Drinkall Nadia Jasmin, Siersma Volkert, Lathe Richard, Waldemar Gunhild, Janbek Janet
Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital- Rigshospitalet, Blegdamsvej 9, entrance 8, Copenhagen, 2100, Denmark.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Alzheimers Res Ther. 2025 Sep 2;17(1):201. doi: 10.1186/s13195-025-01838-z.
The aim of this systematic review and meta-analysis was to synthesize the evidence on the association between herpesviruses, antiviral treatment, and the risk of dementia. We also aimed to explore the impact of time between herpesviruses and dementia on the reported associations.
PubMed and Web of Science were searched along with reference lists of the included studies. We included studies that looked at clinical episodes or serology (IgG/IgM) of herpes simplex virus type 1/2 (HSV1/2) and/or varicella zoster virus (VZV), antiviral treatment and incident dementia (all-cause dementia, Alzheimer's disease, and vascular dementia). Study results were pooled with random effect meta-analyses.
We included 32 studies. The pooled hazard ratio for all-cause dementia was 1.36 [95% CI: 1.01, 1.83] following a clinical episode of HSV1/2, and 1.12 [95% CI: 1.00, 1.25] following a clinical episode of VZV. The pooled estimate for all-cause dementia following antiviral treatment and VZV was 0.88 [95% CI: 0.81, 0.96].
The present review of the scientific literature generally shows little evidence of an association between herpesviruses and risk of dementia. However, the review shows evidence of an association between antiviral treatment and a decreased risk of dementia. Because of considerable heterogeneity, future investigations could advantageously target certain subgroups.
本系统评价和荟萃分析的目的是综合关于疱疹病毒、抗病毒治疗与痴呆风险之间关联的证据。我们还旨在探讨疱疹病毒感染与痴呆发生之间的时间间隔对所报告关联的影响。
检索了PubMed和Web of Science以及纳入研究的参考文献列表。我们纳入了观察单纯疱疹病毒1型/2型（HSV1/2）和/或水痘带状疱疹病毒（VZV）的临床发作或血清学（IgG/IgM）、抗病毒治疗与新发痴呆（全因性痴呆、阿尔茨海默病和血管性痴呆）的研究。研究结果通过随机效应荟萃分析进行汇总。
我们纳入了32项研究。HSV1/2临床发作后全因性痴呆的合并风险比为1.36 [95%置信区间：1.01, 1.83]，VZV临床发作后为1.12 [95%置信区间：1.00, 1.25]。抗病毒治疗和VZV后全因性痴呆的合并估计值为0.88 [95%置信区间：0.81, 0.96]。
本对科学文献的综述总体上显示，几乎没有证据表明疱疹病毒与痴呆风险之间存在关联。然而，该综述显示了抗病毒治疗与痴呆风险降低之间存在关联的证据。由于存在相当大的异质性，未来的研究可以有利地针对某些亚组。
