原发单纯疱疹病毒感染与带状疱疹风险。
Prior Herpes Simplex Virus Infection and the Risk of Herpes Zoster.
机构信息
Department of Veterans Affairs San Diego Healthcare System, San Diego, California, USA.
Department of Medicine, University of California San Diego, San Diego, California, USA.
出版信息
J Infect Dis. 2024 Jan 12;229(1):64-72. doi: 10.1093/infdis/jiad259.
BACKGROUND
The incidence of herpes zoster (HZ) has increased in the United States concurrent with decrease in herpes simplex virus (HSV) prevalence. We hypothesized that lack of HSV-elicited cross-reactive immunity to varicella-zoster virus (VZV) results in an increased risk of HZ. Using specimens from the placebo arm of the Shingles Prevention Study, we investigated whether persons who develop HZ are less likely to have prior HSV infection than persons who do not develop HZ, and whether HZ is less severe in persons with HSV than in HSV seronegative persons.
METHODS
We conducted a nested case-control (1:2) study comparing the seroprevalence of HSV-1 and HSV-2 in cases (persons with polymerase chain reaction-confirmed HZ) to age-, sex-, and health-matched controls (persons without HZ).
RESULTS
Sera from 639 study participants (213 cases and 426 controls) yielded definitive HSV antibody results and were analyzed. Overall, HSV seropositivity rate was 75%. HSV seronegativity was significantly higher in HZ cases than controls (30.5% vs 22.3%; P = .024), with a 55% higher risk of HZ in HSV seronegative than HSV seropositive participants. HSV seropositivity was associated with more severe HZ (P = .021).
CONCLUSIONS
Our study demonstrated that prior infection with HSV partly protects against HZ.
背景
在美国，带状疱疹（HZ）的发病率随着单纯疱疹病毒（HSV）流行率的下降而增加。我们假设缺乏对水痘-带状疱疹病毒（VZV）的 HSV 诱发交叉反应性免疫会增加 HZ 的风险。利用 Shingles Prevention Study 安慰剂组的标本，我们研究了患有 HZ 的人是否比未患 HZ 的人更不可能先前感染 HSV，以及 HSV 阳性者的 HZ 是否比 HSV 阴性者更不严重。
方法
我们进行了一项巢式病例对照（1:2）研究，比较了聚合酶链反应确认的 HZ 病例（213 例）与年龄、性别和健康相匹配的对照组（426 例）的 HSV-1 和 HSV-2 血清阳性率。
结果
共有 639 名研究参与者（213 例病例和 426 例对照）的血清获得了明确的 HSV 抗体结果并进行了分析。总体而言，HSV 血清阳性率为 75%。HZ 病例的 HSV 血清阴性率明显高于对照组（30.5%比 22.3%；P =.024），HSV 血清阴性者发生 HZ 的风险比 HSV 血清阳性者高 55%。HSV 血清阳性与更严重的 HZ 相关（P =.021）。
结论
我们的研究表明，先前感染 HSV 可在一定程度上预防 HZ。
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