A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development

Fowler, Karen; Mucha, Jacek; Neumann, Monika; Lewandowski, Witold; Kaczanowska, Magdalena; Grys, Maciej; Schmidt, Elvira; Natenshon, Andrew; Talarico, Carla; Buck, Philip O.; Diaz-Decaro, John

doi:10.1186/s12889-022-13971-7

Table 3 Region-specific CMV seroprevalence according to population at risk, socioeconomic status, education level, and race/ethnicity

From: A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development

	Australia	Europe	Israel	Japan	Latin America	Canada and the United States	Total
Seroprevalence of CMV IgG by population at risk, % (95% CI^a)
Population at risk [51]	NR	91.4 (87.7–94.2)	NR	NR	NR	NR	91.4 (87.7–94.2)
Seroprevalence of CMV IgM by population at risk, % (95% CI^a)
Population at risk [51]	NR	8.6 (5.7–12.3)	NR	NR	NR	NR	8.6 (5.7–12.3)
Seroprevalence of CMV IgG by socioeconomic status, % (95% CI^a)
Household income, Canadian dollars [46]
0–59,999	NR	NR	NR	NR	NR	58.5^b	58.5
60,000–99,999	NR	NR	NR	NR	NR	34.5^b	34.5
≥ 100,000	NR	NR	NR	NR	NR	27.1^b	27.1
Family income to poverty ratio [61]
Below poverty level	NR	NR	NR	NR	NR	26.4–31.1	26.4–31.1
At or above poverty level	NR	NR	NR	NR	NR	14.9–27.6	14.9–27.6
Family income^c [47]
Low	NR	NR	NR	NR	NR	81.0^b	81.0
Middle class	NR	NR	NR	NR	NR	54.0^b	54.0
High	NR	NR	NR	NR	NR	35.0^b	35.0
Financial status^d [41]
Average	NR	63.5^b	NR	NR	NR	NR	63.5^b
Good	NR	63.5^b	NR	NR	NR	NR	63.5^b
Unknown	NR	60.9^b	NR	NR	NR	NR	60.9^b
Seroprevalence of CMV IgM by socioeconomic status, % (95% CI^a)
Financial status^e [41]
Average	NR	1.4^b	NR	NR	NR	NR	1.4^b
Good	NR	2.6^b	NR	NR	NR	NR	2.6^b
Unknown	NR	2.6^b	NR	NR	NR	NR	2.6^b
Seroprevalence of CMV IgG by education level, % (95% CI^a)
Household reference person’s education level [61]
Less than high school diploma	NR	NR	NR	NR	NR	31.3–37.2	31.3–37.2
High school diploma, GED, associate degree, some college	NR	NR	NR	NR	NR	16.7–22.6	16.7–22.6
College degree or higher	NR	NR	NR	NR	NR	17.8–34.7	17.8–34.7
Education level
Up to university [47]	NR	NR	NR	NR	NR	60.0^b	60.0^b
University [47]	NR	NR	NR	NR	NR	51.0^b	51.0^b
Higher [41]	NR	58.0^b	NR	NR	NR	NR	58.0^b
Secondary [41]	NR	64.5^b	NR	NR	NR	NR	64.5^b
Primary and vocational [41]	NR	72.9^b	NR	NR	NR	NR	72.9^b
Seroprevalence of CMV IgM by education level, % (95% CI^a)
Education level [41]
Higher	NR	2.1^b	NR	NR	NR	NR	2.1^b
Secondary	NR	1.9^b	NR	NR	NR	NR	1.9^b
Primary and vocational	NR	2.1^b	NR	NR	NR	NR	2.1^b
Seroprevalence of CMV IgG by race/ethnicity, % (95% CI^a)
White (99.3%)^f [57]	NR	96.2^b	NR	NR	NR	NR	96.2^b
Mestizo (98.9%)/White (1.1%) [44]	NR	NR	NR	NR	89.6^b	NR	89.6^b
Hispanic [61]	NR	NR	NR	NR	NR	31.0–36.7	31.0–36.7
Non-Hispanic White [61]	NR	NR	NR	NR	NR	10.6–24.2	10.6–24.2
Non-Hispanic Black [61]	NR	NR	NR	NR	NR	15.9–24.6	15.9–24.6
Non-Hispanic other/multiracial [61]	NR	NR	NR	NR	NR	37.0–40.0	37.0–40.0

CI Confidence interval, CMV Cytomegalovirus, GED General educational development, IgG Immunoglobulin G, IgM Immunoglobulin M, NR Not reported
^aSingle measure estimates are presented with 95% CIs (if available in primary publication)
^bConfidence intervals were not reported in primary publication
^cFamily income was defined in the primary publication as low: ≤ $30,000/year; middle: $31,000-$99,000/year; high: ≥ $100,000/year [47]
^dDetails of the definition for financial status were not provided in the primary publication [41]. The following data were not included in our review due to population sizes < 100: those with financial statuses of bad (n = 48; seroprevalence, 58.30%) and very good (n = 76; seroprevalence, 53.90%)
^eDetails of the definition for financial status were not provided in the primary publication [41]. The following data were not included in our review due to population sizes < 100: those with financial status of bad (n = 48; seroprevalence, 2.1%) and very good (n = 76; seroprevalence, 2.6%)
^fThe primary publication [57] indicated that 99.3% of case patients were White

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