Prevalence of human cytomegalovirus in glioblastoma multiforme: a systematic review and meta-analysis.

BACKGROUND

Human cytomegalovirus (HCMV) infection is implicated in glioblastoma pathogenesis through oncogenic and immunomodulatory mechanisms; however, prevalence estimates remain highly variable across studies, warranting systematic evaluation.

METHODS

We systematically searched PubMed, Embase, LILACS, SciELO, and Cochrane for studies on HCMV detection in patients with glioblastoma. A single-arm meta-analysis estimated pooled prevalence with subgroup analyses by region, country, income level, antibody, and detection method. Random-effects models (95% CI) were applied, and heterogeneity quantified using I².

RESULTS

19 studies comprising 988 glioblastoma patients were included, HCMV positivity was 68% (95% CI, 0.53 to 0.80; P < 0.0001; I² = 91.4%). Subgroup analyses revealed a significant prevalence in Europe and Central Asia (82%; 95% CI, 0.38 to 0.97; P < 0.0001; I² = 94.7%) and North America (78%; 95% CI, 0.23 to 0.98; P < 0.0001; I² = 94.3%), followed by Middle East/North Africa (72%; 95% CI, 0.45 to 0.89; P < 0.0001; I² = 87.4%), Latin America and Caribbean (65%; 95% CI, 0.25 to 0.91; P < 0.0001; I² = 85.5%), and East Asia and Pacific (51%; 95% CI, 0.16 to 0.86; P < 0.0001; I² = 94.6%). High-income and upper-middle-income countries have a predominance of 69% and 73% (95% CI, 0.40 to 0.88 and 0.52 to 0.87, P < 0.0001, I² = 95.2% and 83.5%) compared to lower-middle-income (53%; 95% CI, 0.25 to 0.79; P = 0.0012; I² = 90.4%). Technique methods influenced prevalence, with IHC showing 74% positivity versus 66% with PCR, and 65% with ELISA. Antibody analysis highlighted the significance of UL83 (95%) and IE-72 (87%) within studies.

CONCLUSION

This meta-analysis revealed high HCMV detection in patients with glioblastoma, although results varied by region, income, technique, and antibody. Standardized protocols and large studies are needed to clarify HCMV’s role and implications for targeted therapies.