新型冠状病毒感染疫情前后中国健康人群的巨细胞病毒、EB病毒感染情况分析  

Analysis of CMV and EBV infection in healthy populations in China before and after the COVID-19 pandemic

作　　者：赵芷凡 刘卓君 王昱[1] 孙于谦[1] 许兰平[1] 张晓辉[1] 黄晓军[1] 裴旭颖[1] Zhao Zhifan;Liu Zhuojun;Wang Yu;Sun Yuqian;Xu Lanping;Zhang Xiaohui;Huang Xiaojun;Pei Xuying(Peking University People's Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,China)

机构地区：[1]北京大学人民医院,北京大学血液病研究所,国家血液系统疾病临床医学研究中心,造血干细胞移植治疗血液病北京市重点实验室,北京100044

出　　处：《中华血液学杂志》2024年第11期986-990,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金重大项目(82293630);国家自然科学基金面上项目(82470214、82070189);北京市科技新星(20220484076);北京大学临床科学家项目(BMU2024PYJH012);北大医学顶尖学科及学科群发展专项(71003Y3035)。

摘　　要：目的评估中国近10年健康人群巨细胞病毒(CMV)和EB病毒(EBV)感染情况,分析新型冠状病毒(以下简称新冠)感染疫情管控全面解除(以下简称解控)前后健康人群CMV和EBV感染情况的差异。方法对2014年1月至2023年12月在北京大学人民医院进行造血干细胞移植前检查的8827名健康移植供者的CMV和EBV的感染情况进行回顾性分析。运用Logistic回归分析CMV和EBV感染的危险因素。结果8827名健康移植供者中CMV和EBV的免疫球蛋白(Ig)G阳性率分别为94.52%和95.40%,显示出较高的既往感染率。CMV与EBV的既往感染率在解控前后差异无统计学意义(CMV:94.63%对93.92%,P=0.250;EBV:95.36%对95.62%,P=0.670),但既往感染人群IgG平均抗体滴度有所上升[CMV:(100.44±36.50)U/ml对(109.98±36.31)U/ml,P<0.001;EBV:(281.57±226.79)U/ml对(361.08±268.58)U/ml,P<0.001]。新冠疫情解控前后CMV IgM阳性率变化不显著,但EBV IgM阳性率升高(2.77%对6.29%,P<0.001),尤其解控3个月内EBV IgM阳性率达8.10%。进一步分析影响EBV IgM阳性率的因素,结果显示总体人群中性别(OR=1.479,95%CI 1.169~1.872,P=0.001)、年龄[与<18岁组相比,18~50岁组(OR=0.584,95%CI 0.421~0.820,P=0.002),>50岁组(OR=0.389,95%CI 0.248~0.610,P<0.001)]、新冠疫情解控(OR=2.360,95%CI 1.287~3.047,P<0.001)均是EBV IgM阳性的独立危险因素;按年龄段分组,<18岁组EBV IgM阳性率不受性别和新冠疫情解控影响,18~50岁组中性别(OR=1.499,95%CI 1.138~1.975,P=0.004)和新冠疫情解控(OR=2.608,95%CI 1.940~3.507,P<0.001)均是EBV IgM阳性的独立危险因素,>50岁组中新冠疫情解控是EBV IgM阳性的独立危险因素(OR=2.222,95%CI 1.101~4.484,P=0.026)。结论中国健康人群CMV和EBV的既往感染率高,随着年龄增长感染率有所增加。新冠感染可能增加健康人群EBV激活率,其中18岁以上人群新冠感染对EBV激活率的影响更为显著。Objective This study aimed to assess the infection status of cytomegalovirus(CMV)and Epstein-Barr virus(EBV)in healthy populations in China over the past decade and analyze the differences in CMV and EBV infection and related risk factors in healthy populations before and after the lifting of coronavirus disease 2019(COVID-19)pandemic control measures.Methods This study retrospectively analyzes the CMV and EBV infection status of 8827 healthy donors who underwent prehematopoietic stem cell transplantation screening at Peking University People's Hospital from January 2014 to December 2023.Logistic regression analysis was conducted to determine the risk factors for CMV and EBV infection.Results The CMV and EBV IgG positivity rates were 94.52%and 95.40%among the healthy donors,respectively,with no significant differences before and after the lifting of pandemic control measures(all P value>0.05).However,IgG antibody titers increased[CMV:(100.44±36.50)U/ml vs(109.98±36.31)U/ml,P<0.001;EBV:(281.57±226.79)U/ml vs(361.08±268.58)U/ml,P<0.001]after lifting the COVID-19 restrictions.However,the CMV IgM positivity rate remained unchanged.The EBV IgM positivity rate significantly increased after lifting measures(2.77%vs 6.29%,P<0.001),reaching 8.10%within 3 months.Further analysis of the factors affecting EBV IgM positivity revealed that gender(OR=1.479,95%CI 1.169–1.872,P=0.001),age[compared with the group younger than 18 years,the 18–50-year age group(OR=0.584,95%CI 0.421–0.820,P=0.002),the>50-year age group(OR=0.389,95%CI 0.248–0.610,P<0.001)],and the lifting of COVID-19 restrictions(OR=2.360,95%CI 1.287–3.047,P<0.001)were independent factors influencing EBV IgM positivity in the general population.The EBV IgM positivity rate in individuals under 18 years old was not affected by gender or the lifting of COVID-19 restrictions when stratified by age group.Both genders(OR=1.499,95%CI 1.138–1.975,P=0.004)and the lifting of COVID-19 restrictions(OR=2.608,95%CI 1.940–3.507,P<0.001)were independent factors affe

关 键 词：巨细胞病毒 EB病毒 新型冠状病毒 感染 抗体 

分 类 号：R511[医药卫生—内科学]