Effect of Statin Use on Influenza Vaccine Effectiveness.

Effect of Statin Use on Influenza Vaccine Effectiveness.
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DOI:
10.1093/infdis/jiw335
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发表时间:
2016-10-15
期刊:
The Journal of infectious diseases
影响因子:
--
通讯作者:
Belongia EA
Belongia EA
中科院分区:
其他
文献类型:
--
作者:
McLean HQ;Chow BD;VanWormer JJ;King JP;Belongia EA

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背景: 最近的研究表明,他汀类药物的使用可能会降低流感疫苗的有效性(VE),但实验室确认的流感并未得到评估。方法:45岁的 患者在2004年至2005年至2014年至2015年流感季节期间以急性呼吸道疾病为表现的≥患者进行前瞻性研究。疫苗接种和他汀类药物的使用从电子记录中提取。对呼吸道样本进行了流感病毒检测。结果: 分析包括3285名成年人:未使用他汀类药物1217人(37%),未接种他汀类药物903人(27%),接种他汀类药物847人(26%),未接种他汀类药物318人(10%)。他汀类药物使用改良的VE和感染甲型H3N2型流感病毒的风险(P=.002),但不使用2009年甲型H1N1大流行性流感病毒(A[H1N1]pdm09)或乙型流感病毒感染(分别为0.2和0.4)。未使用他汀类药物的人群对甲型H3N2流感的VE为45%(95%可信区间,27%~59%),使用他汀类药物的人群中−为21%(95%CI,−84%~20%)。接种他汀类疫苗的人对甲型H1N1流感pdm09(VE,68%;95%CI,19%-87%)和B型流感(VE,48%;95%CI,1%-73%)有显著的保护作用。按前一季疫苗接种情况分层时,他汀类药物的使用不会显著改变VE。在验证分析中,其他心血管药物的使用没有改变流感VE。结论: 他汀类药物的使用与对抗甲型H3N2型流感病毒的VE减少有关,但与甲型H1N1流感(H1N1)pdm09或B型流感病毒无关。还需要进一步的研究来评估生物学上的可信性并证实这些结果。
Background. Recent studies suggest that statin use may reduce influenza vaccine effectiveness (VE), but laboratory-confirmed influenza was not assessed. Methods. Patients ≥45 years old presenting with acute respiratory illness were prospectively enrolled during the 2004–2005 through 2014–2015 influenza seasons. Vaccination and statin use were extracted from electronic records. Respiratory samples were tested for influenza virus. Results. The analysis included 3285 adults: 1217 statin nonusers (37%), 903 unvaccinated statin nonusers (27%), 847 vaccinated statin users (26%), and 318 unvaccinated statin users (10%). Statin use modified VE and the risk of influenza A(H3N2) virus infection (P = .002) but not 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) or influenza B virus infection (P = .2 and .4, respectively). VE against influenza A(H3N2) was 45% (95% confidence interval [CI], 27%–59%) among statin nonusers and −21% (95% CI, −84% to 20%) among statin users. Vaccinated statin users had significant protection against influenza A(H1N1)pdm09 (VE, 68%; 95% CI, 19%–87%) and influenza B (VE, 48%; 95% CI, 1%–73%). Statin use did not significantly modify VE when stratified by prior season vaccination. In validation analyses, the use of other cardiovascular medications did not modify influenza VE. Conclusions. Statin use was associated with reduced VE against influenza A(H3N2) but not influenza A(H1N1)pdm09 or influenza B. Further research is needed to assess biologic plausibility and confirm these results.
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