Disease- Introduction and burden

Cytomegalovirus (CMV)

Introduction

CMV can lead to severe and life-threatening disease in congenitally infected children and immunosuppressed individuals, but is asymptomatic in immunocompetent individuals.1, It is a causative agent for cardiovascular diseases, cancer, and autoimmune diseases.1 There are a number of vaccines and mAbs which are in different phases of clinical development, but none have been approved till date. 1,2,3

Disease burden
Global
CMV is a ubiquitous virus with a prevalence of about 100% in both Africa and Asia, and 80% in Europe and North America.4 Zuhair et al. estimated a global CMV seroprevalence of 83% in the general population, 86% in women of childbearing age, and 86% in donors of blood ororgans.5

Canada
In Canada, 40 to 50% of pregnant women are positive for CMV lgG antibodies.50 1 in 200 Canadian infants are infected with
CMV during pregnancy.7 1 in 5 children with congenital CMV will develop a permanent disability such as hearing loss or
developmental delay.6,7

United States
In the United States, nearly1 in 3 children are already infected with CMV by age 5.9 The mean prevalence of congenital CMV (cCMV) infection among infants in the United States is estimated to be 0.4% to 0.5%.10 Over half of adults have been infected with CMV by age 40 and 90% of healthy adults have become infected with CMV by the age of 80years. 6,9  1% to 4% of seronegative women have a primary infection in pregnancy.10

Inference
There is a high prevalence in certain age groups in Canada. 20% of children will develop complications of CMV. There are no
licensed vaccines or mAbs for CMV, although many of them are in different phases of clinical development.

References:

  1. Scarpini S, Morigi F, Betti L, Dondi A, Biagi C, Lanari M. Development of a Vaccine against Human Cytomegalovirus: Advances, Barriers, and Implications for the Clinical Practice. Vaccines (Basel). 2021;9(6):551. Published 2021 May 25. doi:10.3390/vaccines9060551.
  2. Struble EB, Murata H, Komatsu T, Scott D. Immune Prophylaxis and Therapy for Human Cytomegalovirus Infection. Int J Mal Sci. 2021;22(16) :8728. Published 2021 Aug 13. doi:10.3390/ijms22168728.
  3. McVoy MM, Tenorio E, Kauvar LM. A Native Human Monoclonal Antibody Targeting HCMV gB (AD-2 Site I). Int J Mal Sci. 2018;19(12):3982. Published 2018 Dec 11. doi:10.3390/ijms19123982.
  4. Al Mana H, Yassine HM, Younes NN, et al. The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review. Pathogens. 2019;8 (4):213. Published 2019 Oct 31. doi:10.3390/pathogens8040213.
  5. Zuhair M, Smit GSA, Wallis G, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: A systematic review and meta-analysis. Rev Med Viral. 2019;29(3):e2034. doi:10.1002/rmv.2034.
  6. CYTOMEGALOVIRUS SURVEILLANCE PROTOCOL FOR ONTARIO HOSPITALS. https://www.oha.com/Documents/Cytomegalovirus%2o(May% 202019).pdf. Last accessed 16 July 2’&22.
  7. What is CMV? https://cmvcanada.com/about-cmv/. Last accessed 16th July 2022.
  8. the most common infectious cause of birth defects. https://www.canadianhealthcarenetwork.ca/cmv-most-common-infectiouscause-birth defects#:-:text=One%2oin%20200%2obabies%2oin,partial%2oblindness%20and%20developmental%20disabilities. Last accessed 16th July 2022.
  9. About Cytomegalovirus (CMV). https://www.cdc.gov/cmv/overview.html#:-:text=ln%2othe%20United%20States%2C%2onearly,(variety) %2oof”/o2othe%2ovirus. Last accessed 16th July 2022.
  10. Messinger CJ, Lipsitch M, Bateman BT, et al. Association Between Congenital Cytomegalovirus and the Prevalence at Birth of Microcephaly in the United States. JAMA Pediatr. 2020;174(12):1159-1167. doi:10.1001/jamapediatrics.2020.3009