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Urinary Cytomegalovirus Shedding in the United States: the National Health and Nutrition Examination Surveys, 1999–2004
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  • Alternative Title:
    Clin Infect Dis
  • Description:
    Background There are no data on the prevalence of cytomegalovirus (CMV) shedding from a representative sample of the US population. This information is critical for understanding and preventing CMV. Methods We tested urine specimens from CMV IgG-positive participants aged 6–49 years in three racial/ethnic groups from the National Health and Nutrition Examination Surveys (NHANES) 1999–2004 for the presence of CMV DNA with real-time polymerase chain reaction (PCR) assay. We examined the association of sociodemographic characteristics with shedding prevalence and viral loads. Results Among 6,828 CMV IgG-positive subjects tested, 537 had CMV DNA detected in urine—a shedding prevalence of 9.70%. Among persons 6–49 years, shedding prevalence was 3.83%. The prevalence of urinary shedding was inversely associated with increasing age (26.60%, 6.50%, and 3.45% in CMV IgG-positive subjects aged 6–11, 12–19, and 20–49 years, respectively; P < 0.001 for trend test and pairwise comparisons). Urinary viral load also decreased significantly with age (mean: 2.97, 2.69, and 2.43 log10 copies/mL in those age groups, respectively; P < 0.001 for trend test and pairwise comparisons). Conclusions Urinary CMV shedding and viral loads decreased dramatically by age, likely reflecting higher rates of primary CMV infection and longer duration of shedding in younger individuals. The findings demonstrate that children 6–11 years of age continue to shed CMV at higher rates and viral loads than adolescents and adults and thus may still be an important source for CMV transmission.
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