Age-Stratified Seroprevalence of Cytomegalovirus and Epstein–Barr Virus in a Population-Based Cohort in Japan, 2017–2024

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ID: 338695
2026
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Abstract
Abstract Background Cytomegalovirus (CMV) and Epstein–Barr virus (EBV) are ubiquitous latent herpes viruses, but contemporary population-based seroprevalence data in Japan remain limited, particularly in younger age groups. This study aimed to characterize age- and sex-specific CMV and EBV seroprevalence in a population-based Japanese cohort and to describe combined serostatus patterns across age groups. Methods We conducted a cross-sectional seroepidemiological analysis of the Tohoku Medical Megabank Project Birth and Three-Generation (TMM BirThree) cohort. Serum samples collected between 2017 and 2024 were tested for CMV IgG (age 4–40 years; n = 2,247) and EBV viral capsid antigen IgG (age 4–30 years; n = 1,647) using commercial ELISA. Seroprevalence was stratified by age and sex. Combined CMV/EBV serostatus patterns were described, and sensitivity analyses assessed temporal consistency and intra-family clustering. Results CMV seroprevalence increased during childhood and adolescence and plateaued at approximately 70–80% in early adulthood, whereas EBV seroprevalence rose steadily, exceeding 70% in late adolescence and 90% in the late 20s, with minimal sex differences. Dual seropositivity increased with age, the CMV−/EBV− group declined, and CMV−/EBV+ remained more common than CMV+/EBV− across all age groups. These patterns were consistent in sensitivity analyses. Conclusions CMV and EBV exhibit distinct age-related seroepidemiologic patterns in Japan despite overlapping transmission routes. The early plateau of CMV seroprevalence and near-universal EBV seropositivity by young adulthood indicate divergent infection dynamics with implications for congenital CMV prevention, infectious mononucleosis risk, and ongoing vaccine strategy.
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Authors Mami Ishikuro, John D Diaz-Decaro, Kenichi Noguchi, Taku Obara, Masatsugu Orui, Kazuki Kumada, Hisaaki Kudo, Soichi Ogishima, Naoki Nakaya, Atsushi Hozawa, Shinichi Kuriyama, Kumi Kawaji, Steffi Naomi, Susan A. Hall, Laura H. Hendrix, Katja Engelberg, Anita Iyer, Enejda Senko, Osamu Kogawara, Masayuki P. Yamamoto, Eiichi N. Kodama
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Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag678
URL
https://doi.org/10.1093/ofid/ofag678
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