The results of a systematic review and meta-analysis suggest there is an increased risk for tuberculosis among people with cytomegalovirus infection, researchers reported in The Lancet.
“In December 2021, we read an article ... in The Lancet Global Health that showed children who had cytomegalovirus infection were at increased risk of subsequently developing tuberculosis disease,” Shaun Lee, PhD,associate professor at the Monash University Malaysia School of Pharmacy, told Healio. “The article also pointed out a few epidemiological studies supporting this correlation.”
Lee and colleagues conducted a systematic review and meta-analysis to assess and summarize the available evidence on the relationship between CMV and TB. They searched six databases for studies published through Dec. 31, 2021.
The final analysis included 15 articles with a sample size of 38,618 patients. According to the analysis, people with CMV had a higher risk for TB compared with those not infected with CMV (OR = 3.20; 95% CI, 2.18-4.70). Lee and colleagues reported that age was the only covariate that had a significant impact on the association.
Additionally, an analysis of risk estimates showed a “significant correlation” between CMV infection and active TB (adjusted HR = 2.92; 95% CI, 1.34-4.51; adjusted OR = 1.14; 95% CI, 0.71-1.57).
The researchers said that the data also suggested a clear dose-response relationship between levels of CMV antibodies and the risks for TB events (OR for high levels of CMV antibodies = 4.07; OR for medium levels of CMV antibodies = 3.58).
“As the clinical community progresses toward attaining The End TB Strategy vision with the goal of reducing tuberculosis incidence and mortality and eliminating catastrophic costs for tuberculosis-affected households by 2030, our study draws attention to the increased risk of tuberculosis disease in people with existing cytomegalovirus infection,” Lee said. “It provides further evidence to aid in the development of guidance for risk-based, targeted community screening and treatment to control tuberculosis.”
Lee said priority consideration should be given to CMV-positive people in community-based screening and treatment for latent TB to address the global burden of TB.