Background

Cytomegalovirus (CMV) can cause tissue-invasive diseases in various organs after primary infection or through reactivation of latent-to-lytic switch over a lifetime. The number of individuals who are at risk of CMV diseases, such as elderly or immunocompromised patients, is constantly increasing; however, recent epidemiological changes associated with CMV disease have not been fully evaluated.

Methods

We used claims data of about 50 million individuals between 2010 and 2015 from the Korean Health Insurance Review and Assessment Service nationwide database. The code for CMV end-organ diseases in the ‘Relieved Co-payment Policy’ program matches the ICD-10 code of B25, except for congenital CMV infection and mononucleosis. A 628 cases of CMV and 3140 controls (without CMV disease), matched for age and sex, were selected from this dataset in order to evaluate the effect of adult CMV diseases on all-cause death.

Results

The overall unadjusted incidence rate (IR) of CMV end-organ diseases was 0.52/100,000 individuals. The standardized IR, adjusted for age and sex, have continuously increased from 0.32/100,000 in 2010 to 0.75/100,000 in 2015. The overall unadjusted IR in adult population was highest in 70–79 years for six years (0.96/100,000). In the model adjusted for age, sex, immunocompromised status including solid-organ or hematopoietic stem cell transplant recipients, hematologic malignancies, and human immunodeficiency virus diseases, the hazard ratio of case group was 5.2 (95% confidence interval, 3.6–7.4) for all-cause mortality.

Conclusion

Nationwide data indicates that CMV end-organ disease has steadily increased in the past six years and is associated with higher mortality.

中文翻译：

---

发达国家巨细胞病毒终末器官疾病的流行病学变化：一项全国性的、基于一般人群的研究

背景

巨细胞病毒 (CMV) 可在初次感染后或通过在一生中重新激活潜伏至溶解开关而在各种器官中引起组织侵袭性疾病。处于 CMV 疾病风险中的个体数量不断增加，例如老年人或免疫功能低下的患者；然而，最近与 CMV 疾病相关的流行病学变化尚未得到充分评估。

方法

我们使用了韩国健康保险审查和评估服务全国数据库中 2010 年至 2015 年间约 5000 万人的索赔数据。除先天性 CMV 感染和单核细胞增多症外，“减免共同支付政策”计划中 CMV 终末器官疾病的代码与 ICD-10 代码 B25 相匹配。从该数据集中选择了 628 例 CMV 病例和 3140 例对照（无 CMV 疾病），年龄和性别相匹配，以评估成人 CMV 疾病对全因死亡的影响。

结果

CMV 终末器官疾病的总体未调整发病率 (IR) 为 0.52/100,000 人。经年龄和性别调整后的标准化 IR 从 2010 年的 0.32/100,000 持续增加至 2015 年的 0.75/100,000。6 年来，成年人口的总体未调整 IR 在 70-79 岁期间最高（0.96/100,000）。在针对年龄、性别、免疫受损状态（包括实体器官或造血干细胞移植受者、血液系统恶性肿瘤和人类免疫缺陷病毒疾病）调整的模型中，病例组的风险比为 5.2（95% 置信区间，3.6-7.4）全因死亡率。

结论

全国数据表明，CMV 终末器官疾病在过去六年中稳步增加，并与更高的死亡率相关。