Kaposi肉瘤相关疱疹病毒感染及其与全因死亡率和心血管死亡率的关系：一项前瞻性队列研究

Kaposi's sarcoma-associated herpesvirus infection and its association with all-cause and cardiovascular mortality in the general adults: A prospective cohort study

DOI 原文链接

用sci-hub下载

JOURNAL OF MEDICAL VIROLOGY

影响因子:4.6

分区:医学3区 / 病毒学3区

发表日期:2024 Oct

作者: Xiaoping Huang, Xueliang Huang, Yushao Li, Lixia Li, Jiaman Liao, Hao Huang, Ying Zhao, Yiqiang Zhan

DOI: 10.1002/jmv.29953

摘要

本研究旨在探讨Kaposi肉瘤相关疱疹病毒（KSHV）/人类疱疹病毒8型（HHV8）感染与美国成人全因死亡率及心血管死亡率之间的关联。分析了1988年至1994年期间的National Health and Nutrition Examination Survey III（NHANES III）数据，共包括13,993名年龄在18至90岁之间接受KSHV血清学检测的参与者。死亡情况通过至2019年12月的国家死亡指数（National Death Index）确认。采用Cox比例风险模型分析KSHV血清阳性与死亡风险的关系，调整了年龄、性别、种族、体质指数和血清甘油三酯等潜在混杂因素。在追踪中位数为26.5年的时间内，共记录到5503例死亡。结果显示，KSHV血清阳性与全因死亡风险增加相关（风险比[HR]：1.32，95%置信区间[CI]：1.03‒1.69）以及心血管死亡风险增加（HR：1.58，95% CI：1.00‒2.50），调整各项混杂因素后。值得注意的是，女性中KSHV感染与全因死亡的关联仍显著（HR：1.32，95% CI：1.02‒1.72），而心血管死亡的关联仅在男性中具有统计学意义（HR：1.90，95% CI：1.02，3.53）。KSHV感染可能是美国成人全因及心血管死亡的独立风险因素。研究结果强调了进一步验证这些关联的必要性，以及揭示KSHV感染与死亡风险增加背后的生物学机制。

Abstract

To investigate the association between Kaposi's sarcoma-associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8) infection and both all-cause and cardiovascular mortality in a representative cohort of US adults, data from the National Health and Nutrition Examination Survey III (NHANES III; 1988‒1994) were analyzed, including 13,993 participants aged 18‒90 years who underwent KSHV serology evaluations. Mortality outcomes were ascertained through December 2019 using the National Death Index. Cox proportional hazards models were employed to examine the association between KSHV seropositivity and mortality, adjusting for potential confounders such as age, sex, ethnicity, body mass index, and serum TG. Over a median follow-up period of 26.5 years, 5503 deaths were recorded. KSHV seropositivity was associated with an increased hazard of all-cause mortality (Hazard Ratio [HR]: 1.32, 95% Confidence Interval [CI]: 1.03‒1.69) and cardiovascular mortality (HR: 1.58, 95% CI: 1.00‒2.50) after adjusting for age, sex, ethnicity, and body mass index. Notably, the association between KSHV infection and all-cause mortality persisted among women (HR: 1.32, 95% CI: 1.02‒1.72) after adjusting for all confounders, whereas the association with cardiovascular mortality was only statistically significant for men (HR: 1.90, 95% CI: 1.02, 3.53).KSHV infection may represent an independent risk factor for all-cause and cardiovascular mortality among US adults. These findings highlight the need for further research to validate these associations in independent populations and to elucidate the biological mechanisms underlying the observed increased mortality associated with KSHV infection.