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Emergence of Cytomegalovirus Mononucleosis Syndrome Among Young Adults in Hong Kong Linked to Falling Seroprevalence: Results of a 14-Year Seroepidemiological Study.

Abstract：

Background:Cytomegalovirus (CMV) mononucleosis is a manifestation of primary CMV infection. This study aims to establish the link between long-term population CMV seroepidemiological trends and incidence of CMV mononucleosis requiring hospitalization. Furthermore, by analyzing serial laboratory data of patients hospitalized with CMV mononucleosis, we aim to provide insights into the natural history of this syndrome. Methods:We conducted a 14-year observational study in a tertiary hospital in Hong Kong. Cytomegalovirus immunoglobulin G data of 2349 adults were analyzed for trends in CMV susceptibility during the study period. The clinical features, risk factors, antiviral treatment data, and laboratory findings of 25 adult patients presenting with CMV mononucleosis during this period were retrieved. Results:Susceptibility to CMV infection among the adult population aged 18-45 in Hong Kong increased from 14.5% in 2004 to 32.2% in 2012-2017 (P < .001), and this led to doubling of observed CMV mononucleosis incidence among inpatients in our center during the study period. All patients with CMV mononucleosis were hospitalized for investigation of fever of unknown origin. Household contact with young children was the most common risk factor followed by recent overseas travel. Derangement of liver function tests was universally observed and was more severe than in previously published western CMV mononucleosis patient cohorts. Most patients showed clinical improvement within the third week of illness. Conclusions:We conclude that increasing CMV susceptibility among young adults in Hong Kong has resulted in a rising observed incidence of CMV mononucleosis, which is typically a self-limited illness characterized by anicteric hepatitis.

journal_name

Open Forum Infect Dis

journal_title

Open forum infectious diseases

authors

Sridhar S,Chung TWH,Chan JFW,Cheng VCC,Lau SKP,Yuen KY,Woo PCY

doi

10.1093/ofid/ofy262

subject

Has Abstract

pub_date

2018-10-20 00:00:00

pages

ofy262

issue

issn

2328-8957

pii

ofy262

journal_volume

pub_type

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Emergence of Cytomegalovirus Mononucleosis Syndrome Among Young Adults in Hong Kong Linked to Falling Seroprevalence: Results of a 14-Year Seroepidemiological Study.