Martinez L, Nicol MP, Wedderburn CJ, et al. - Researchers herein examined if the acquisition of viral infections, such as cytomegalovirus, in early life is associated with an increased risk of tuberculosis disease in children.

• Pregnant women who were between 20 and 28 weeks of gestation were recruited from two clinics (TC Newman and Mbekweni).

• Bacillus Calmette–Guérin vaccination was administered to all infants at birth as per national policy.

• Nasopharyngeal swabs were collected from infants at birth, age 3 and 6 weeks, and age 3, 6, 12, and 24 months for cytomegalovirus detection using qPCR.

• At an age younger than 3 weeks, 2% were cytomegalovirus positive.

• There appeared a continuous increase in cytomegalovirus positivity with age from 3% by age 6 weeks to 21% by 3 months, 35% by 6 months, and 42% by 12 months.

• Observations revealed that the risk of subsequently developing tuberculosis disease was high among infants that acquire cytomegalovirus in the first year of life.

• Deterring or delaying the acquisition of cytomegalovirus perinatally or in the first months of life may aid in preventing tuberculosis in early childhood in high-burden countries.