Human herpesvirus infections and dementia or mild cognitive impairment: a systematic review and meta-analysis.

Authors:
Harriet J Forbes
Harriet J Forbes
London School of Hygiene and Tropical Medicine
United Kingdom
Elizabeth Williamson
Elizabeth Williamson
The School of Pharmacy
United Kingdom
Judith Breuer
Judith Breuer
University College London
United Kingdom
Andrew C Hayward
Andrew C Hayward
University College London
United Kingdom
Angelique Mavrodaris
Angelique Mavrodaris
Cambridge Institute of Public Health
Robinson Way | United Kingdom
Basil H Ridha
Basil H Ridha
Institute of Neurology
United Kingdom
Martin N Rossor
Martin N Rossor
UCL Institute of Neurology
United Kingdom

Sci Rep 2019 Mar 18;9(1):4743. Epub 2019 Mar 18.

Faculty of Epidemiology & Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom.

Interest is growing in the role of infectious agents in the pathogenesis of dementia, but current evidence is limited. We conducted a systematic review and meta-analysis to investigate the effect of any of eight human herpesviruses on development of dementia or mild cognitive impairment (MCI). We searched the Cochrane Library, Embase, Global Health, Medline, PsycINFO, Scopus, Web of Science, clinical trials registers and grey literature sources from inception to December 2017 for observational studies with cohort, case control or self-controlled designs, or randomised controlled trials of interventions against herpesviruses. Pooled effect estimates and 95% confidence intervals (CIs) were generated through random effects meta-analyses across studies with the same design, outcome, and virus type, method and site of measurement. We included 57 studies across various geographic settings. Past infection with herpesviruses, measured by IgG seropositivity, was generally not associated with dementia risk. A single cohort study rated moderate quality showed an association between varicella zoster virus reactivation (ophthalmic zoster) and incident dementia (HR 2.97; 95%CI, 1.89 to 4.66). Recent infection with, or reactivation of, herpes simplex virus type 1 or type 1/2 unspecified, cytomegalovirus and human herpes virus-6 measured by serum IgM, high titre IgG or clinical disease may be associated with dementia or MCI, though results were inconsistent across studies and overall evidence rated very low quality. Longitudinal population studies with robust repeated virus measurements taken sufficiently proximal to dementia onset are needed to establish whether, when and among whom herpesviruses affect dementia risk.

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http://dx.doi.org/10.1038/s41598-019-41218-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426940PMC
March 2019
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