School of Life Course and Population Sciences, King's College London, London, United Kingdom.
Department of Psychological Medicine, Institute of Psychiatry, Psychological and Neurosciences, King's College London, London, United Kingdom.
PLoS One. 2022 Oct 27;17(10):e0276807. doi: 10.1371/journal.pone.0276807. eCollection 2022.
The effect of antibiotics on the human microbiome is now well established, but their indirect effect on the related immune response is less clear. The possible association of Herpes zoster, which involves a reactivation of a previous varicella zoster virus infection, with prior antibiotic exposure might indicate a potential link with the immune response.
A case-control study was carried out using a clinical database, the UK's Clinical Practice Research Datalink. A total of 163,754 patients with varicella zoster virus infection and 331,559 age/sex matched controls were identified and their antibiotic exposure over the previous 10 years, and longer when data permitted, was identified. Conditional logistic regression was used to identify the association between antibiotic exposure and subsequent infection in terms of volume and timing.
The study found an association of antibiotic prescription and subsequent risk of varicella zoster virus infection (adjusted odds ratio of 1.50; 95%CIs: 1.42-1.58). The strongest association was with a first antibiotic over 10 years ago (aOR: 1.92; 95%CIs: 1.88-1.96) which was particularly pronounced in the younger age group of 18 to 50 (aOR 2.77; 95%CIs: 1.95-3.92).
By finding an association between prior antibiotics and Herpes zoster this study has shown that antibiotics may be involved in the reactivation of the varicella zoster virus. That effect, moreover, may be relatively long term. This indirect effect of antibiotics on viruses, possibly mediated through their effect on the microbiome and immune system, merits further study.
抗生素对人类微生物组的影响现已得到充分证实，但它们对相关免疫反应的间接影响尚不清楚。带状疱疹（涉及水痘-带状疱疹病毒的再激活）与先前抗生素暴露的可能关联可能表明与免疫反应之间存在潜在联系。
使用临床数据库（英国临床实践研究数据链接）进行了病例对照研究。共确定了 163754 例水痘-带状疱疹病毒感染患者和 331559 名年龄/性别匹配的对照者，并确定了他们在过去 10 年中的抗生素暴露情况，如果数据允许，还会更长时间。使用条件逻辑回归来确定抗生素暴露与随后感染的关联，包括数量和时间。
研究发现抗生素处方与随后的水痘-带状疱疹病毒感染风险之间存在关联（调整后的优势比为 1.50；95%置信区间：1.42-1.58）。与 10 年前首次使用抗生素的相关性最强（调整后的优势比为 1.92；95%置信区间：1.88-1.96），在 18 至 50 岁的年轻年龄组中尤为明显（调整后的优势比为 2.77；95%置信区间：1.95-3.92）。
通过发现先前使用抗生素与带状疱疹之间的关联，本研究表明抗生素可能参与了水痘-带状疱疹病毒的再激活。此外，这种效应可能是相对长期的。抗生素对病毒的这种间接影响，可能通过其对微生物组和免疫系统的影响而产生，值得进一步研究。
