Health impact of a hypothetical intervention on immune burden of cytomegalovirus (CMV) among older adults in the US: a prospective analysis of the Health and Retirement Study Cohort

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-05-12 DOI:10.1016/j.lana.2025.101122

Yuelin He , Jessica Faul , Kate Duchowny , Chihua Li , Rebecca Stebbins , Grace A. Noppert

{"title":"Health impact of a hypothetical intervention on immune burden of cytomegalovirus (CMV) among older adults in the US: a prospective analysis of the Health and Retirement Study Cohort","authors":"Yuelin He , Jessica Faul , Kate Duchowny , Chihua Li , Rebecca Stebbins , Grace A. Noppert","doi":"10.1016/j.lana.2025.101122","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cytomegalovirus (CMV) infection has been indicted in the etiology of multiple aging-related diseases. We aimed to quantify the proportion of diseases that could be prevented with a potential CMV treatment among US older individuals.</div></div><div><h3>Methods</h3><div>We analyzed disease prevalence among 8934 eligible individuals from the US Health and Retirement Study (HRS) in 2016–2020. In our hypothetical intervention, the treatment would improve immune control of CMV and shift the distribution of continuous CMV IgG antibody levels from the highest quartile to the lower 3 quartiles. We estimated top-quartile CMV level attributable fractions for 7 outcomes: heart diseases, stroke, high blood pressure, high cholesterol, cancers, diabetes, and difficulty with Activities of Daily Living using a novel logistic regression-based approach which allows for continuous covariate adjustment for counterfactual prevalence, stratified by gender and race/ethnicity.</div></div><div><h3>Findings</h3><div>In the study sample, a hypothetical intervention that decreased CMV IgG below the highest quartile level in 2016 would result in a 3·57 (95% Confidence Interval: 1·54, 5·60) percentage points reduction of diabetes cases and a 1·81 (95% CI: 0·75, 2·86) percentage points reduction of high blood pressure cases among Non-Hispanic White (NHW) women. Among NHW men, the same intervention would lead to a 2·43 (95% CI: 0·49, 4·37) percentage points reduction of diabetes, a 2·89 (95% CI: 0·93, 4·86) percentage points reduction of heart diseases and a 2·52 (95% CI: 1·39, 3·65) percentage points reduction of high blood pressure.</div></div><div><h3>Interpretation</h3><div>Our findings provide initial evidence for the potential population health impact of CMV intervention, specifically on high blood pressure, diabetes, and heart diseases.</div></div><div><h3>Funding</h3><div><span>National Institutes of Health</span>, <span>National Institute on Aging</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"47 ","pages":"Article 101122"},"PeriodicalIF":7.0000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Americas","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667193X25001322","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Cytomegalovirus (CMV) infection has been indicted in the etiology of multiple aging-related diseases. We aimed to quantify the proportion of diseases that could be prevented with a potential CMV treatment among US older individuals.

Methods

We analyzed disease prevalence among 8934 eligible individuals from the US Health and Retirement Study (HRS) in 2016–2020. In our hypothetical intervention, the treatment would improve immune control of CMV and shift the distribution of continuous CMV IgG antibody levels from the highest quartile to the lower 3 quartiles. We estimated top-quartile CMV level attributable fractions for 7 outcomes: heart diseases, stroke, high blood pressure, high cholesterol, cancers, diabetes, and difficulty with Activities of Daily Living using a novel logistic regression-based approach which allows for continuous covariate adjustment for counterfactual prevalence, stratified by gender and race/ethnicity.

Findings

In the study sample, a hypothetical intervention that decreased CMV IgG below the highest quartile level in 2016 would result in a 3·57 (95% Confidence Interval: 1·54, 5·60) percentage points reduction of diabetes cases and a 1·81 (95% CI: 0·75, 2·86) percentage points reduction of high blood pressure cases among Non-Hispanic White (NHW) women. Among NHW men, the same intervention would lead to a 2·43 (95% CI: 0·49, 4·37) percentage points reduction of diabetes, a 2·89 (95% CI: 0·93, 4·86) percentage points reduction of heart diseases and a 2·52 (95% CI: 1·39, 3·65) percentage points reduction of high blood pressure.

Interpretation

Our findings provide initial evidence for the potential population health impact of CMV intervention, specifically on high blood pressure, diabetes, and heart diseases.

Funding

National Institutes of Health, National Institute on Aging.

查看原文本刊更多论文

假设干预对美国老年人巨细胞病毒（CMV）免疫负担的健康影响：健康与退休研究队列的前瞻性分析

巨细胞病毒（CMV）感染已被认为是多种衰老相关疾病的病因。我们的目的是量化美国老年人中可以通过潜在的巨细胞病毒治疗预防的疾病的比例。方法分析2016-2020年美国健康与退休研究（HRS）中8934名符合条件的个体的疾病患病率。在我们假设的干预中，治疗将改善CMV的免疫控制，并将连续CMV IgG抗体水平的分布从最高的四分位数转移到较低的3个四分位数。我们使用一种新颖的基于逻辑回归的方法估计了7个结局的前四分位数CMV水平归因分数：心脏病、中风、高血压、高胆固醇、癌症、糖尿病和日常生活活动困难，该方法允许对反事实患病率进行连续协变量调整，并按性别和种族/民族分层。在研究样本中，假设干预措施将CMV IgG降低到2016年最高四分位数水平以下，将导致非西班牙裔白人（NHW）女性中糖尿病病例减少3.57（95%置信区间：1.54,5.60）个百分点，高血压病例减少1.81 （95% CI: 0.75, 2.86）个百分点。在NHW男性中，同样的干预将导致糖尿病降低2.43 （95% CI: 0.49, 4.37）个百分点，心脏病降低2.89 （95% CI: 0.93, 4.86）个百分点，高血压降低2.52 （95% CI: 1.39, 3.65）个百分点。我们的研究结果为巨细胞病毒干预对人群健康的潜在影响提供了初步证据，特别是对高血压、糖尿病和心脏病的影响。资助国家卫生研究院，国家老龄研究所。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.