Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Neurotherapeutics. 2018 Apr;15(2):417-429. doi: 10.1007/s13311-018-0611-x.
This retrospective cohort study is to investigate the association between herpes simplex virus (HSV) infections and dementia, and the effects of anti-herpetic medications on the risk involved, using Taiwan's National Health Insurance Research Database (NHIRD). We enrolled a total of 33,448 subjects, and identified 8362 with newly diagnosed HSV infections and 25,086 randomly selected sex- and age-matched controls without HSV infections in a ratio of 1:3, selected from January 1, to December 31, 2000. A multivariable Cox proportional hazards regression model was used to evaluate the risk of developing dementia in the HSV cohort. This analysis revealed an adjusted hazard ratio of 2.564 (95% CI: 2.351-2.795, P < 0.001) for the development of dementia in the HSV-infected cohort relative to the non-HSV cohort. Thus, patients with HSV infections may have a 2.56-fold increased risk of developing dementia. A risk reduction of dementia development in patients affected by HSV infections was found upon treatment with anti-herpetic medications (adjusted HR = 0.092 [95% CI 0.079-0.108], P < 0.001). The usage of anti-herpetic medications in the treatment of HSV infections was associated with a decreased risk of dementia. These findings could be a signal to clinicians caring for patients with HSV infections. Further research is, therefore, necessary to explore the underlying mechanism(s) of these associations.
本回顾性队列研究旨在利用台湾全民健康保险研究数据库（NHIRD）探讨单纯疱疹病毒（HSV）感染与痴呆的关系，以及抗病毒药物治疗对相关风险的影响。我们共纳入 33448 名受试者，其中 8362 名患有新诊断的 HSV 感染，25086 名按性别和年龄以 1:3 的比例随机选择的无 HSV 感染对照者，入选时间为 2000 年 1 月 1 日至 12 月 31 日。采用多变量 Cox 比例风险回归模型评估 HSV 队列发生痴呆的风险。该分析显示，与非 HSV 队列相比，HSV 感染队列发生痴呆的调整后风险比为 2.564（95%CI：2.351-2.795，P<0.001）。因此，HSV 感染者发生痴呆的风险可能增加 2.56 倍。在 HSV 感染患者接受抗病毒药物治疗后，痴呆的发病风险降低（调整后 HR=0.092[95%CI 0.079-0.108]，P<0.001）。HSV 感染患者使用抗病毒药物治疗与痴呆风险降低相关。这些发现可能为治疗 HSV 感染患者的临床医生提供信号。因此，有必要进行进一步研究以探讨这些关联的潜在机制。
