Predicting risk factors for varicella zoster virus infection and postherpetic neuralgia after hematopoietic cell transplantation using ordered logistic regression analysis
Predicting risk factors for varicella zoster virus infection and postherpetic neuralgia after hematopoietic cell transplantation using ordered logistic regression analysis
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使用有序逻辑回归分析预测造血细胞移植后水痘带状疱疹病毒感染和带状疱疹后神经痛的危险因素
DOI：
10.1007/s00277-016-2883-8
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发表时间：
2017
期刊：
影响因子：
3.5
通讯作者：
Taniwaki M
中科院分区：
文献类型：
--
作者：
Kanbayashi Y;Matsumoto Y;Kuroda J;Kobayashi T;Horiike S;Hosokawa T;Taniwaki M
为了确定水痘带状疱疹病毒（VZV）感染和造血细胞移植（HCT）后带状疱疹后神经痛（PHN）的风险因素，我们对2004年11月至2014年7月期间接受HCT的163例连续患者进行了回顾性图表分析。总体而言，男性/女性（M/F）比例为80/83，HCT时的中位年龄为54岁（范围15-69），自体/同种异体HCT（自体/同种异体HCT）比例为71/92。44例患者[M/F，25/19;中位年龄，57（范围：16-68）岁;自体/异体HCT，26/18]在HCT后发生VZV感染。所有病例均经无环鸟苷（ACV）或伐昔洛韦治疗成功，无VZV相关死亡。44例患者中有9例（20%）[M/F，5/4;中位年龄，58（范围：21-63）岁;自体/异体HCT，7/2]在带状疱疹消退后发生PHN。多变量有序logistic分析确定在停止ACV时接受免疫抑制治疗[比值比（OR）= 74.53; 95%可信区间（CI）= 6.99-794.32;P= 0.0004]是allo-HCT受者中VZV感染和PHN的危险因素。而在auto-HCT受者中，只有高龄是发生肝硬化的危险因素（OR = 1.06，95%CI = 1.002- 1.127，P = 0.0429）。我们的研究结果表明，在停止无环鸟苷时接受免疫抑制治疗是allo-HCT受者的一个重要危险因素，而高龄是auto-HCT受者的一个重要危险因素。
To identify risk factors for varicella zoster virus (VZV) infection and postherpetic neuralgia (PHN) after hematopoietic cell transplantation (HCT), we conducted a retrospective chart review of 163 consecutive patients who underwent HCT between November 2004 and July 2014. Overall, the male/female (M/F) ratio was 80/83, median age at HCT was 54 (range 15–69) years, and autologous/allogeneic HCT (auto/allo-HCT) ratio was 71/92. Forty-four patients [M/F, 25/19; median age, 57 (range: 16–68) years; auto/allo-HCT, 26/18] developed VZV infection after HCT. All cases were successfully treated with acyclovir (ACV) or valacyclovir, and there was no VZV-related death. Nine (20%) of the 44 patients [M/F, 5/4; median age, 58 (range: 21–63) years; auto/allo-HCT, 7/2] developed PHN after resolution of zoster. Multivariate ordered logistic analysis identified receiving immunosuppressive therapy at the cessation of ACV [odds ratio (OR) = 74.53; 95% confidence interval (CI) = 6.99–794.32;P= 0.0004] as a risk factor for VZV infection and PHN in allo-HCT recipients. However, in auto-HCT recipients, only advanced age was identified as a risk factor (OR = 1.06, 95% CI = 1.002–1.127,P= 0.0429). Our findings indicate receiving immunosuppressive therapy at the cessation of ACV is a significant risk factor for allo-HCT recipients, while advanced age is a significant risk factor for auto-HCT recipients.