本帖於 2018-11-06 09:40:37 時間, 由普通用戶 吃與活 編輯
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新觀點：皰疹導致老年癡呆——證據越來越充足
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2018-11-06 09:08:20
Anti-herpetic Medications and Reduced Risk of Dementia
in Patients with Herpes Simplex Virus Infections
-a Nationwide, Population-Based Cohort Study in Taiwan.
Tzeng NS1,2,
Chung CH3,4,5,
Lin FH4,
Chiang CP6,
Yeh CB1,7,
Huang SY1,7,
Lu RB1,8,9,10,11,12,
Chang HA1,2,
Kao YC1,13,
Yeh HW1,
Chiang WS1,14,
Chou YC4,
Tsao CH5,
Wu YF5,
Chien WC15,16.
- 1
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 2
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 3
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China.
- 4
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 5
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China.
- 6
- Department of Dermatology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 7
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 8
- Division of Clinical Psychology, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
- 9
- Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
- 10
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China.
- 11
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China.
- 12
- Center for Neuropsychiatric Research, National Health Research Institute, Zhunan, Miaoli County, Taiwan, Republic of China.
- 13
- Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- 14
- Department and Institute of Mathematics, Tamkang University, New Taipei City, Taiwan, Republic of China.
- 15
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. chienwu@ndmctsgh.edu.tw.
- 16
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, Republic of China. chienwu@ndmctsgh.edu.tw.
Abstract
This retrospective cohort study is to investigate the association between herpes simplex virus (HSV) infections and dementia, and the effects of anti-herpetic medications on the risk involved, using Taiwan's National Health Insurance Research Database (NHIRD). We enrolled a total of 33,448 subjects, and identified 8362 with newly diagnosed HSV infections and 25,086 randomly selected sex- and age-matched controls without HSV infections in a ratio of 1:3, selected from January 1, to December 31, 2000. A multivariable Cox proportional hazards regression model was used to evaluate the risk of developing dementia in the HSV cohort. This analysis revealed an adjusted hazard ratio of 2.564 (95% CI: 2.351-2.795, P < 0.001) for the development of dementia in the HSV-infected cohort relative to the non-HSV cohort. Thus, patients with HSV infections may have a 2.56-fold increased risk of developing dementia. A risk reduction of dementia development in patients affected by HSV infections was found upon treatment with anti-herpetic medications (adjusted HR = 0.092 [95% CI 0.079-0.108], P < 0.001). The usage of anti-herpetic medications in the treatment of HSV infections was associated with a decreased risk of dementia. These findings could be a signal to clinicians caring for patients with HSV infections. Further research is, therefore, necessary to explore the underlying mechanism(s) of these associations.
KEYWORDS:
Anti-herpetic medications; Cohort study; Dementia; Herpes simplex virus; National Health Insurance Research Database
