Ku Han-Chang, Tsai Yi-Tseng, Konara-Mudiyanselage Sriyani-Padmalatha, Wu Yi-Lin, Yu Tsung, Ko Nai-Ying
An Nan Hospital, China Medical University, Tainan 709, Taiwan.
International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
J Clin Med. 2021 May 25;10(11):2300. doi: 10.3390/jcm10112300.
The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56-3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054-2.41)), men who have sex with men (AOR: 1.21 (95% CI: -0.76-1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53-4.38)) and not receiving ART (AOR: 2.89 (95% CI: -0.44-2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.
感染人类免疫缺陷病毒（HIV）的患者中带状疱疹（HZ）的发病率高于普通人群。然而，接受抗逆转录病毒治疗（ART）的HIV患者中HZ的发病率仍不明确。这项荟萃分析旨在估计ART时代后HZ的合并发病率和危险因素。我们从四个数据库中识别出评估2000年1月1日至2021年2月28日ART时代后HZ发病率的研究。使用随机效应模型从11篇文章中计算合并风险比。通过直观检查漏斗图、进行随机效应荟萃回归和使用I统计量来评估纳入试验的异质性。在筛选的2111项研究中，我们确定了11项符合最终纳入系统评价的研究和8项符合荟萃分析的研究。ART时代后（1997年引入ART后）HZ的合并发病率为每100人年2.30（95%置信区间（CI）：1.56 - 3.05）。HIV感染者中HZ发病的风险因素包括男性（优势比（AOR）：4.35（95%CI：0.54 - 2.41））、男男性行为者（AOR：1.21（95%CI： - 0.76 - 1.13））、CD4细胞计数<200个/μL（AOR：11.59（95%CI：0.53 - 4.38））以及未接受ART（AOR：2.89（95%CI： - 0.44 - 2.56））。接受ART的HIV感染患者中HZ的发病率显著低于未接受ART的患者。诊断后立即启动ART以治疗所有HIV阳性个体对于将HZ的疾病负担降至最低至关重要。
