Department of Medical Microbiology, Maastricht University Medical Centre, P, Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands.
Immun Ageing. 2013 Jul 23;10(1):30. doi: 10.1186/1742-4933-10-30.
Studies about associations of infections with herpes viruses and other pathogens, such as Chlamydia pneumoniae (CP) and Helicobacter pylori (HP) with cardiovascular disease (CVD), diabetes mellitus (DM), frailty and/or mortality are conflicting. Since high levels of antibodies against these pathogens occur in the elderly, the role of these pathogens in morbidity and mortality of vulnerable elderly was explored.
Blood samples of 295 community dwelling psycho-geriatric patients were tested for IgG antibodies to herpes simplex virus type 1 and 2, varicella zoster virus, Epstein Barr virus (EBV), cytomegalovirus (CMV), human herpes virus type 6 (HHV6), CP and HP. Frailty was defined with an easy-to-use previously described frailty risk score. Relative risks (RR) with 95% confidence intervals were calculated to evaluate associations between CVD, DM, frailty and pathogens. Pathogens as a predictor for subsequent mortality were tested using Kaplan Meier analyses and Cox proportional hazard models. The mean age was 78 (SD: 6.7) years, 20% died, 44% were defined as frail, 20% had DM and 49% had CVD. Presence of CMV antibody titers was associated with frailty, as shown by using both qualitative and quantitative tests, RR ratio 1.4 (95% CI: 1.003-2.16) and RR ratio 1.5 (95% CI: 1.06-2.30), respectively. High IgG antibody titers of HHV6 and EBV were associated with DM, RR ratio 3.3 (95% CI: 1.57-6.49). None of the single or combined pathogens were significantly associated with mortality and/or CVD.
Prior CMV infection is associated with frailty, which could be in line with the concept that CMV might have an important role in immunosenescence, while high IgG titers of HHV6 and EBV are associated with DM. No association between a high pathogen burden and morbidity and/or mortality could be demonstrated.
关于感染疱疹病毒和其他病原体（如肺炎衣原体（CP）和幽门螺杆菌（HP））与心血管疾病（CVD）、糖尿病（DM）、虚弱和/或死亡率之间的关联的研究结果相互矛盾。由于老年人血液中针对这些病原体的抗体水平较高，因此研究了这些病原体在脆弱老年人发病率和死亡率中的作用。
对 295 名居住在社区的心理老年患者的血液样本进行了针对单纯疱疹病毒 1 型和 2 型、水痘带状疱疹病毒、EB 病毒（EBV）、巨细胞病毒（CMV）、人类疱疹病毒 6 型（HHV6）、CP 和 HP 的 IgG 抗体检测。使用易于使用的先前描述的虚弱风险评分定义虚弱。计算相对风险（RR）和 95%置信区间以评估 CVD、DM、虚弱与病原体之间的关联。使用 Kaplan-Meier 分析和 Cox 比例风险模型测试病原体作为随后死亡率的预测因子。平均年龄为 78 岁（标准差：6.7），20%的患者死亡，44%的患者被定义为虚弱，20%的患者患有糖尿病，49%的患者患有 CVD。使用定性和定量测试均显示，CMV 抗体滴度的存在与虚弱有关，RR 比为 1.4（95%CI：1.003-2.16）和 RR 比为 1.5（95%CI：1.06-2.30）。HHV6 和 EBV 的高 IgG 抗体滴度与 DM 相关，RR 比为 3.3（95%CI：1.57-6.49）。单个或组合病原体均与死亡率和/或 CVD 无显著相关性。
先前的 CMV 感染与虚弱相关，这可能与 CMV 在免疫衰老中可能具有重要作用的概念一致，而 HHV6 和 EBV 的高 IgG 滴度与 DM 相关。未发现高病原体负担与发病率和/或死亡率之间存在相关性。
