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.

Abstract

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