疱疹病毒感染、抗病毒治疗与痴呆风险——瑞典一项基于登记处的队列研究
Herpesvirus infections, antiviral treatment, and the risk of dementia-a registry-based cohort study in Sweden.
作者信息
Lopatko Lindman Karin, Hemmingsson Eva-Stina, Weidung Bodil, Brännström Jon, Josefsson Maria, Olsson Jan, Elgh Fredrik, Nordström Peter, Lövheim Hugo
机构信息
Department of Community Medicine and Rehabilitation, Geriatric Medicine Umeå University Umeå Sweden.
Department of Public Health and Caring Sciences, Geriatric Medicine Uppsala University Uppsala Sweden.
出版信息
Alzheimers Dement (N Y). 2021 Feb 14;7(1):e12119. doi: 10.1002/trc2.12119. eCollection 2021.
INTRODUCTION
Herpesviruses, including Herpes simplex virus type 1 (HSV1) and varicella zoster-virus (VZV), have been implicated in Alzheimer's disease (AD) development. Likewise, antiviral treatment has been suggested to protect against dementia development in herpes-infected individuals.
METHODS
The study enrolled 265,172 subjects aged ≥ 50 years, with diagnoses of VZV or HSV, or prescribed antiviral drugs between 31 December 2005 and 31 December 2017. Controls were matched in a 1:1 ratio by sex and birth year.
RESULTS
Antiviral treatment was associated with decreased risk of dementia (adjusted hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.86 to 0.92), while herpes infection without antiviral drugs increased the risk of dementia (adjusted HR 1.50, 95% CI 1.29 to 1.74).
DISCUSSION
Antiviral treatment was associated with a reduced long-term risk of dementia among individuals with overt signs of herpes infection. This is consistent with earlier findings indicating that herpesviruses are involved in the pathogenesis of AD.
引言
包括1型单纯疱疹病毒（HSV1）和水痘带状疱疹病毒（VZV）在内的疱疹病毒与阿尔茨海默病（AD）的发展有关。同样，有人提出抗病毒治疗可预防疱疹感染个体发生痴呆。
方法
该研究纳入了265172名年龄≥50岁、在2005年12月31日至2017年12月31日期间被诊断为VZV或HSV或开具了抗病毒药物的受试者。对照组按性别和出生年份以1:1的比例进行匹配。
结果
抗病毒治疗与痴呆风险降低相关（调整后的风险比[HR]为0.89，95%置信区间[CI]为0.86至0.92），而未使用抗病毒药物的疱疹感染会增加痴呆风险（调整后的HR为1.50，95%CI为1.29至1.74）。
讨论
抗病毒治疗与有明显疱疹感染迹象的个体长期痴呆风险降低相关。这与早期表明疱疹病毒参与AD发病机制的研究结果一致。
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