCMV infection.
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Reviews in Medical Virology - 2022 - Sapuan - A systematic review and meta‐analysis of the prevalence of human
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Accepted/In Press date: 12 September 2022
Published date: November 2022
Additional Information:
Funding Information:
We thank academic liaison librarian Zena Ali (St George's, University of London) and Cochrane information specialist and systematic reviewer Elizabeth Stofold (St George's, University of London), for their guidance in developing the search strategy and inclusion criteria of our systematic review. We would also like to acknowledge St George's, University of London for supporting our work. No funding sources to declare. Open access publishing was facilitated by St George's, University of London, as part of the Wiley - St George's, University of London agreement.
Publisher Copyright:
© 2022 The Authors. Reviews in Medical Virology published by John Wiley & Sons Ltd.
Keywords:
cytomegalovirus, pregnant, prevalence, seropositive, shedding
Identifiers
Local EPrints ID: 470538
URI: http://eprints.soton.ac.uk/id/eprint/470538
ISSN: 1099-1654
PURE UUID: bab3dc14-dad0-4055-93c3-5ee72c53975f
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Date deposited: 12 Oct 2022 16:47
Last modified: 17 Mar 2024 04:04
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Contributors
Author:
Shari Sapuan
Author:
Anastasia Theodosiou
Author:
Blair L. Strang
Author:
Paul T. Heath
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