Infectious Disease

Study shows link between CMV and latent TB

November 06, 2021

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US data showed that cytomegalovirus was independently linked to latent tuberculosis infection and both were linked to high levels of C-reactive protein, suggesting increased systemic inflammation, the researchers reported.

“Previous studies have shown that cytomegalovirus infection can affect the progression to active tuberculosis and tuberculosis outcomes.” Yuri van der Heijden, MD, MPH, Assistant professor of medicine in the Infectious Disease Department at Vanderbilt University Medical Center, Healio said.

Source: Adobe Stock.

Cytomegalovirus has been independently linked to latent tuberculosis infection, according to a recent study. Source: Adobe Stock.

“DR. Moise A. Huamans Group had worked with data from the National Health and Nutritional Examination Survey (NHANES) with potentially interesting results on the subject, particularly regarding the relationship between cytomegalovirus infection and tuberculosis infection, rather than active tuberculosis.

Van der Heijden and colleagues analyzed NHANES data from 1999 to 2000 for tuberculin skin tests (TST), TB questionnaires, and cytomegalovirus (CMV) antibody tests.
Of the 7,363 participants they included in the study, 403 (5.5%) had latent TB infection (LTBI). Of 4,215 participants who were tested for CMV, 90% of participants with LTBI were CMV positive compared to 58% of participants without LTBI, the researchers reported.

The study also showed that a higher proportion of participants with LTBI compared to those without LTBI (45% vs. 31%) had high C-reactive protein (CRP) levels and that a CMV IgG positive status was associated with LTBI was (OR = 8.37; 95% CI, 3.67-19.05). LTBI and CMV were both associated with higher CRP in weighted univariate logistic regression models.

The researchers found that older age (30 to 49 years vs. 6 to 19 years), male gender, foreign birth, and large household sizes were significantly associated with LTBI. Positive CMV-IgG remained associated with LTBI in a multivariable regression model (adjusted OR = 2.94; 95% CI 1.19-7.28).

Van der Heijden explained that the association between CMV and LTBI was still exploratory and that no conclusions could be drawn about the direction of the association due to the design of the study, for example whether one infection predisposes to the other. However, there is growing knowledge that infections like CMV “can alter host immunity to affect the development of tuberculosis in humans,” he said.

Van der Heijden added that previous results showing that certain individuals do not become infected with TB despite high exposure “raise questions about intrinsic host factors” and how they can be influenced by the interaction between common pathogens and the host’s immune system One possible explanation is that people with both infections share common external risk factors for both infections.

“Cytomegalovirus and tuberculosis infections are linked, and both infections appear to play a role in chronic inflammation,” said van der Heijden. “The clinical implications of our results require further investigation.”

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