Key result
Greater area-level social deprivation was associated with higher CMV seropositivity in solid organ transplant recipients (75.5% in the most deprived vs 51.7% in the least deprived quintiles; P<0.001).
Why the study?
CMV causes significant morbidity and mortality in solid organ transplant recipients, but risk factors for CMV seropositivity, including area-level social deprivation, have not been fully characterized.
Is area-level social deprivation associated with pretransplant CMV seropositivity in adult solid organ transplant recipients?
Cross-Sectional (n=389,288)
Yes
Is area-level social deprivation associated with pretransplant CMV seropositivity in adult solid organ transplant recipients?
Higher area-level social deprivation is independently associated with increased pretransplant CMV seropositivity among solid organ transplant recipients.
Social deprivation may link to higher CMV seropositivity in transplant recipients; leaves open whether addressing it alters pretransplant risk.
Importance: Cytomegalovirus (CMV) is associated with significant morbidity and mortality in solid organ transplant (SOT) recipients. The risk factors for CMV seropositivity in SOT recipients, including area-level social deprivation in the US, have not been fully characterized. Objective: To (1) evaluate CMV seroprevalence, (2) assess the recipient characteristics associated with CMV seropositivity, and (3) assess the association of area-level social deprivation index (SDI) scores with pretransplant CMV serostatus. Design, Setting, and Participants: This retrospective cross-sectional analysis of the Scientific Registry of Transplant Recipients database included all adult (aged ≥18 years) SOT recipients from January 1, 2008, to May 31, 2022. Data were analyzed from April 10 to October 25, 2023. Exposure: Recipient characteristics and area-level SDI. Main Outcomes and Measures: Multivariable generalized linear models were used to evaluate the association between (1) patient characteristics and CMV and (2) social deprivation (measured by SDI scores, which were assessed in quintiles, from lowest to highest) and CMV seropositivity. In addition, differences based on patient demographics and the transplanted organ(s) were evaluated. Results: Among the 389 288 SOT recipients included in the analysis, mean (SD) age was 53.3 (13.0) years; 63.0% were male, 21.4% were Black, 15.2% were Hispanic White, 56.2% were non-Hispanic White, and 62.7% were CMV seropositive. The mean (SD) age was higher among CMV seropositive (54.0 [12.7] years) compared with CMV seronegative (52.0 [13.5] years) patients. Seropositivity for CMV was higher among women (69.9%) than men (58.5%) and among Black (74.8%) and Hispanic White (80.2%) patients compared with non-Hispanic White patients (50.4%). Seropositivity for CMV was highest among kidney (64.5%), liver (63.6%), and kidney and liver (66.2%) recipients. Greater SDI scores were associated with greater CMV seropositivity, ranging from 51.7% for the least deprived to 75.5% for the most deprived quintiles (P < .001), independent of age, sex, or race. Conclusions and Relevance: In this cross-sectional study, an association between SDI and CMV seropositivity was observed among SOT recipients, independent of age, sex, or race and ethnicity. To optimize posttransplant outcomes in CMV seropositive recipients, efforts targeting prevention of CMV reactivation need to be prioritized in these higher-risk populations.
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Abidi et al. (2024) conducted a cross-sectional in Solid organ transplant (n=389,288). Area-level social deprivation index (SDI) vs. Lower social deprivation index (least deprived quintile) was evaluated on CMV seropositivity (p=<.001). Greater area-level social deprivation was associated with higher CMV seropositivity in solid organ transplant recipients (75.5% in the most deprived vs 51.7% in the least deprived quintiles; P<0.001).
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