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Epidemiol Infect. 2019 Jan;147:e154. doi: 10.1017/S0950268819000487.

The seroprevalence of cytomegalovirus infection in Belgium anno 2002 and 2006: a comparative analysis with hepatitis A virus seroprevalence.

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Department of Virology,Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University,Merelbeke,Belgium.
Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University,Diepenbeek,Belgium.
Institute of Health and Society (IRSS), Université catholique de Louvain,Brussels,Belgium.
Department of Epidemiology and Public Health,sciensano,Brussels,Belgium.
Scientific Directorate Infectious Diseases in Humans, Service of Viral Diseases, Sciensano,Brussels,Belgium.
Department of Laboratory Medicine,Antwerp University Hospital,Edegem,Belgium.
Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute, University of Antwerp,Antwerp,Belgium.


Cytomegalovirus (CMV) infection is endemic worldwide but its seroprevalence varies widely. The goal of this study was to estimate the age-specific seroprevalence of CMV infection in Belgium based on two cross-sectional serological datasets from 2002 and 2006. The seroprevalence was estimated relying on diagnostic test results based on cut-off values pre-specified by the manufacturers of the tests as well as relying on mixture models applied to continuous pathogen-specific immunoglobulin G antibody titre concentrations. The age-specific seroprevalence of hepatitis A virus (HAV), based on three Belgian cross-sectional serological datasets from 1993, 2002 and 2006, was used as a comparator since individuals acquire lifelong immunity upon recovery, implying an increasing seroprevalence with age. The age group weighted overall CMV seroprevalence derived from the mixture model was 32% (95% confidence interval (CI) 31-34%) in 2002 and 31% (95% CI 30-32%) in 2006. We demonstrated that CMV epidemiology differs from the immunizing infection HAV. This was the first large-scale study of CMV and HAV serial datasets in Belgium, estimating seroprevalence specified by age and birth cohort.


Cytomegalovirus; estimating age and birth cohort-specific seroprevalence; hepatitis A virus; mixture modelling; seroincidence

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