Epidemiology and Infection

Original Papers

Viral infections

Socioeconomic disparities in the seroprevalence of cytomegalovirus infection in the US population: NHANES III

J. B. DOWDa1 c1, A. E. AIELLOa1 and D. E. ALLEYa2

a1 Department of Epidemiology, Center for Social Epidemiology & Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA

a2 Health and Society Scholars Program, University of Pennsylvania, PA, USA


There is a strong relationship between socioeconomic status (SES) and health outcomes in the United States, although the mechanisms are poorly understood. Increasing evidence points to links between lifelong exposure to infectious disease and subsequent chronic disease. Exposure and susceptibility to infections may be one way SES affects long-term health, although little population-based research to date has examined social patterning of infections in the United States. This paper tests the relationship between income, education, race/ethnicity and seroprevalence of cytomegalovirus (CMV) infection at different ages in a representative sample of the US population, and tests potential mediators for these relationships. The study finds significant racial and socioeconomic disparities in CMV seroprevalence beginning at early ages and persisting into middle age. Potential exposures do not explain the relationship between SES and CMV positivity. Because reactivation of latent CMV infections may contribute to chronic disease and immune decline later in life, future research should determine the exposure or susceptibility pathways responsible for these disparities in the prevalence of CMV infection.

(Accepted February 18 2008)

(Online publication April 16 2008)