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Abstract
Background
Information related to herpes simplex virus 1 and 2 (HSV-1 and 2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) seroprevalence in France is either lacking, incomplete, or outdated, despite their public health burden.
Method
We used routinely collected serological data between 2018 and 2022 to estimate HSV-1, HSV-2, VZV, EBV, and CMV seroprevalence in France. To account for demographic differences between our analytic samples and the French population and get estimates for sparsely sampled districts and age classes, we used a multilevel regression and poststratification approach combined with Bayesian model averaging via stacking weights.
Results
The observed seroprevalence (number of positive tests/number of tests) were 64.6% (93,294/144,424), 16.9% (24,316/144,159), 93.0% (141,419/152,084), 83.4% (63,199/75, 781), and 49.0% (23,276/47,525), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV. Between 2018 and 2022, France had a model-based average (equal-tailed interval at 95%) expected seroprevalence equal to 61.1% (60.7,61.5), 14.5% (14.2,14.81), 89.5% (89.3,89.8), 85.6% (85.2,86.0), and 50.5% (49.3,51.7), respectively, for HSV-1, HSV-2, VZV, EBV, and CMV infections. We found an almost certain lower expected seroprevalence in Metropolitan France than in overseas territories for all viruses but VZV, for which it was almost certainly greater. The expected seroprevalences were likely greater among females for all viruses.
Limitations
Our results relied on the assumption that individuals were sampled at random conditionally to variables used to build the poststratification table.
Implications
The analysis highlights spatial and demographic patterns in seroprevalence that should be considered for designing tailored public health policies.
Acknowledgements
The authors acknowledge the Plateforme Bioinformatique (PB-IBENS, https://www.ibens.bio.ens.psl.eu/spip.php?rubrique55), the genotoul bioinformatics platform (Toulouse Occitanie, Bioinfo Genotoul, https://doi.org/10.15454/1.5572369328961167E12), and the ISO 9001 certified IRD i-Trop HPC (South Green Platform, https://bioinfo.ird.fr/- http://www.southgreen.fr) for providing HPC resources that have contributed to the research results reported within this paper.
Ethical considerations
Study declared to the French Data Protection Authority (the Commission nationale de l’informatique et des libertés, CNIL) by the French National Centre for Scientific Research (CNRS) Data Protection Department (DPD). All the data processing was compliant with the French reference methodology MR-004 (research not involving the human person, studies and evaluations in the field of health). The study was also approved by Comité d’Ethique de Recherche en Maladies Infectieuses et Tropicales (CER-MIT, Institutional Review Board N° IRB00011642), decision number 2022-1104.
Authors contributions
OS designed and implemented the initial statistical analysis and wrote the first version of the manuscript.
BV extracted and preprocessed the raw data and provided key information on how data were collected.
SHB supervised the collection, extraction and preprocessing of the raw data and provided key information on how data were collected.
SA and MTS critically reviewed the statistical analysis and its interpretation and provided the technical and financial support allowing this research to be carried out.
SB and DB provided key clinical and public health knowledge about human herpesviruses. All authors approved the last version of the manuscript.
Disclosure statement
No potential conflict of interest was reported by the author(s).