Back to Search
Start Over
Association of herpesviruses and stroke: Systematic review and meta-analysis
- Source :
- PLoS ONE, Vol 13, Iss 11, p e0206163 (2018), PLoS ONE, PLOS ONE
- Publication Year :
- 2018
- Publisher :
- Public Library of Science (PLoS), 2018.
-
Abstract
- BackgroundHerpesviruses induce a range of inflammatory effects potentially contributing to an increased risk of stroke.ObjectivesTo investigate whether patients with infection, or reactivation of, human herpesviruses are at increased stroke risk, compared to those without human herpesviruses.Data sourcesSix medical databases and grey literature sources from inception to January 2017.Study eligibility criteriaStudies where the exposure was any human herpesvirus and the outcome was stroke. We included randomised controlled trials, cohort, case-control, case-crossover and self-controlled case series designs.MethodsMeta-analyses when sufficiently homogeneous studies were available. Quality of evidence across studies was assessed.ResultsWe identified 5012 publications; 41 met the eligibility criteria. Across cohort and self-controlled case series studies, there was moderate quality evidence that varicella infection in children was associated with a short-term increased stroke risk. Zoster was associated with a 1.5-fold increased stroke risk four weeks following onset (summary estimate: 1.55, 95%CI 1.46-1.65), which resolved after one year. Subgroup analyses suggested post-zoster stroke risk was greater among ophthalmic zoster patients, younger individuals and those not prescribed antivirals. Recent infection/reactivation of cytomegalovirus and herpes simplex viruses, but not past infection, was associated with increased stroke risk; however the evidence across studies was mainly derived from small, very low quality case-control studies.ConclusionsOur review shows an increased stroke risk following zoster and suggests that recent infection or reactivation of other herpesviruses increases stroke risk, although better evidence is needed. Herpesviruses are common and potentially preventable; these findings may have implications for reducing stroke burden.
- Subjects :
- Herpesviruses
Cerebrovascular Diseases
Science
Immunology
Blood Pressure
Pathology and Laboratory Medicine
Research and Analysis Methods
Vascular Medicine
Microbiology
Varicella Zoster Virus
Risk Factors
Medicine and Health Sciences
Humans
Public and Occupational Health
Enzyme-Linked Immunoassays
Immunoassays
Microbial Pathogens
Herpesviridae
Ischemic Stroke
Biology and life sciences
Organisms
Herpesviridae Infections
Vaccination and Immunization
Stroke
Hemorrhagic Stroke
Neurology
Medical Microbiology
Viral Pathogens
Viruses
Hypertension
Immunologic Techniques
Medicine
Preventive Medicine
Pathogens
DNA viruses
Publication Bias
Follow-Up Studies
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 13
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.pmid.dedup....1e0750479f66bd320df953d4a4ab8fa6