Herpes zoster associated with stroke incidence in people living with human immunodeficiency virus: a nested case-control study.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
28 Sep 2023
Historique:
received: 25 04 2023
accepted: 19 09 2023
medline: 2 10 2023
pubmed: 29 9 2023
entrez: 28 9 2023
Statut: epublish

Résumé

The incidence of stroke is increasing among younger people with human immunodeficiency virus (HIV). The burden of stroke has shifted toward the young people living with HIV, particularly in low- and middle-income countries. People infected with herpes zoster (HZ) were more likely to suffer stroke than the general population. However, the association of HZ infection with the incidence of stroke among patients with HIV remains unclear. A nested case-control study was conducted with patients with HIV registered in the Taiwan National Health Insurance Research Database in 2000-2017. A total of 509 stroke cases were 1:10 matched to 5090 non-stroke controls on age, sex, and date of first stroke diagnosis. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals (CI) of stroke incidence. The odds ratio of stroke was significantly higher in the HIV-infected population with HZ (adjusted odds ratio [AOR]: 1.85, 95% CI: 1.42-2.41). A significantly increased AOR of stroke was associated with hypertension (AOR: 3.53, 95% CI: 2.86-4.34), heart disease (AOR: 2.32, 95% CI: 1.54-3.48), chronic kidney disease (AOR: 1.82, 95% CI: 1.16-2.85), hepatitis C virus infection (AOR: 1.49, 95% CI: 1.22-1.83), hyperlipidemia (OR: 1.41, 95% CI: 1.12-1.78), and treatment with protease inhibitors (AOR: 1.33, 95% CI: 1.05-1.69). Our findings suggest that HZ concurrent with HIV may increase the risk of stroke. The incidence rates of stroke were independent of common risk factors, suggesting strategies for early prevention of HZ infection among people living with HIV.

Sections du résumé

BACKGROUND BACKGROUND
The incidence of stroke is increasing among younger people with human immunodeficiency virus (HIV). The burden of stroke has shifted toward the young people living with HIV, particularly in low- and middle-income countries. People infected with herpes zoster (HZ) were more likely to suffer stroke than the general population. However, the association of HZ infection with the incidence of stroke among patients with HIV remains unclear.
METHODS METHODS
A nested case-control study was conducted with patients with HIV registered in the Taiwan National Health Insurance Research Database in 2000-2017. A total of 509 stroke cases were 1:10 matched to 5090 non-stroke controls on age, sex, and date of first stroke diagnosis. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals (CI) of stroke incidence.
RESULTS RESULTS
The odds ratio of stroke was significantly higher in the HIV-infected population with HZ (adjusted odds ratio [AOR]: 1.85, 95% CI: 1.42-2.41). A significantly increased AOR of stroke was associated with hypertension (AOR: 3.53, 95% CI: 2.86-4.34), heart disease (AOR: 2.32, 95% CI: 1.54-3.48), chronic kidney disease (AOR: 1.82, 95% CI: 1.16-2.85), hepatitis C virus infection (AOR: 1.49, 95% CI: 1.22-1.83), hyperlipidemia (OR: 1.41, 95% CI: 1.12-1.78), and treatment with protease inhibitors (AOR: 1.33, 95% CI: 1.05-1.69).
CONCLUSIONS CONCLUSIONS
Our findings suggest that HZ concurrent with HIV may increase the risk of stroke. The incidence rates of stroke were independent of common risk factors, suggesting strategies for early prevention of HZ infection among people living with HIV.

Identifiants

pubmed: 37770849
doi: 10.1186/s12879-023-08628-8
pii: 10.1186/s12879-023-08628-8
pmc: PMC10536781
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

636

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Han-Chang Ku (HC)

Department of Nursing, Chang Gung University of Science and Technology, Chiayi Branch, Chiayi, Taiwan.

Yi-Lin Wu (YL)

Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.

Hei-Tung Yip (HT)

Clinical Trial Research Center (CTC), China Medical University Hospital, Taichung, Taiwan.

Cheng-Yang Hsieh (CY)

Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan.

Chung-Yi Li (CY)

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.

Huang-Tz Ou (HT)

Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan.

Yen-Chin Chen (YC)

Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 7010, Taiwan.

Nai-Ying Ko (NY)

Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 7010, Taiwan. nyko@mail.ncku.edu.tw.

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