引入水痘带状疱疹病毒减毒活疫苗后巨细胞动脉炎发病率增加。
Increased Incidence of Giant Cell Arteritis After Introduction of a Live Varicella Zoster Virus Vaccine.
作者信息
Agger William A, Deviley Jake A, Borgert Andrew J, Rasmussen Cary M
机构信息
Department of Infectious Disease, Gundersen Health System, La Crosse, Wisconsin, USA.
Department of Medical Research, Gundersen Health System, La Crosse, Wisconsin, USA.
出版信息
Open Forum Infect Dis. 2020 Dec 30;8(2):ofaa647. doi: 10.1093/ofid/ofaa647. eCollection 2021 Feb.
BACKGROUND
Varicella zoster virus (VZV) has been associated with giant cell arteritis (GCA). The introduction of a live attenuated vaccine against this virus (ZVL) might have changed the incidence of GCA.
METHODS
The incidence of GCA was retrospectively measured using 2 matched cohorts seen in a regional health system located in the Midwestern United States: ZVL recipients from the years 2007 through 2015 following the introduction of the vaccine and nonrecipients from the years 2000 through 2015.
RESULTS
In the ZVL cohort, a significant increase of GCA was associated with clinical criteria alone for the diagnosis of GCA (hazard ratio [HR], 2.70; 95% CI, 1.48-4.45; = .004). In addition, using only pathologically confirmed GCA, the same matched cohort comparison analysis also found that ZVL recipients were at significantly higher risk than those who did not receive ZVL (HR, 2.70; 95% CI, 1.48-4.95; = .001).
CONCLUSION
Using a matched cohort, retrospective comparison, ZVL was associated with an increased incidence of GCA.
背景
水痘带状疱疹病毒（VZV）与巨细胞动脉炎（GCA）有关。针对该病毒的减毒活疫苗（ZVL）的引入可能改变了GCA的发病率。
方法
采用回顾性研究方法，在美国中西部一个区域卫生系统中选取两个匹配队列来测量GCA的发病率：2007年至2015年疫苗引入后接种ZVL的人群以及2000年至2015年未接种疫苗的人群。
结果
在ZVL队列中，仅根据GCA的临床诊断标准，GCA的发病率显著增加（风险比[HR]，2.70；95%可信区间[CI]，1.48 - 4.45；P = 0.004）。此外，仅使用病理确诊的GCA，同样的匹配队列比较分析还发现，接种ZVL的人群比未接种ZVL的人群风险显著更高（HR，2.70；95% CI，1.48 - 4.95；P = 0.001）。
结论
通过匹配队列的回顾性比较，发现ZVL与GCA发病率增加有关。
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