Department of Infectious Diseases, Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA.
Division of Infectious Diseases, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Clin Infect Dis. 2023 Feb 8;76(3):e1335-e1340. doi: 10.1093/cid/ciac549.
Studies evaluating stroke following varicella zoster virus (VZV) infection are limited, and the utility of zoster vaccination against this phenomenon is unclear. This study aimed to determine the risk of stroke 30 days following zoster infection and to evaluate the impact of zoster vaccinations on the risk of stroke in VZV-infected patients.
This retrospective case-control study was conducted from January 2010 to January 2020 utilizing nationwide patient data retrieved from the Veterans Affairs' Corporate Data Warehouse.
A total of 2 165 505 patients ≥18 years of age who received care at a Veterans Affairs facility were included in the study, of whom 71 911 had a history of zoster infection. Zoster patients were found to have 1.9 times increased likelihood of developing a stroke within 30 days following infection (odds ratio [OR], 1.93 [95% confidence interval {CI}, 1.57-2.4]; P < .0001). A decreased risk of stroke was seen in patients who received the recombinant zoster vaccine (OR, 0.57 [95% CI, .46-.72]; P < .0001) or the live zoster vaccine (OR, 0.77 [95% CI, .65-.91]; P = .002).
Patients had a significantly higher risk of stroke within the first month following recent herpes zoster infection. Receipt of at least 1 zoster vaccination was found to mitigate this increased risk. Vaccination may therefore be viewed as a protective tool against the risk of neurologic postinfection sequelae.
评估水痘带状疱疹病毒（VZV）感染后中风的研究有限，带状疱疹疫苗对此现象的应用效果尚不清楚。本研究旨在确定带状疱疹感染后 30 天内发生中风的风险，并评估带状疱疹疫苗接种对 VZV 感染患者中风风险的影响。
本回顾性病例对照研究于 2010 年 1 月至 2020 年 1 月期间利用退伍军人事务部企业数据仓库中的全国患者数据进行。
共纳入 2165505 名年龄≥18 岁、在退伍军人事务医疗机构接受治疗的患者，其中 71911 名患者有带状疱疹感染史。带状疱疹患者在感染后 30 天内发生中风的可能性增加 1.9 倍（比值比 [OR]，1.93 [95%置信区间 {CI}，1.57-2.4]；P<0.0001）。接受重组带状疱疹疫苗（OR，0.57 [95%CI，0.46-0.72]；P<0.0001）或活带状疱疹疫苗（OR，0.77 [95%CI，0.65-0.91]；P=0.002）的患者发生中风的风险降低。
患者在带状疱疹感染后第一个月内发生中风的风险显著增加。至少接种 1 剂带状疱疹疫苗可降低这种风险增加。因此，疫苗接种可被视为预防神经感染后后遗症的保护工具。
