Chen H-H, Lin C-L, Yeh C-J, Yeh S-Y, Kao C-H
Institute of Medicine and Public Health, Chung Shan Medical University, Taichung, Taiwan.
Eur J Clin Microbiol Infect Dis. 2015 Jul;34(7):1451-8. doi: 10.1007/s10096-015-2372-3. Epub 2015 Apr 12.
This study evaluated whether statin therapy increases the risk of herpes zoster (HZ) infection in Asia. This retrospective cohort study used the Longitudinal Health Insurance Database (LHID2000). From the LHID2000, patients aged 20 years were divided into two cohorts according to their statin use and were matched at a 1:1 ratio according to propensity scores, which were calculated using a logistic regression for estimating the probability of treatment assignment. The primary outcome was HZ infection. All patients were followed from the index date until the date of HZ infection, withdrawal from the insurance system, or the end of 2011. The study included 53,069 patients receiving statin therapy as a statin cohort and 53,069 patients without statin therapy as a nonstatin cohort. The mean follow-up durations for the statin cohort and nonstatin cohort were 4.89 [standard deviation (SD) = 2.86] years and 4.75 (SD = 2.90) years, respectively. The patients in the statin cohort had a 21 % higher risk of contracting HZ infection than the patients in the nonstatin cohort [95 % confidence interval (CI) = 1.13-1.29]. The incidence of HZ infection increased with the Charlson comorbidity index (CCI) score in both cohorts. A high mean defined daily dose of the six types of statins considered in this study was associated with a significantly increased risk of HZ infection. Statin therapy can increase HZ infection in Asia. More benefit-risk evaluations for statin use are necessary in Asia.
本研究评估了他汀类药物治疗是否会增加亚洲地区带状疱疹（HZ）感染的风险。这项回顾性队列研究使用了纵向健康保险数据库（LHID2000）。从LHID2000中，20岁及以上的患者根据他汀类药物的使用情况被分为两个队列，并根据倾向得分以1:1的比例进行匹配，倾向得分是使用逻辑回归计算得出的，用于估计治疗分配的概率。主要结局是HZ感染。所有患者从索引日期开始随访，直至发生HZ感染、退出保险系统或2011年底。该研究纳入了53069名接受他汀类药物治疗的患者作为他汀类药物队列，以及53069名未接受他汀类药物治疗的患者作为非他汀类药物队列。他汀类药物队列和非他汀类药物队列的平均随访时间分别为4.89[标准差（SD）=2.86]年和4.75（SD=2.90）年。他汀类药物队列中的患者感染HZ的风险比非他汀类药物队列中的患者高21%[95%置信区间（CI）=1.13 - 1.29]。两个队列中HZ感染的发生率均随查尔森合并症指数（CCI）评分的增加而升高。本研究中考虑的六种他汀类药物的高平均限定日剂量与HZ感染风险显著增加相关。他汀类药物治疗会增加亚洲地区的HZ感染。在亚洲，有必要对他汀类药物的使用进行更多的效益风险评估。
