本研究评估了免疫功能正常的社区获得性肺炎 (CAP) 患者单纯疱疹病毒 (HSV) 再激活的频率、临床意义和危险因素。该研究包括 2007 年至 2017 年间参加 CAPNETZ 研究的成年 CAP 患者并有残留痰样本可供分析。除了常规诊断外，还使用 ​​PCR 检测痰液和血液样本中的 HSV-1/2。使用 Fisher 精确检验或 Mann Whitney 检验比较 HSV 阳性和阴性患者的人口统计学、合并症和 CRB-65 评分。 Logistic 回归分析调查了 HSV 重新激活对改良医院康复量表 (HRS) 的影响，直至第 7 天，分为 3 类（无氧疗、氧疗、入住 ICU 或死亡）。 在 245 名患者中，HSV-1 和 HSV- 2 分别在 30 名患者（12.2%，95%CI 8.7-16.9）和 0 名患者中检测到。所有 HSV 阳性患者均住院治疗，CRB-65 严重程度评分为 0-2，并在第一个 28 天存活。与 HSV 阴性组相比，HSV 阳性组患者的中位年龄（70.5 岁对 66 岁）较高，且肿瘤合并症发生率较高（16.7% 对 8.8%）。两组之间共同病原体的分布和结果参数没有显着差异。在多变量逻辑回归模型中，年龄（AOR 1.029，p = 0.012）和CRB-65评分（AOR 1.709，p = 0.048）与较高的HRS独立相关，但HSV-1作为单一或共同病原体则不与较高的HRS独立相关。表明 HSV-1 重新激活在 CAP 中很常见，但可能与特定危险因素或复杂病程无关。© 2024。作者。

This study assessed the frequency, clinical significance, and risk factors for Herpes simplex virus (HSV) reactivation in immunocompetent patients with community-acquired pneumonia (CAP).The study included adult CAP-patients who were enrolled in the CAPNETZ study between 2007 and 2017 and had a residual sputum sample available for analysis. In addition to routine diagnostics, sputum and blood samples were tested for HSV-1/2 using PCR. Demographics, comorbidities, and CRB-65 score were compared between HSV-positive and negative patients using Fisher exact or Mann Whitney test. Logistic regression analyses investigated the influence of HSV reactivation on a modified hospital recovery scale (HRS) until day 7, divided into 3 categories (no oxygen therapy, oxygen therapy, ICU admission or death).Among 245 patients, HSV-1 and HSV-2 were detected in 30 patients (12.2%, 95%CI 8.7-16.9) and 0 patients, respectively. All HSV-positive patients were hospitalized, had a CRB-65 severity score of 0-2 and survived the first 28 day. In the HSV-positive group, patients had a non-significantly higher median age (70.5 versus 66 years) and a higher rate of oncological comorbidities (16.7% versus 8.8%) compared to the HSV-negative group. Distribution of co-pathogens and outcome parameters did not significantly differ between both groups. In a multivariate logistic regression model, age (AOR 1.029, p = 0.012) and CRB-65 score (AOR 1.709, p = 0.048), but not HSV-1 as single or co-pathogen were independently associated with higher HRS.Our study suggests that HSV-1 reactivation is common in CAP but might not be associated with specific risk factors or a complicated disease course.© 2024. The Author(s).