Cytomegalovirus - This Common Chronic Infection is Bad News

[Dean Pomerleau]

All,

 

Over on the thread Common Chronic Viral Infections Linked to Cognitive Decline we've seen how cytomegalovirus (CMV) is associated with immunosenescence, atherosclerotic plaques, and cognitive decline. It appear the body's immune system gets worn out (i.e. immune system stem cells get depleted) by trying in vain to eliminate chronic CMV infection. This heighted immune response results in systemic inflammation, increased plaque formation in arteries and reduced blood flow to the brain, triggering cognitive decline. Overall bad news.

 

The news is made even worse by the fact that between 50 and 80% of people are infected with cytomegalovirus by age 40! And in the elderly, the typical infection rate can be upwards of 95%... 

 

But the real kicker, and the reason for this new thread devoted to CMV, is this study [1], ominously titled Cytomegalovirus infection accelerates epigenetic aging, which was covered this week in a blog post by Reason over at FightAging!

 

In the study, they looked at the CMV status of two sets of people - some their 20s and some in their 90+ and correlated CMV status with "epigenetic age" as measured by "clock like" changes in DNA methylation that appear to happen as people age. This epigenetic age metric has been shown in several studies to correlated with both physical and mental fitness [2], and with mortality rate [3]. For example Marioni et al. [3] observed that 69–79 year old individuals had a 16% increased mortality during a 4–10 year follow-up if the epigenetic age was 5 years higher than the calendar age.

 

What they found first was that 57% of the 20-somethings tested positive for CMV, and 95% of the nonagenarians tested positive - once again showing CMV infection is extremely common in the general population.

 

Further, they found that in the younger cohort, being CMV-positive as associated with a 2.5 year increase in epigenetic age, and in the older folks, testing positive for CMV was associated with a 7 year increase in epigenetic age. 

 

But it gets worse. This 2011 study [4] found that in 14,000+ people age ≥25 from the NHANES III cohort, being CMV-positive was associated with an 20% increase in all-cause mortality over a ~16 year follow-up period. People who were both CMV-positive and had elevated C-reactive protein (> 3.0 mg/L) had it even worse - they were at a 30% higher risk of mortality relative to the (already mortality-challenged) CMV-positive folks with low CRP. Here is the graph of the data for all-cause mortality as a function of CMV status and CRP level ("high" CRP means ≥ 3.0 mg/L):

 

 

 

Notice how simply being CMV-positive (even with low CRP) was dramatically worse for all-cause mortality risk than if you have a CRP of > 3.0 mg/L, but are free from CMV infection.

 

How sucky is that? We try so hard to make sure our level of systemic inflammation (as measured by C-reative protein) is low. But it turns out having high CRP isn't nearly as bad for longevity as simply having a chronic CMV infection, which almost everyone has.

 

In short, having what has long been thought to be a (relatively) harmless chronic infection with CMV appears associated with dramatic speeding up of the aging process and an increase in mortality risk. 

 

More bad news - once you've got CMV, you've got it for life. There are antiviral drugs to fight CMV given to people who have compromised immune systems and solid organ recipients, but they don't cure it and have nasty side effects like immune system suppression and kidney damage to boot.

 

LEF offers tests for chronic CMV infection or acute CMV infection for $59 and $99 respectively (member pricing), but for those who've recently donated blood, you should be able to call your blood bank like I did to find out your CMV status for free.

 

What can someone do to avoid contracting CMV if they are lucky enough not to have it already? It's passed via bodily fluids, so the best way to avoid contracting it is through practicing good hygiene, including:

 

• Wash your hands often. Use soap and water for 15 to 20 seconds, especially if you have contact with young children or their diapers, drool or other oral secretions. This is especially important if the children attend child care.
• Avoid contact with tears and saliva when you kiss. Instead of kissing on the lips, for instance, kiss on the forehead. This is especially important if you're pregnant.
• Avoid sharing food or drinking out of the same glass as others. Sharing glasses and kitchen utensils can spread the CMV virus.
• Be careful with disposable items. When disposing of diapers, tissues and other items that have been contaminated with bodily fluids, be careful not to touch your hands to your face until after thoroughly washing your hands.
• Clean toys and countertops. Clean any surfaces that come into contact with children's urine or saliva.
• Practice safe sex. Wear a condom during sexual contact to prevent spreading the CMV virus through semen and vaginal fluids.

Given the serious apparent downsides of CMV infection, protecting my current CMV-negative status seems to me the most compelling reason to diligently adhering to this admittedly rather burdensome set of hygiene practices.

 

--Dean

 

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[1] Exp Gerontol. 2015 Dec;72:227-9. doi: 10.1016/j.exger.2015.10.008. Epub 2015 Oct 

17.

 

Cytomegalovirus infection accelerates epigenetic aging.

 

Kananen L(1), Nevalainen T(2), Jylhävä J(3), Marttila S(4), Hervonen A(5), Jylhä 

M(6), Hurme M(7).

 

Full text: http://sci-hub.cc/10.1016/j.exger.2015.10.008

 

Epigenetic mechanisms such as DNA methylation (DNAm) have a central role in the

regulation of gene expression and thereby in cellular differentiation and tissue 

homeostasis. It has recently been shown that aging is associated with profound

changes in DNAm. Several of these methylation changes take place in a clock-like 

fashion, i.e. correlating with the calendar age of an individual. Thus, the

epigenetic clock based on these kind of DNAm changes could provide a new

biomarker for human aging process, i.e. being able to separate the calendar and

biological age. Information about the correlation of the time indicated by this

clock to the various aspects of immunosenescence is still missing. As chronic

cytomegalovirus (CMV) infection is probably one of the major driving forces of

immunosenescence, we now have analyzed the correlation of CMV seropositivity with

the epigenetic age in the Vitality 90+cohort 1920 (122 nonagenarians and 21 young

controls, CMV seropositivity rates 95% and 57%, respectively). The data showed

that CMV seropositivity was associated with a higher epigenetic age in both of

these age groups (median 26.5 vs. 24.0 (p < 0.02,Mann–Whitney U-test) in the

young controls and 76.0 vs. 70.0 (p < 0.01) in the nonagenarians). Thus, these

data provide a new aspect to the CMV associated pathological processes.

 

DOI: 10.1016/j.exger.2015.10.008 

PMID: 26485162

 

------

[2] Marioni, R.E., Shah, S., McRae, A.F., Ritchie, S.J., Muniz-Terrera, G., Harris, S.E., et al., 2015b. The epigenetic clock is correlated with physical and cognitive fitness in the Lothian birth cohort 1936. Int. J. Epidemiol. (doi:dyu277 [pii])

 

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[3] Marioni, R.E., Shah, S., McRae, A.F., Chen, B.H., Colicino, E., Harris, S.E., et al., 2015a. DNA methylation age of blood predicts all-cause mortality in later life. Genome Biol. 16 (1), 25 (doi:s13059-015-0584-6 [pii]).

 

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[4] PLoS One. 2011 Feb 17;6(2):e16103. doi: 10.1371/journal.pone.0016103.

 

Seropositivity to cytomegalovirus, inflammation, all-cause and cardiovascular

disease-related mortality in the United States.

 

Simanek AM(1), Dowd JB, Pawelec G, Melzer D, Dutta A, Aiello AE.

 

Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21379581/

 

BACKGROUND: Studies have suggested that CMV infection may influence

cardiovascular disease (CVD) risk and mortality. However, there have been no

large-scale examinations of these relationships among demographically diverse

populations. The inflammatory marker C-reactive protein (CRP) is also linked with

CVD outcomes and mortality and may play an important role in the pathway between 

CMV and mortality. We utilized a U.S. nationally representative study to examine 

whether CMV infection is associated with all-cause and CVD-related mortality. We 

also assessed whether CRP level mediated or modified these relationships.

METHODOLOGY/PRINCIPAL FINDINGS: Data come from subjects ≥ 25 years of age who

were tested for CMV and CRP level and were eligible for mortality follow-up on

December 31(st), 2006 (N = 14153) in the National Health and Nutrition

Examination Survey (NHANES) III (1988-1994). Cox proportional hazard models were 

used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for

all-cause and CVD-related mortality by CMV serostatus. After adjusting for

multiple confounders, CMV seropositivity remained statistically significantly

associated with all-cause mortality (HR 1.19, 95% CI: 1.01, 1.41). The

association between CMV and CVD-related mortality did not achieve statistical

significance after confounder adjustment. CRP did not mediate these associations.

However, CMV seropositive individuals with high CRP levels showed a 30.1% higher 

risk for all-cause mortality and 29.5% higher risk for CVD-related mortality

compared to CMV seropositive individuals with low CRP levels.

CONCLUSIONS/SIGNIFICANCE: CMV was associated with a significant increased risk

for all-cause mortality and CMV seropositive subjects who also had high CRP

levels were at substantially higher risk for both for all-cause and CVD-related

mortality than subjects with low CRP levels. Future work should target the

mechanisms by which CMV infection and low-level inflammation interact to yield

significant impact on mortality.

 

DOI: 10.1371/journal.pone.0016103 

PMCID: PMC3040745

PMID: 21379581

 

 

[TomBAvoider]

Scary. You say you tested CMV-negative. I have not been tested, so I looked into getting this checked out ASAP. It does not seem simple, at least to me - I envy your certitude.

 

To elaborate. It would be useful to make sure that one's immune system has not missed the CMV. Supposedly only immune compromised individuals would not ping a response, but are we 100% sure that's accurate in all cases? I mean, for example there's been mixed claims about CR'd individuals and immunity, with evidence that primary immunity in such individuals is fine, or even enhanced, but also reports of poor reactions to common viral/bacterial infections. It is also possible that a select class of viruses does not trigger a particular profile of immunity, and people in our situation have unusual enough physiologies that we can't be entirely sure where we stand with regard to things like immune reactions (or the lack of) to the CMV. That of course doesn't even address the mechanism by which CMV achieves its scary effects (as you described) - what if the damage is done primarily by the immune reaction itself rather than direct effects of CMV - in that scenario, not having a reaction to CMV (i.e. not detectable by testing), means that you are off the hook anyway regardless of whether you have a CMV reservoir or not.

[Dean Pomerleau]

Tom,

 

Scary. You say you tested CMV-negative. I have not been tested, so I looked into getting this checked out ASAP.

 

Why don't you give blood and call your blood bank a couple days later to check your CMV status? That way, you get the test for free, and you help out someone who needs blood. BTW, the blood bank tests your blood for CMV because certain populations (HIV-positive, immunocompromised folks, and infants) require CMV-negative blood products.

 

 It does not seem simple, at least to me - I envy your certitude.

 

It looks reasonably straightforward to me. Unless you suspect you've been recently infected with CMV, it looks like the right test to get is the $59 CMV IgG test. It will tell you if you've been infected in the past, and therefore have a chronic CMV infection.

 

--Dean

[Gordo]

This thread prompted me to give blood today.  No sense in paying for a test when you can get it free and help someone out at the same time (summer donations are always lower, compounded by zika virus precautionary exclusions and the need is higher).  Anyway, I guess I'll try to call and find out my status in a couple days, part of me doesn't really want to know since I'll be ticked off if I'm positive and there is nothing I can do about it, but on the other hand, if I'm negative I'll probably do more to stay that way.  One good thing was that my hemoglobin level was 17 g/dl (high end of range).  I thought my iron might be low since I don't eat meat and don't take iron supplements, apparently all those plant sources of iron are doing their job, I wonder if the dandelion greens I've been eating have been a help there?  

 

A couple funny things happened, at first the nurse trying to take my temperature seemed perplxed when it seemed too low, "lets try a different location", eventually it did hit 97.0, haha.  I do eat a lot of ice, and it was an oral reading...   Next she goes to take my blood pressure, and becomes even more perplexed, "80/52 - I might have to do this again, do you exercise a lot or something?" haha.  I don't think that was a legit reading though, her second attempt came out higher and I was OK'ed to donate.  That said, it took at least 50% longer for them to draw my blood compared to the fat woman donating on the bed next to mine who started after me and left before me.

[drewab]

That said, it took at least 50% longer for them to draw my blood compared to the fat woman donating on the bed next to mine who started after me and left before me.

 

Why do you think this is the case? Fat women should have thick blood that flows slowly, no? Or is it because there is less pressure forcing it through.

 

I always thought all those aspirin like compounds in plants keep CR practitioners blood fairly thin (though not dangerously so as we see with fish oil).

[Dean Pomerleau]

Good job giving blood Gordo. As you say, summer is a tough time for the blood banks and hospitals. 

 

Anyway, I guess I'll try to call and find out my status in a couple days, part of me doesn't really want to know since I'll be ticked off if I'm positive and there is nothing I can do about it, but on the other hand, if I'm negative I'll probably do more to stay that way. 

 

I felt exactly the same ambivalence when I called to get my CMV status. But as always I figure it's better to know then to be in the dark about health issues.

 

One good thing was that my hemoglobin level was 17 g/dl (high end of range). 

 

Wow - that is pretty high. I wonder if you've got genes for high iron retention. Have you had your ferritin checked? It sounds like it might be a good idea for you to give blood regularly Gordo. Having high (or low) iron is not very healthy.

 

I've had the same temperature and blood pressure issues trying to donate. A couple times I've been turned away. Regarding speed of donation, I too am very slow compared with others. Once when trying to donate double reds my blood just stopped flowing and I had to quit half way through. The phlebotomist was very surprised, because I have such "good veins" - i.e. they stick out a lot and are easy to find. 

 

Drew, I suspect it is because we have such supple veins and arteries and such responsive cardiovascular systems that we can naturally (and reflexively) constrict the blood flow to our peripheral veins. 

 

--Dean

[Gordo]

I always thought all those aspirin like compounds in plants keep CR practitioners blood fairly thin (though not dangerously so as we see with fish oil).

 

 

I'm pretty sure blood pressure trumps all other factors.  Think of drilling a small hole into a tire that is inflated to 60PSI vs. a tire inflated to 30PSI, the higher pressure tire is going to have a much faster outflow of air.  Other factors are the clotting effectiveness of your blood, I'm not sure what contributes to that, but my blood seems to clot easily, like Dean described, toward the end mine pretty much stopped flowing, the nurse had to wiggle the needle around and I had to grip/manipulate a ball continuously in my hand to get the blood out.  

 

Dean - I haven't been tested for iron per se. The hemoglobin level was high end of "normal".  Not sure that means "higher than it should be" but I haven't researched that.

[Dean Pomerleau]

Gordo,

 

Dean - I haven't been tested for iron per se. The hemoglobin level was high end of "normal".  Not sure that means "higher than it should be" but I haven't researched that.

 

There is a U-shaped curve between hemoglobin and all-cause mortality, although most (but not all) of the increased risk at both ends (hemoglobin < 14.1 or > 15.6 mg/dL) goes away in non-smokers [1] after correcting for other risk factors.

 

--Dean

 

--------

Scand J Clin Lab Invest. 2006;66(7):567-76.

 

Haemoglobin predicts total mortality in a general young and middle-aged male

population. The Tromsø Study.

 

Skjelbakken T(1), Wilsgaard T, Førde OH, Arnesen E, Løchen ML.

 

Author information: 

(1)Institute of Medicine, University of Trømso, Trømso, Norway.

tove.skjelbaken@ism.uit.no

 

Full text: http://www.tandfonline.com.sci-hub.cc/doi/full/10.1080/00365510600863895

 

OBJECTIVE: The prognostic value of haemoglobin within normal references is seldom

emphasized. The relationship between haemoglobin and mortality has been

questioned because of the possible confounding of other risk factors. We

investigated whether there was a curve linear relationship between haemoglobin

and total mortality, and evaluated the possible modifying effects of smoking,

body mass index, total cholesterol and systolic blood pressure.

MATERIALS AND METHODS: In all, 6541 men aged between 20 and 49 years were

examined in 1974 in a prospective, population-based study from the municipality

of Tromsø, Northern Norway. During 20 years of follow-up (127 120 person-years), 

495 deaths were identified.

RESULTS: We found a U-shaped relationship between quintiles of haemoglobin and

total mortality. Among the 35-49 years group, the multiple adjusted hazard ratios

(95% CI) were 1.83 (1.31-2.57) in quintile 1 and 1.72 (1.23-2.41) in quintile 5, 

compared to quintile 3 of haemoglobin. Compared to the age-adjusted hazard

ratios, the multiple adjustments tended to non-significantly enhance the

association in the lowest quintiles and non-significantly attenuate the

association in the highest quintiles. The relationship was most pronounced in

smokers in a dose-response manner, but also present in non-smokers.

CONCLUSIONS: High and low haemoglobin levels have an independent prognostic

effect on mortality, although a possible effect of residual confounding cannot be

ruled out. Smokers in quintile 1 and quintile 5 of haemoglobin were at increased 

risk of dying.

 

DOI: 10.1080/00365510600863895 

PMID: 17101548

[Gordo]

Without knowing the full details of the adjustments they made, it just seems "suspect" to apply that to us.  I would guess that in many/most cases high hemoglobin levels correlated with high red meat consumption, and high red meat consumption is linked with higher mortality.  If someone did a similar study with a vegan cohort that would be more revealing I think.  

[Dean Pomerleau]

Gordo,

 

Your very high normal hemoglobin level (17 mg/dl, RR 13.2-17.1) is made all the more surprising by your vegan diet. Not that I think you have it but what I'd want to know if I were you is if I have hereditary hemochromatosis (HH) - the tendency for body to retain too much iron. It is rare, but no that rare. In fact, HH is the most common genetic disease in the US, striking between 1 in 100 and 1 in 200 people. A level of 17mg/dl in the blood may not be too detrimental, but in HH folks iron builds up in the liver (as ferritin) and can cause long-term health problems, e.g. liver cancer [1], without a person even realizing they have a hereditary iron absorption issue.

 

If I were you, I'd get my ferritin and/or transferrin saturation tested just to be sure I don't have it. I would also check on 23andMe to see if I've got gene alleles associated with HH. Having the risk allele for third highlighted SNP (C282Y) is the most common explanation for HH [1][2].

 

Again, I'm not suggesting you have HH, but given your hemoglobin level on a vegan diet, I'd want to check to make sure.

 

--Dean

 

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[1] Liver Cancer. 2014 Mar;3(1):31-40. doi: 10.1159/000343856.

 

Hepatic iron overload and hepatocellular carcinoma.

 

Kew MC(1).

 

Author information: 

(1)Department of Medicine, Groote Schuur Hospital and University of Cape Town,

Cape Town, Africa ; Department of Medicine, University of the Witwatersrand,

Johannesburg, South Africa.

 

In recent years it has become increasingly evident that excess body iron may be

complicated by the supervention of hepatocellular carcinoma (HCC). Hereditary

hemochromatosis (HH) was the first condition in which hepatic iron overload was

shown to predispose to the development of HCC. The inherited predisposition to

excessive absorption of dietary iron in HH is almost always the result of

homozygosity of the C282Y mutation of the HFE gene, which causes inappropriately 

low secretion of hepcidin. HCC develops in 8-10% of patients with HH and is

responsible for approximately 45% of deaths in the HCC patients. Cirrhosis is

almost always present when HCC is diagnosed. Dietary iron overload is a condition

which occurs in rural-dwelling Black Africans in southern Africa as a result of

the consumption, over time, of large volumes of alcohol home-brewed in iron

containers and having, as a consequence, a high iron content. Iron loading of the

liver results and may be complicated by malignant transformation of the liver

(relative risk of approximately 10.0). Accompanying cirrhosis does occur but is

less common than that in HH. The development of HCC as a consequence of increased

dietary iron, and the fact that it may develop in the absence of cirrhosis, has

been confirmed in an animal model. Drinking water with a high iron content might 

contribute to the high incidence of HCC in parts of Taiwan. The metabolic

syndrome [obesity, insulin resistance type 2 (or diabetes mellitus type 2),

non-alcoholic fatty liver or non-alcoholic steatohepatitis] has in recent years

become a major public health problem in some resource-rich countries. A link

between excess body iron and insulin resistance or the metabolic syndrome has

become apparent. The metabolic syndrome may be complicated by the supervention of

HCC, and recent evidence suggests that increased body iron may contribute to this

complication.

 

DOI: 10.1159/000343856 

PMCID: PMC3995380

PMID: 24804175

 

-------------------

[2] Can J Gastroenterol. 2007 Feb;21(2):101-4.

The myths and realities of hemochromatosis.

Beaton MD(1), Adams PC.

Author information:
(1)Department of Medicine, London Health Sciences Centre, 339 Windermere Road,
London, Ontario, Canada.

 

Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657669/

Hemochromatosis is a common genetic condition and yet there are still a number of
misperceptions surrounding the diagnosis and management of this condition.
Hemochromatosis affects both men and women. Typical patients do not have
alcoholism or viral hepatitis, and often have normal liver enzymes. Clinical
expression is highly variable. Genetic testing is widely available and
particularly useful in family studies. Hemochromatosis can be readily diagnosed
and treated. The purpose of the present review is to address the medical myths
and misconceptions of hemochromatosis.


PMCID: PMC2657669

PMID: 17299614

[Gordo]

So I called up the Red Cross donor info line, they looked up my records, but told me they don't always test for CMV and they didn't have any result for me for my recent donation.  She said that my blood was last tested (negative) for CMV in 1997.  Dean, do you donate via the red cross or somewhere else?  Did you know they don't always check CMV status?  I'm kind of bummed about this, but at least I know I wasn't infected 20 years ago  ;)

[Dean Pomerleau]

Gordo,

 

Sorry to hear they didn't test your blood for CMV this time. In my area (Western PA and Northern WV), the primary blood bank is not the Red Cross, but Central Blood Bank, which appears to check for CMV more regularly. I was actually told by David Stern at the CR conference that the Red Cross regularly tested too. That's where I got the idea to call my blood bank. 

 

Honestly that's pretty poor that the Red Cross doesn't test every pint of blood they collect for CMV, since they do by law test for other blood-borne illnesses, pathogens and chronic infections like HIV (see below for list). It just goes to show how lax the medical community's attitude is towards this common, but apparently quite detrimental, chronic infection.

 

Any thoughts about following up on your unusually high hemoglobin?

 

--Dean

 

Here is the list of tests that the Red Cross says they do for every pint collected, to ensure the safety of the blood they supply to hospitals:

 

Blood donations are tested for the following:

• ABO and Rh blood types.
• Unexpected red blood cell antibodies that are a result of prior transfusion, pregnancy, or other factors.
• Hepatitis B surface antigen, indicating a current infection (hepatitis) or carrier state for hepatitis B virus.
• Antibody to hepatitis B core antigen, indicator of a present or past infection with the hepatitis B virus.
• Antibody to hepatitis C virus, indicating a current or past infection with hepatitis C virus (most common cause of non-A/non-B hepatitis).
• Antibody to HTLV-I/II, indicator of infection with a virus that may cause adult T-cell leukemia or neurological disease.
• Antibody to HIV-1/2, indicator of infection with human immunodeficiency virus (HIV).
• Nucleic Acid Test (NAT) for hepatitis C (HCV), hepatitis B (HBV) and HIV.
• Screening test for antibodies to syphilis.
• NAT for West Nile Virus (WNV).
• Enzyme-linked immunoassay (ELISA) test for Trypanosoma cruzi (Chagas Disease).
• In addition, all platelet apheresis donations are tested for bacterial contamination.

[Gordo]

Any thoughts about following up on your unusually high hemoglobin?

 

Yes, I'd like to explore that, but I'm not sure how to proceed.  I feel like if I go to my doc he/she will just say "your level is in the normal range, you are in good health with no symptoms, and no family history of liver disease/cancer so you don't need testing".  In the little bit of searching I did, it seemed like one treatment was giving blood, so maybe I should just keep donating blood as often as I'm allowed until the hemoglobin level goes down?  Maybe eventually the Red Cross will even test my donation for CMV?  ;)

[Dean Pomerleau]

Gordo,

 

Yes, I'd like to explore that [my unusually high hemoglobin for a vegan], but I'm not sure how to proceed.

 

Given your proclivity for self-experimentation, I had imagined you'd have had your genes sequenced via 23andMe, in which case you could check for many of these common SNPs indicative of hereditary hemochromatosis (HH), as described above. Why don't you spring for 23andMe testing on your own nickle?

 

Alternatively, LEF offers a ferritin blood test for $28 (member price), that would allow you to skip your insurance company and test for iron overload quickly, cheaply and directly.

 

But regardless of whether you've got HH, with a hemoglobin of 17, I'd definitely want to donate blood as often as possible if I were you, both to make sure you don't build up too much iron, and to help people in need of blood. As you said, frequent blood donation is one primary treatment for HH anyway.

 

--Dean

[AlPater]

Gordo, They do not call the disease iron overload for nothing.  Get iron and its associated factors in blood tested would be my and I think Dean's suggestion.  Iron is bad news when in excess.

[Gordo]

I have been planning on doing genetic testing but haven't actually done it yet.  I spent the 4 hours required to sign up for the human genome project, but so far they haven't done a collection that was convenient for me, and I have no idea if the data I'd get from that would be comprable to 23andme?  I'll probably just do the 23andme version by year end.

 

Has anyone reading this done the ferritin blood test before?  Just curious what others' numbers were (particularly if you eat a plant based diet).

[Dean Pomerleau]

Gordo,

 

You obviously didn't try searching the forums for "ferritin", since if you had, you'd have seen I always mention my ferritin results when discussing my latest blood work. As I discuss in that post, my ferritin is always very close to (if not below) the low end of the reference rage, (not unusual as a vegan), despite the fact I supplement with iron. You can see the long history of my low ferritin levels in my bloodwork table.

 

--Dean

[Dean Pomerleau]

All,

 

I had a nice chat today with Beverly from the Central Blood Bank (CBB) where I donate blood regularly. I mostly called to ask about blood donation after travel to Costa Rica (more on that on the CR² mini-retreat thread shortly), but while I had her on the phone, I picker her brain about CMV. She told me the CBB tests "nearly every unit" of blood they collect for CMV - qualifying that statement with the fact that they don't bother to test the blood from folks who have previously tested CMV-positive, since there wouldn't be any point for continued testing. I explained to her that a friend had been unsuccessful when he tried to call to find out his CMV status from the Red Cross after donating with them recently. She said there are now blood bags that filter out CMV, and she said they may be using those and so don't bother testing blood for CMV anymore.

 

She said CBB tests for CMV because "we wouldn't want to give CMV-positive blood to CMV-negative transfusion recipients." I said that was interesting, because I talked to an MD friend of mine who told me that in the hospitals he's worked in, they rarely test for CMV status prior to a transfusion except if the recipient is an infant or is known to be immunocompromised. She said "let me check on that with one of my colleagues" and put me on hold. A few minutes later she came back and said her more knowledgeable colleague wasn't sure how hospitals deal with CMV-status when giving people blood transfusions.

 

I told her I was surprised hospitals don't take it more seriously, given the evidence for negative health consequences of chronic CMV infection, some of the research about which is being done right here in Pittsburgh. She was unaware of the evidence, but curious, so I sent her a link to this thread so she could read more.

 

So Gordo, Beverly provided a potential explanation for why the Red Cross doesn't (always) test for CMV, and  further evidence of the rather casual attitude our healthcare system seems to have regarding CMV. I'd be curious if Beverly's explanation is correct, and that the Red Cross doesn't (or no longer) tests for CMV because they believe their procedure filters CMV out of the blood they collect. Anyone want to give their local Red Cross donation center a call?

 

--Dean

[Saul]

Hi ALL!

 

Getting back to cytelomegavirus -- this was the main topic in Dr. J's talk at CR IX. 

 

His experiments had given evidence that CR'ed animals resist infection better than controls -- but that, when infected (with whatever), CR'd animals take longer to recover than controls.  He wanted to make a similar human study -- but sadly, there weren't  enough CR volunteers at the Conference. 

 

(One thing that surprises me:  I know that when I (very rarely) catch a cold, it's very mild and disappears quickly -- and as I recall that's the case for mos on CR  -- which doesn't sound consistent with "longer to recover for CR'ed animals").

 

  -  Saul

[Gordo]

(One thing that surprises me:  I know that when I (very rarely) catch a cold, it's very mild and disappears quickly -- and as I recall that's the case for mos on CR  -- which doesn't sound consistent with "longer to recover for CR'ed animals").

 

Since I started CR and a plant based diet, I have not had one cold, flu, fever, sore throat, runny nose, or cough, not a single sick day from work, which is amazing for me since prior to that I never went a year going all the way back to grade school where I didn't require a sick day.  When my kids come down with something, I often feel a bit run down like my body is fighting something, but that is the extent of my symptoms (my son just had bacterial pneumonia, I know my body was fighting something off simultaneously, but my only symptoms were feeling sluggish and not tolerating cold exposure like I normally do - which is something I should probably discuss in the cold exposure thread.  

 

On the other hand, upset stomachs and gas have gone way up for me - the downside to eating boatloads of fiber, beans, and the occasional strange food gone wrong/bad.

 

In another sort of related tangent to this thread, I'm also a bit surprised they don't test blood donations for lymes in areas where it is a serious threat.  According to the CDC: "Lyme disease is the most commonly reported vectorborne illness in the United States. In 2014, it was the fifth most common Nationally Notifiable disease. However this disease does not occur nationwide and is concentrated heavily in the northeast and upper Midwest."

I wouldn't want a blood transfusion with lyme bacteria in it.

 

I live in a lyme hot spot.  I have been so concerned about it in the past that I bought my own high power dark field microscope to examine my blood, looking for spirochetes in particular.  So far I haven't seen any, but I am fascinated by looking at blood under a microscope. I even had people over one time to look at anyone's blood who was interested, got 3 volunteers.  There are some great videos on youtube showing what the spirochetes look like under a microscope if anyone is interested.  This guy has a decent video and didn't even use a darkfield.  In his description he links to numerous other videos. I have seen bacteria in a friend's blood.

https://www.youtube.com/watch?v=Hbin5ZT6A5s

[Cloud]

I don't know if I am CMV-negative or not but it seems almost impossible to avoid to be infected,especially if you have young children. How to avoid that my children get the CMV in the kindergarden ? And after at school when they will exchange the first kisses?

What is the infection rate of the CMV ? With these premises the whole population should be infected...

[Dean Pomerleau]

Cloud,

 

I don't know if I am CMV-negative or not but it seems almost impossible to avoid to be infected,especially if you have young children. How to avoid that my children get the CMV in the kindergarden ? And after at school when they will exchange the first kisses?
What is the infection rate of the CMV ? With these premises the whole population should be infected...

 

I agree. It does seem like CMV should be nearly ubiquitous. Of course, it actually is nearly ubiquitous, with nearly 1/3 of children infected by age 5, 50% of adults by age 40, and more than 85% of people by age 80, according to the CDC. In fact, the US infection rate is actually on the low side of countries where the prevalence of CMV is known, as shown by this graphic from [1] of the frequency of CMV infection in adults between age 16 and 50 around the world:

 

 

Note - the white countries are not low rates of infection, but simply places where no data is available. Where most of the world lives (China and India), the adult infection rate is over 95%!

 

--Dean

 

------------

[1]  Front Microbiol. 2015 Sep 24;6:1016. doi: 10.3389/fmicb.2015.01016. eCollection

2015.

 

Ongoing burden of disease and mortality from HIV/CMV coinfection in Africa in the

antiretroviral therapy era.

 

Adland E(1), Klenerman P(2), Goulder P(3), Matthews PC(4).

Free full text: http://journal.frontiersin.org/article/10.3389/fmicb.2015.01016/full

 

Human Cytomegalovirus (CMV) is a well-recognized pathogen in the context of HIV

infection, but since the roll out of ART, clinical and scientific interest in the

problem of HIV/CMV coinfection has diminished. However, CMV remains a significant

cofactor in HIV disease, with an influence on HIV acquisition, disease

progression, morbidity, and mortality. Disease manifestations may be a result of 

direct interplay between the two viruses, or may arise as a secondary consequence

of immune dysregulation and systemic inflammation. The problem is most relevant

when the rates of coinfection are high, most notably in sub-Saharan Africa, and

in children at risk of acquiring both infections early in life. Understanding the

interplay between these viruses and developing strategies to diagnose, treat and 

prevent CMV should be a priority.

 

DOI: 10.3389/fmicb.2015.01016 

PMCID: PMC4585099

PMID: 26441939

[Brett Black]

Here's a patent that describes treatment with widely used and available antiviral drugs to reduce the impact of CMV infection on the immune system:

 

 

Use of antivirals to treat cmv-related conditions

US 20100280052 A1

 

Abstract

 

The invention provides for the use of compounds active against cytomegalovirus (CMV) in the preparation of medicaments for improving the immune response of a CMV-seropositive, immunocompetent individual, or for the amelioration of certain other medical conditions. Suitable compounds include the nucleoside analogues acyclovir, famciclovir, and valacyclovir. Infection with cytomegalovirus is widespread and commonly believed to be both asymptomatic in immunocompetent individuals and unbeatable without the use of highly cytotoxic drugs. It is suggested herein that, in fact, CMV infection produces a disproportionately large immune response, thereby weakening the ability of the immune system to respond to other infections (and hence is not asymptomatic). Further, treatment with comparatively low doses of drugs having low cytotoxicity (and hence similarly low efficacy) can reduce the magnitude of this CMV-specific immune response, improving the overall immune response, and ameliorating the symptoms of other medical conditions.

https://www.google.com/patents/US20100280052

[Brett Black]

Some longecity posts relevant to this thread:

 

Cytomegalovirus dramatically alters immune system

http://www.longecity.org/forum/topic/76392-cytomegalovirus-dramatically-alters-immune-system/

 

Working Towards a Way to Clear Cytomegalovirus

http://www.longecity.org/forum/topic/72824-working-towards-a-way-to-clear-cytomegalovirus/

 

Impact of Lifelong Cytomegalovirus Infection on Aging

http://www.longecity.org/forum/topic/74524-impact-of-lifelong-cytomegalovirus-infection-on-aging/

 

Are All Those Memory T Cells Present in the Elderly in Fact Due to CMV Exposure?

http://www.longecity.org/forum/topic/68778-are-all-those-memory-t-cells-present-in-the-elderly-in-fact-due-to-cmv-exposure/

[Todd Allen]

Note - the white countries are not low rates of infection, but simply places where no data is available. Where most of the world lives (China and India), the adult infection rate is over 95%!

 

Dean, tweak your monitor's contrast and color balance.  It looks to me that China and India are in the second to worst category of 81%-95%.  In the worst category are Turkey, Brazil and the countries of Africa for which there are data.  And surprising to me it looks like Poland and France are doing the best with respect to CMV.