Infectious Reactivation of Cytomegalovirus Explaining Age-and Sex-Specific Patterns of Seroprevalence

van Boven, M.; van de Kassteele, J.; Korndewal, M. J.; van Dorp, C. H.; Kretzschmar, M.; van der Klis, F.; de Melker, H. E.; Vossen, A. C.; van Baarle, D.

doi:10.1101/102491

bioRxiv · 10.1101/102491

Infectious Reactivation of Cytomegalovirus Explaining Age-and Sex-Specific Patterns of Seroprevalence

van Boven, M.·van de Kassteele, J.·Korndewal, M. J.·van Dorp, C. H.·Kretzschmar, M.·van der Klis, F.·de Melker, H. E.·Vossen, A. C.·van Baarle, D.

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Abstract

Human cytomegalovirus is a herpes virus with poorly understood transmission dynamics. We here provide quantitative estimates of the transmissibility of primary infection, reactivation, and re-infection using age-and sex-specific antibody response data. The data are optimally described by three distributions of antibody measurements, i.e. uninfected, infected, and infected after reactivation/re-infection. Estimates of seroprevalence increase gradually with age, such that at 80 years 73% (95%CrI: 64%-78%) of females and 62% (95%CrI: 55%-68%) of males is infected, while 57% (95%CrI: 47%-67%) of females and 37% (95%CrI: 28%-46%) of males has experienced a reactivation or re-infection episode. Merging the statistical analyses with transmission models, we find that infectious reactivation is key to provide a good fit fit to the data. Estimated reactivation rates increase from low values in children to 2%-6% per year older women. The results advance a hypothesis in which adult-to-adult transmission after infectious reactivation is the main driver of infection.

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van Boven, M., van de Kassteele, J., Korndewal, M. J., van Dorp, C. H., Kretzschmar, M., van der Klis, F., de Melker, H. E., Vossen, A. C., van Baarle, D.. 2017-01-24. Infectious Reactivation of Cytomegalovirus Explaining Age-and Sex-Specific Patterns of Seroprevalence. https://doi.org/10.1101/102491

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