Tuberculosis is one of the leading causes of mortality worldwide from an infectious disease. This review aimed to investigate the association between prior cytomegalovirus infection and tuberculosis disease.
Six bibliographic databases were searched from their respective inception to December 31, 2021. Data were pooled using random-effects meta-analysis.
Of 5,476 identified articles, 15 satisfied the inclusion criteria with a total sample size of 38,618 patients. Pooled findings showed that individuals with cytomegalovirus infection had a higher risk of tuberculosis disease compared to those not infected with cytomegalovirus (OR: 3.20, 95% CI: 2.18 to 4.70). Age was the only covariate that exerted a significant effect on the result of the association. Meta-analysis of risk estimates reported in individual studies showed a marked and significant correlation of cytomegalovirus infection with active tuberculosis (Adjusted HR: 2.92, 95% CI: 1.34 to 4.51; Adjusted OR: 1.14, 95% CI: 0.71 to 1.57). A clear dose-response relation was inferred between the levels of cytomegalovirus antibodies and the risks of tuberculosis events (OR for high levels of cytomegalovirus antibodies: 4.07; OR for medium levels of cytomegalovirus antibodies: 3.58).
The results suggest an elevated risk of tuberculosis disease among individuals with a prior cytomegalovirus infection.

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