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Abstract
Background. Cytomegalovirus (CMV), a member of the Herpesviridae family (subfamily Betaherpesvirinae), is highly prevalent worldwide (seroprevalence 45-100%) and can cause severe disease in immunocompromised hosts. Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder affecting at least 2% of the population, in which immune dysregulation has been implicated.
Objective. To investigate the association between CMV infection and OCD using serological, cytokine, and molecular markers.
Methods. Ninety Iraqi participants were enrolled: 60 OCD patients (40 females, 20 males) and 30 healthy controls, aged 20-60 years. CMV-specific IgG, IgM, PP65 antigen, IL-6, and TNF-α were measured by ELISA, and CMV DNA was detected by real-time PCR of the UL83 (PP65) gene.
Results. OCD patients showed significantly higher positivity than controls for CMV IgG (96.67% vs 56.67%), IgM (75.00% vs 20.00%), and PP65 antigen (90.00% vs 16.67%) (P = 0.000). IL-6 (191.28 ± 74.03 vs 14.33 ± 8.22) and TNF-α (581.26 ± 90.01 vs 45.10 ± 16.10) were markedly elevated, and CMV DNA was detected in 45% of patients versus none of the controls (P = 0.000). No significant associations were found with gender or occupation.
Conclusions. CMV infection and the accompanying immune activation are significantly associated with OCD, consistent with Khanna et al. (1997), suggesting that CMV-induced immune dysregulation may contribute to OCD pathogenesis.
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Copyright (c) 2026 Ruqayah Taher Habash, Fatemeh Roodbari
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
- Rawlinson W, Scott G. Cytomegalovirus: a common virus causing serious disease. Aust Fam Physician. 2003;32(10):789-793.
- Cannon MJ. Congenital cytomegalovirus (CMV) epidemiology and awareness. J Clin Virol. 2010;46:S6-S10. doi: https://doi.org/10.1016/j.jcv.2009.09.002
- Griffiths PD. The pathogenesis of human cytomegalovirus. J Pathol. 2012;235(2):288-297. doi: https://doi.org/10.1002/path.2937
- Lachmann R, Loenenbach A, Waterboer T, Brenner N, Pawlita M, Michel A, et al. Cytomegalovirus (CMV) seroprevalence in the adult population of Germany. PLoS One. 2018;13(7):e0200267. doi: https://doi.org/10.1371/journal.pone.0200267
- Phillips AC, Carroll D, Khan N, Moss P. Cytomegalovirus antibody levels are associated with depression and anxiety. Brain Behav Immun. 2008. doi: https://doi.org/10.1016/j.bbi.2007.06.012
- Baillie J, Sahlender DA, Sinclair JH. Human cytomegalovirus infection inhibits tumor necrosis factor alpha (TNF-α) signaling by targeting the 55-kilodalton TNF-α receptor. J Virol. 2003;77(12):7007-7016. doi: https://doi.org/10.1128/jvi.77.12.7007-7016.2003
- Bloch MH, Landeros-Weisenberger A, Rosario MC, Pittenger C, Leckman JF. Meta-analysis of the symptom structure of obsessive-compulsive disorder. Am J Psychiatry. 2008;165(12):1532-1542. doi: https://doi.org/10.1176/appi.ajp.2008.08020320
- Konuk N, Tekin IO, Ozturk U, Atik L, Atasoy N, Bektas S, et al. Plasma levels of tumor necrosis factor-alpha and interleukin-6 in obsessive-compulsive disorder. Compr Psychiatry. 2007;48(4):371-375. doi: https://doi.org/10.1016/j.comppsych.2007.01.006
- Marazziti D, Mucci F, Fontenelle LF. The cytokine profile of OCD: pathophysiological insights. Int J Interferon Cytokine Mediator Res. 2015;7:35-42. doi: https://doi.org/10.2147/IJICMR.S73265
- Khanna S, Ravi V, Shenoy PK, Chandramukhi A, Channabasavanna SM. Viral antibodies in blood in obsessive compulsive disorder. Indian J Psychiatry. 1997;39(3):190-195.
- Caliendo AM, St George K, Kao SY, Allega J, Tan BH, LaFontaine R, et al. Comparison of quantitative and qualitative PCR assays for cytomegalovirus DNA in plasma. J Clin Microbiol. 2001;39(4):1334-1338. doi: https://doi.org/10.1128/JCM.39.4.1334-1338.2001
- El Sanousi SM, Osman ZA, Mohamed A, Al Awfi MS, Babair YH, Babair MH. Comparison of real-time PCR versus ELISA in the diagnosis of cytomegalovirus infection in pregnant women. Clin Microbiol Infect Dis. 2016;1(3):67-69. doi: https://doi.org/10.15761/CMID.10001134
- Lamothe H, Tamouza R, Hartmann A, Mallet L. Individualized immunological data for precise classification of OCD patients. Brain Sci. 2018;8(8):149. doi: https://doi.org/10.3390/brainsci8080149
- Li H, Weng P, Najarro K, Xue QL, Semba RD, Margolick JB, et al. Chronic CMV infection in older women: longitudinal comparisons of CMV DNA in peripheral monocytes, anti-CMV IgG titers, and serum IL-6. Exp Gerontol. 2014;54:84-89. doi: https://doi.org/10.1016/j.exger.2014.01.025
- Tedder RS, Ijaz S, Gilbert N, Barbara JAJ, Corden D, Lloyd C, et al. Development and evaluation of an internally controlled semiautomated PCR assay for quantification of cell-free cytomegalovirus. J Med Virol. 2002;66(4):518-523. doi: https://doi.org/10.1002/jmv.2197
References
Rawlinson W, Scott G. Cytomegalovirus: a common virus causing serious disease. Aust Fam Physician. 2003;32(10):789-793.
Cannon MJ. Congenital cytomegalovirus (CMV) epidemiology and awareness. J Clin Virol. 2010;46:S6-S10. doi: https://doi.org/10.1016/j.jcv.2009.09.002
Griffiths PD. The pathogenesis of human cytomegalovirus. J Pathol. 2012;235(2):288-297. doi: https://doi.org/10.1002/path.2937
Lachmann R, Loenenbach A, Waterboer T, Brenner N, Pawlita M, Michel A, et al. Cytomegalovirus (CMV) seroprevalence in the adult population of Germany. PLoS One. 2018;13(7):e0200267. doi: https://doi.org/10.1371/journal.pone.0200267
Phillips AC, Carroll D, Khan N, Moss P. Cytomegalovirus antibody levels are associated with depression and anxiety. Brain Behav Immun. 2008. doi: https://doi.org/10.1016/j.bbi.2007.06.012
Baillie J, Sahlender DA, Sinclair JH. Human cytomegalovirus infection inhibits tumor necrosis factor alpha (TNF-α) signaling by targeting the 55-kilodalton TNF-α receptor. J Virol. 2003;77(12):7007-7016. doi: https://doi.org/10.1128/jvi.77.12.7007-7016.2003
Bloch MH, Landeros-Weisenberger A, Rosario MC, Pittenger C, Leckman JF. Meta-analysis of the symptom structure of obsessive-compulsive disorder. Am J Psychiatry. 2008;165(12):1532-1542. doi: https://doi.org/10.1176/appi.ajp.2008.08020320
Konuk N, Tekin IO, Ozturk U, Atik L, Atasoy N, Bektas S, et al. Plasma levels of tumor necrosis factor-alpha and interleukin-6 in obsessive-compulsive disorder. Compr Psychiatry. 2007;48(4):371-375. doi: https://doi.org/10.1016/j.comppsych.2007.01.006
Marazziti D, Mucci F, Fontenelle LF. The cytokine profile of OCD: pathophysiological insights. Int J Interferon Cytokine Mediator Res. 2015;7:35-42. doi: https://doi.org/10.2147/IJICMR.S73265
Khanna S, Ravi V, Shenoy PK, Chandramukhi A, Channabasavanna SM. Viral antibodies in blood in obsessive compulsive disorder. Indian J Psychiatry. 1997;39(3):190-195.
Caliendo AM, St George K, Kao SY, Allega J, Tan BH, LaFontaine R, et al. Comparison of quantitative and qualitative PCR assays for cytomegalovirus DNA in plasma. J Clin Microbiol. 2001;39(4):1334-1338. doi: https://doi.org/10.1128/JCM.39.4.1334-1338.2001
El Sanousi SM, Osman ZA, Mohamed A, Al Awfi MS, Babair YH, Babair MH. Comparison of real-time PCR versus ELISA in the diagnosis of cytomegalovirus infection in pregnant women. Clin Microbiol Infect Dis. 2016;1(3):67-69. doi: https://doi.org/10.15761/CMID.10001134
Lamothe H, Tamouza R, Hartmann A, Mallet L. Individualized immunological data for precise classification of OCD patients. Brain Sci. 2018;8(8):149. doi: https://doi.org/10.3390/brainsci8080149
Li H, Weng P, Najarro K, Xue QL, Semba RD, Margolick JB, et al. Chronic CMV infection in older women: longitudinal comparisons of CMV DNA in peripheral monocytes, anti-CMV IgG titers, and serum IL-6. Exp Gerontol. 2014;54:84-89. doi: https://doi.org/10.1016/j.exger.2014.01.025
Tedder RS, Ijaz S, Gilbert N, Barbara JAJ, Corden D, Lloyd C, et al. Development and evaluation of an internally controlled semiautomated PCR assay for quantification of cell-free cytomegalovirus. J Med Virol. 2002;66(4):518-523. doi: https://doi.org/10.1002/jmv.2197