Epidemiološke značajke infekcije uzrokovane citomegalovirusom na području Hrvatske

master's thesis

• Title (english): Epidemiological characteristics of cytomegalovirus infection in Croatia
• Author: Izabela Vrtar
• Mentor: Godrana Mlinarić-Galinović (mentor)
• Committee member: Sven Seiwerth (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Godrana Mlinarić-Galinović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Medical Microbiology and Parasitology); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Medical Microbiology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Epidemiology

Abstract

Citomegalovirus (CMV) je virus rasprostranjen diljem svijeta. Prevalencija se razlikuje u različitim područjima i različitim populacijskim skupinama. Cilj ovog istraživanja bio je analizirati seroprevalenciju i epidemiološke značajke CMV infekcije u Hrvatskoj. U istraživanju je sudjelovalo 1446 ispitanika testiranih tijekom dvogodišnjeg razdoblja (2013-2014. godine). Ispitivanu je skupinu sačinjavalo 537 (37%) muškaraca i 909 (63%) žena u dobi od 2 mjeseca do 84 godine. CMV IgM i IgG protutijela dokazana su pomoću komercijalnog imunoenzimnog testa. U svih IgM/IgG reaktivnih uzoraka određen je aviditet IgG protutijela za potvrdu akutne primarne CMV infekcije. CMV IgG protutijela dokazana su u ukupno 74% ispitanika. Seroprevalencija se nije značajno razlikovala između muškaraca (72%) i žena (75%). Uočen je značajan porast seropozitiviteta s dobi. U djece mlađe od 6 mjeseci nađena je visoka seroprevalencija (79%), što je ukazivalo na transplacentarno prenesena majčina protutijela. Nakon 6 mjeseci, CMV seroprevalencija je postupno rasla s 48% u dobnoj skupini od 6 mjeseci do 9 godina do 93% u ispitanika starijih od 60 godina (p <0,001). Seroprevalencija se nije razlikovala između stanovnika urbanih područja (74%) u odnosu na one iz prigradskih/ruralnih područja (72%). Uspoređujući različite populacijske skupine, prevalencija CMV IgG protutijela je bila najniža (54%) u djece i adolescenata, 77% u odrasloj općoj populaciji te vrlo visoka u bolesnika na hemodijalizi (92 %; p < 0,001 ).
Akutna infekcija dokazana je u 4% bolesnika (u 52% dokazana je akutna primarna CMV infekcija na temelju niskog IgG aviditeta, dok je u 48% visok aviditet ukazivao na CMV reaktivaciju ili reinfekciju). Većina primarnih infekcija (86%) je zabilježena je kod osoba mlađih od 30 godina. Nasuprot tome, CMV reaktivacija/reinfekcija se javljala u svim dobnim skupinama s učestalošću od 5% do 25%, počevši s dobnom skupinom od 20 do 29 godina. U trudnica nije bilo razlike u IgG ili IgM seropozitivnosti između žena s urednom i žena s patološkom trudnoćom.

Abstract (english)

Cytomegalovirus (CMV) is a ubiquitous virus throughout the world. The prevalence of antibodies varies in different regions and different population groups. The aim of this study was to analyze the seroprevalence and epidemiological characteristics of CMV infection in Croatia. The study included 1446 Croatian inhabitants tested during a two-year period (2013-2014). There were 537 (37%) males and 909 (63%) males and females aged 2 months to 84 years. CMV IgM and IgG antibodies were detected using a commercial ELISA test. All IgM/IgG reactive samples were further tested for IgM avidity to confirm acute primary CMV infection. The overall CMV IgG seroprevalence rate was 74%. There were no significant differences in the seropositivity among males (72%) and females (75%). A significant increase in the seroprevalence with age was observed. In children less than 6 months, a high positivity was found (79%) which indicate transplacentally derived maternal antibodies. After 6 months, CMV seropositivity progressively increased from 48% in 6 months-9-years age group to 93% in participants above 60 (p<0.001). Seroprevalence did not differ among participants residing in urban areas (74%) compared to those residing in suburban/rural areas (72%). Comparing different population groups, seropositivity was lowest (54%) in children and adolescents, 77% in adult general population and very high in patients on hemodialysis (92%; p<0,001). Acute infection was detected in 4% patients (in 52% acute primary CMV infection was documented by low IgG avidity while in 48% high AI indicates CMV reactivation or reinfection). The majority of primary infections (86%) were detected in subjects less than 30 years. In contrast, CMV reactivation/reinfection was common in all age groups (5-25%) starting with 20-29 age group. In pregnant women there was no difference in the IgG or IgM seropositivity among women with normal pregnancy and women with bad obstetric history.

• Keywords: citomegalovirus; infekcija; seroprevalencija; antitijela; avidnost; IgM; IgG
• Keywords (english): cytomegalovirus; infection; seroprevalence; antibodies; avidity; IgM; IgG
• Language: croatian
• URN:NBN: urn:nbn:hr:105:808761
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-12 07:29:31