Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster A population-based study from primary care in Madrid (Spain)
Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster A population-based study from primary care in Madrid (Spain)
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DOI：
10.4161/hv.28620
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发表时间：
2014-06-01
影响因子：
4.8
通讯作者：
Gil de Miguel, Angel
中科院分区：
文献类型：
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作者：
Esteban-Vasallo, Maria D.;Felicitas Dominguez-Berjon, M.;Gil de Miguel, Angel
本研究的目的是估计带状疱疹（HZ）的发病率密度率（IDR），并分析其与社会人口统计学特征和选定的慢性疾病的关系。研究队列包括2009年10月1日西班牙马德里自治区公共卫生系统纳入的成年人口（5 244 402人）。数据来源为2009年10月1日至2012年12月31日期间初级保健的电子病历。通过地理编码推断个体社会经济地位（SES）。泊松回归分析按性别分层，以确定与HZ相关的因素。我们确定了81 541例HZ病例（61.7%为女性，46.5%为60岁及以上年龄组）。IDR男性为每1000人年4.11人，女性为每1000人年5.95人。IDR随着年龄的增长而增加，在本地人群、社会经济地位较低的人群和免疫缺陷患者中都是如此。调整后发现，年龄、出生地、社会经济地位较低、hiv感染/艾滋病患者（男性3.20,CI95% 2.90-3.53；女性2.98,CI95% 2.58-3.45）和其他免疫缺陷（1.57,CI95% 1.41-1.75和1.65,CI95% 1.50-1.80）的发病率较高。慢性阻塞性肺病、哮喘、糖尿病、缺血性心脏病、其他心血管疾病和癌症也与HZ发病率增加有关。我们的结论是，年龄较大、社会经济地位较低和具有某些潜在医疗条件的本地患者患HZ的可能性更高。电子数据库对于估计HZ的发病率，以及寻找与社会人口学和临床特征的关联是有用的。确定未被认识的HZ危险因素，如哮喘或心血管疾病，对于解释HZ的流行病学、有针对性的疫苗接种计划和监测其效果至关重要。
The objectives of this study were to estimate incidence density rates (IDR) of herpes zoster (HZ) and to analyze the association with sociodemographic characteristics and selected chronic medical conditions. The study cohort consisted of the adult population included in the Public Health System of the Autonomous Community of Madrid, Spain on 1/10/2009 (5 244 402 persons). Data source were electronic medical records from primary care between 1/10/2009-31/12/2012. Individual socioeconomic status (SES) was inferred by geocoding. Poisson regression analyses were stratified by sex, to identify factors associated with HZ. We identified 81 541 incident cases of HZ (61.7% in women and 46.5% in the group aged 60 and over). IDR was 4.11 per 1000 person-years in men and 5.95 in women. IDR were higher with age, in autochthonous population, those with lower SES and in patients with immunodeficiencies. After adjustment, higher incidence rate ratios were found with age, autochthonous origin, lower SES, and in patients with HIV-infection/AIDS (3.20, CI95% 2.90-3.53 in men and 2.98, CI95% 2.58-3.45 in women), and other immunodeficiencies (1.57, CI95% 1.41-1.75 and 1.65, CI95% 1.50-1.80). COPD, asthma, DM, ischemic heart disease, other cardiovascular diseases, and cancer were also associated with an increased incidence of HZ. We conclude that older, autochthonous patients with lower SES and with certain underlying medical conditions had a higher probability of suffering HZ. Electronic databases are useful for estimating the incidence of HZ, and for finding associations with sociodemographic and clinical characteristics. Identifying unrecognized risk factors for HZ, such as asthma or cardiovascular diseases, is crucial to interpret the epidemiology of HZ, to target vaccination programs and to monitor their effect.