Risk factors for herpes zoster in a large cohort of unvaccinated older adults: a prospective cohort study
Risk factors for herpes zoster in a large cohort of unvaccinated older adults: a prospective cohort study
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DOI：
10.1017/s0950268814003653
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发表时间：
2015-10-01
影响因子：
4.2
通讯作者：
Macintyre, C. R.
中科院分区：
文献类型：
--
作者：
Liu, B.;Heywood, A. E.;Macintyre, C. R.
我们分析了 2006 年至 2009 年招募的 255024 名 545 岁成年人的前瞻性队列数据，以确定与带状疱疹诊断相关的特征。通过与带状疱疹特异性药物治疗和住院记录的联系来确定诊断，并估计风险比。超过 940583 人年，7771 名参与者被诊断为带状疱疹； 253 人（3.3%）住院。调整年龄和其他因素后，与带状疱疹诊断相关的特征包括：近期患有免疫抑制疾病[调整后的风险比 (aHR) 1.58，95% 置信区间 (CI) 1.32-1.88]、女性（aHR 1.36，95% CI 1.30-1.43）、近期癌症诊断（aHR 1.35，95% CI） 1.24-1.46），以及严重的身体限制与无限制（aHR 1.33，95% CI 1.23-1.43）。免疫抑制患者（aHR 3.78，95% CI 2.18-6.55）、癌症患者（aHR 1.78，95% CI 1.24-2.56）或身体严重受限的患者（aHR 2.50，95% CI 1.56-4.01）因带状疱疹住院的相对风险较高。身体缺陷人群的带状疱疹诊断和住院风险增加这一新发现应促使人们评估带状疱疹疫苗在该人群中的使用情况。
We analysed data from a prospective cohort of 255024 adults aged 545 years recruited from 2006-2009 to identify characteristics associated with a zoster diagnosis. Diagnoses were identified by linkage to pharmaceutical treatment and hospitalization records specific for zoster and hazard ratios were estimated. Over 940583 person-years, 7771 participants had a zoster diagnosis; 253 (3.3%) were hospitalized. After adjusting for age and other factors, characteristics associated with zoster diagnoses included: having a recent immunosuppressive condition [adjusted hazard ratio (aHR) 1.58, 95% confidence interval (CI) 1.32-1.88], female sex (aHR 1.36, 95% CI 1.30-1.43), recent cancer diagnosis (aHR 1.35, 95% CI 1.24-1.46), and severe physical limitation vs. none (aHR 1.33, 95% CI 1.23-1.43). The relative risk of hospitalization for zoster was higher for those with an immunosuppressive condition (aHR 3.78, 95% CI 2.18-6.55), those with cancer (aHR 1.78, 95% CI 1.24-2.56) or with severe physical limitations (aHR 2.50, 95% CI 1.56-4.01). The novel finding of an increased risk of zoster diagnoses and hospitalizations in those with physical limitations should prompt evaluation of the use of zoster vaccine in this population.