Cytomegalovirus infection and coronary heart disease risk: a meta-analysis

Abstract

The chronic inflammatory process including cytomegalovirus (CMV) infection has been hypothesized to induce the progression of atherosclerosis in coronary heart disease (CHD). Numbers studies were conducted to analyze the association between CMV infection and risk of CHD, but no clear consensus had been reached. To assess this relationship more precisely, a meta-analysis was performed. The electronic databases PubMed, Embase, and CNKI were searched; data were extracted and analyzed independently by two investigators. Ultimately, 55 studies, involving 9,000 cases and 8,608 controls from six prospective studies (all with a nested case-control design) and 49 retrospective case-control studies were included. Overall, people exposed to CMV infection had an odds ratio (OR) of 1.67 (95% CI, 1.56-1.79) for CHD risk, relative to those not exposed. CMV infection was clearly identified as a risk factor for CHD in both prospective studies (OR, 1.31; 95% CI, 1.132-1.517) and retrospective studies (OR, 1.79; 95% CI, 1.659-1.939), and in both Asian group (OR, 2.69; 95% CI, 2.304-3.144) and non-Asian group (OR, 1.48; 95% CI, 1.371-1.600). Interestingly, in the subgroup analyses by detection methods of CMV, the increased risk (OR, 8.121) was greater among studies using polymerase chain reaction than the risk (OR, 1.561) among studies using enzyme-linked immunosorbent assay. In conclusion, this meta-analysis suggested that CMV infection is associated with an increased risk for CHD, especially among Asian populations.

How does cytomegalovirus factor into diseases of aging and vaccine responses, and by what mechanisms?

“…In a populationbased study involving 1468 participants, a composite measure of TNF-α and IL-6 mediated a substantial proportion of the association between CMV and allcause (18.9%, P < 0.001) and cardiovascular (29.0%, P = 0.02) mortality (Roberts et al 2010). A metaanalysis based on 9000 CMV-infected individuals and 8.608 controls from six prospective studies and 49 retrospective case-control studies showed that CMV infection overall has an odds ratio of 1.67 for CAD risk (Ji et al 2012). The European Prospective Investigation into Cancer (EPIC) study identified an association between higher levels of CMV-IgG and ischemic heart disease (with a hazard ratio of 1.4 when compared to seronegativity).…”

Hepatitis C virus and atherosclerosis: A legacy after virologic cure?

“…However, a sizeable minority of patients suffering from atherosclerosis do not harbour the classical risk factors. Other predisposing factors appear to contribute to the disease process including chronic viral infections (1)(2)(3).…”

Human Cytomegalovirus and Autoimmune Disease

“…A similar matter of recent debate is if and how infection with human cytomegalovirus (HCMV), another human herpes virus, could be linked with certain autoimmune diseases and how both conditions could interfere with each other. Several features including its extensive manipulation of adaptive and innate immune functions [2–5], the very large coding capacity [6], its lytic replication in multiple tissues [7] both locally and systemically, its lifelong persistence during subsequent phases of latency and reactivation, and its ubiquitous prevalence in human populations readily explain why HCMV was frequently linked with AID but also with further acquired disorders like arteriosclerosis and vascular disease [8], immune aging [9], and certain types of tumors [10]. …”