Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Data Science, Hanmi Pharm. Co., Ltd, Seoul, Korea.
Medicine (Baltimore). 2022 Oct 14;101(41):e31116. doi: 10.1097/MD.0000000000031116.
Herpesviruses affect the development of dementia. We investigated the association between herpes infection and subsequent diagnoses of dementia. Data from the National Health Insurance Service of South Korea were used. Patients aged ≥50 years with the relevant diagnostic codes in the reference year 2009 were included and prospectively reviewed from January 2010 to December 2018. All study participants were followed from the index date until the onset of dementia, death, or the study endpoint. The three cohorts comprised 92,095 patients with herpes simplex virus (HSV) infections, 97,323 patients with varicella-zoster virus (VZV) infections, and 183,779 controls. During the follow-up period, 15,831 (17.19%) subjects with HSV infection and 17,082 (17.55%) VZV-infected subjects, compared to 27,028 (14.17%) control subjects, were subsequently diagnosed with dementia (all, P < .001). The adjusted hazard ratio for developing dementia was found to be 1.18 (95% confidence interval [CI]; 1.16-1.20) in HSV and 1.09 (95% CI; 1.07-1.11) in VZV patients (all, P < .001). HSV1 infections such as oral or ocular subtypes, but not HSV2, anogenital subtype, were associated with dementia, including several subtypes such as Alzheimer's disease (AD), vascular dementia, and dementia with Lewy bodies. VZV infection is also associated with AD. In this Korean nationwide population-based cohort study, both HSV and VZV infections were associated with a higher risk of dementia, particularly AD. Among the subtypes of HSV infection, HSV1 is associated with a risk of dementia. Further studies including appropriate public health interventions could evaluate the causality of these relationships.
疱疹病毒会影响痴呆的发展。我们研究了疱疹感染与随后痴呆诊断之间的关系。使用了来自韩国国家健康保险服务的数据。纳入年龄≥50 岁且在参考年 2009 年有相关诊断代码的患者,并在 2010 年 1 月至 2018 年 12 月期间进行前瞻性审查。所有研究参与者均从索引日期开始随访至痴呆、死亡或研究终点。三个队列包括 92095 例单纯疱疹病毒(HSV)感染患者、97323 例水痘带状疱疹病毒(VZV)感染患者和 183779 例对照。在随访期间,与对照组相比,15831 例(17.19%)HSV 感染患者和 17082 例(17.55%)VZV 感染患者被诊断为痴呆(均,P<.001)。调整后的痴呆发病风险比在 HSV 中为 1.18(95%置信区间[CI];1.16-1.20),在 VZV 中为 1.09(95%CI;1.07-1.11)(均,P<.001)。HSV1 感染(如口腔或眼部亚型)而非 HSV2(生殖器亚型)与痴呆相关,包括几种亚型,如阿尔茨海默病(AD)、血管性痴呆和路易体痴呆。VZV 感染也与 AD 相关。在这项韩国全国基于人群的队列研究中,HSV 和 VZV 感染均与痴呆风险增加相关,尤其是 AD。在 HSV 感染的亚型中,HSV1 与痴呆风险相关。进一步的研究包括适当的公共卫生干预措施,可以评估这些关系的因果关系。
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