Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization
Abstract Background Primary varicella-zoster virus (VZV) infection during pregnancy poses significant risks to both mother and fetus, including congenital varicella syndrome (CVS) and serious maternal complications. In Iran, the absence of varicella vaccination in the national immunization program l...
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BMC
2025-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11415-2 |
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| author | Morteza Pourahmad Mohammad Javad Tarrahi Mahnaz Momenzadeh Kiana Shahzamani Abdolreza Sotoodeh Jahromi Ziba Farajzadegan Somayeh Haghighipour Behrooz Ataei Fatemeh Nikokar Nasim Kakavand |
| author_facet | Morteza Pourahmad Mohammad Javad Tarrahi Mahnaz Momenzadeh Kiana Shahzamani Abdolreza Sotoodeh Jahromi Ziba Farajzadegan Somayeh Haghighipour Behrooz Ataei Fatemeh Nikokar Nasim Kakavand |
| author_sort | Morteza Pourahmad |
| collection | DOAJ |
| description | Abstract Background Primary varicella-zoster virus (VZV) infection during pregnancy poses significant risks to both mother and fetus, including congenital varicella syndrome (CVS) and serious maternal complications. In Iran, the absence of varicella vaccination in the national immunization program leaves many women susceptible. This systematic review and meta-analysis aimed to determine the overall seroprevalence of VZV antibodies among reproductive-age women in Iran. Methods A comprehensive search was conducted in both international and Iranian databases for studies published up to November 15, 2024. Eligible studies reporting VZV seroprevalence among Iranian women aged 15–49 years were identified. Screening, data extraction, and risk of bias assessment were independently performed by two reviewers. Pooled seroprevalence was estimated using a random-effects meta-analysis in STATA version 18. Heterogeneity was evaluated with the Cochrane Q test and I² statistic. Subgroup analyses and meta-regression explored sources of heterogeneity. Sensitivity analyses (leave-one-out) and publication bias (Doi plot, LFK index) were also performed. The protocol was registered in PROSPERO (CRD42025647813). Results Data from 20 studies, including 5,629 participants, were analyzed. A pooled VZV seroprevalence of 81% (95% CI: 77–85%) was found, indicating that approximately 19% of reproductive-age women in Iran remain susceptible. Higher seroprevalence was observed in pregnant women (88%) compared with non-pregnant women (79%), with the lowest rates among medical students (74%). Despite subgroup and meta-regression analyses, substantial heterogeneity remained unexplained. Sensitivity analyses supported the robustness of the results, while possible publication bias was suggested. Conclusions Nearly one in five reproductive-age women in Iran lack immunity to VZV. Targeted vaccination, especially among non-pregnant women and students, may reduce susceptibility. Preconception screening for VZV immunity could help prevent maternal and fetal complications. However, given the high unexplained heterogeneity, results should be interpreted with caution. |
| format | Article |
| id | doaj-art-7cb3914b1dd44daaa99aacfdb4e5a5fc |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-7cb3914b1dd44daaa99aacfdb4e5a5fc2025-08-20T03:44:00ZengBMCBMC Infectious Diseases1471-23342025-08-0125111310.1186/s12879-025-11415-2Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunizationMorteza Pourahmad0Mohammad Javad Tarrahi1Mahnaz Momenzadeh2Kiana Shahzamani3Abdolreza Sotoodeh Jahromi4Ziba Farajzadegan5Somayeh Haghighipour6Behrooz Ataei7Fatemeh Nikokar8Nasim Kakavand9Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical SciencesDepartment of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical SciencesHepatitis Research Center, School of Medicine, Lorestan University of Medical SciencesZoonoses Research Center, Jahrom University of Medical SciencesCommunity and Preventive Medicine Department, Medicine Faculty, Isfahan University of Medical SciencesInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical SciencesInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical SciencesDepartment of Obstetrics and Gynecology, Shahid Beheshti University of Medical SciencesSchool of Medicine, Isfahan University of Medical SciencesAbstract Background Primary varicella-zoster virus (VZV) infection during pregnancy poses significant risks to both mother and fetus, including congenital varicella syndrome (CVS) and serious maternal complications. In Iran, the absence of varicella vaccination in the national immunization program leaves many women susceptible. This systematic review and meta-analysis aimed to determine the overall seroprevalence of VZV antibodies among reproductive-age women in Iran. Methods A comprehensive search was conducted in both international and Iranian databases for studies published up to November 15, 2024. Eligible studies reporting VZV seroprevalence among Iranian women aged 15–49 years were identified. Screening, data extraction, and risk of bias assessment were independently performed by two reviewers. Pooled seroprevalence was estimated using a random-effects meta-analysis in STATA version 18. Heterogeneity was evaluated with the Cochrane Q test and I² statistic. Subgroup analyses and meta-regression explored sources of heterogeneity. Sensitivity analyses (leave-one-out) and publication bias (Doi plot, LFK index) were also performed. The protocol was registered in PROSPERO (CRD42025647813). Results Data from 20 studies, including 5,629 participants, were analyzed. A pooled VZV seroprevalence of 81% (95% CI: 77–85%) was found, indicating that approximately 19% of reproductive-age women in Iran remain susceptible. Higher seroprevalence was observed in pregnant women (88%) compared with non-pregnant women (79%), with the lowest rates among medical students (74%). Despite subgroup and meta-regression analyses, substantial heterogeneity remained unexplained. Sensitivity analyses supported the robustness of the results, while possible publication bias was suggested. Conclusions Nearly one in five reproductive-age women in Iran lack immunity to VZV. Targeted vaccination, especially among non-pregnant women and students, may reduce susceptibility. Preconception screening for VZV immunity could help prevent maternal and fetal complications. However, given the high unexplained heterogeneity, results should be interpreted with caution.https://doi.org/10.1186/s12879-025-11415-2Human herpesvirus 3Varicella-Zoster virusImmunizationChickenpoxSeroepidemiologic studiesWomen |
| spellingShingle | Morteza Pourahmad Mohammad Javad Tarrahi Mahnaz Momenzadeh Kiana Shahzamani Abdolreza Sotoodeh Jahromi Ziba Farajzadegan Somayeh Haghighipour Behrooz Ataei Fatemeh Nikokar Nasim Kakavand Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization BMC Infectious Diseases Human herpesvirus 3 Varicella-Zoster virus Immunization Chickenpox Seroepidemiologic studies Women |
| title | Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization |
| title_full | Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization |
| title_fullStr | Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization |
| title_full_unstemmed | Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization |
| title_short | Varicella-zoster virus seroprevalence among reproductive-age women in Iran: a meta-analysis and implications for targeted immunization |
| title_sort | varicella zoster virus seroprevalence among reproductive age women in iran a meta analysis and implications for targeted immunization |
| topic | Human herpesvirus 3 Varicella-Zoster virus Immunization Chickenpox Seroepidemiologic studies Women |
| url | https://doi.org/10.1186/s12879-025-11415-2 |
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