Herpes Zoster virus infection and the risk of developing dementia: A systematic review and meta-analysis

Abstract

Background: Herpes Zoster, commonly known as shingles, is a viral infection that affects a significant portion of the adult population; however, its potential role in the onset or progression of neurodegenerative disorders like dementia remains unclear. Methods: We searched the following databases: PubMed, Scopus, Cochrane library, and Web of Science. We included any randomized control trials and controlled observational studies as Cross-sectional, prospective, or retrospective cohort and case-control studies that investigated the prevalence of dementia in Herpes Zoster Virus (HZV)-infected patients and HZV-free control group or if the study investigated the prevalence of HZV in demented patients. Also, if the studies measured the levels of dementia biomarkers in patients with HZV compared with a healthy control group. Results: After the complete screening, 9 studies were included in the meta-analysis. In the outcome of the incidence of HZV, the pooled analysis showed no statistically significant difference between the dementia group and the No dementia group (RR = 1.04% CI = 0.86–1.25, P = .70). In the outcome of incidences of dementia and Alzheimer’s disease, the pooled analysis showed no statistically significant difference between the HZV group and the incidence of dementia (RR = 0.99, 95% CI = 0.92–1.08, P = .89), (RR = 3.74, 95% CI = 0.22–62.70, P = .36) respectively. In the outcome of incidences of Herpes Zoster ophthalmicus (HZO), the generic inverse variance showed a statistically significant association between patients who have HZO and increased incidence of dementia (RR = 6.26, 95% CI = 1.30–30.19, P = .02). Conclusion: Our study showed no significant association between HZV and the incidence of dementia or Alzheimer’s disease, but it shows a significant association between HZO and the incidence of dementia. More multicenter studies are needed to establish the actual association between the HZV and dementia.

Risk of dementia following herpes zoster infection among patients undertreatment versus those not: A systematic review and meta‐analysis

“…This systematic review and meta‐analysis included six studies. Three studies 18 , 19 , 24 were deemed low risk of bias, while three 20 , 25 , 26 exhibited a moderate overall risk. Figure 2 presents the results of the risk of bias assessment.…”

“… 16 , 17 A meta‐analysis focused on non‐randomized observational studies determined no significant relationship between HZ and dementia. 18 HZ can lead to cerebral vasculopathy and stroke, particularly if the cranial nerves are affected, resulting in neurologic damage. 13 Previous studies found that the incidence of stroke and vasculopathy was higher in patients with herpes zoster ophthalmicus (HZO) than in other types of HZ.…”

Herpes Zoster and Cardiovascular Disease: Exploring Associations and Preventive Measures through Vaccination

“…Consequently, antiviral treatment is linked to a diminished long-term risk of dementia in individuals displaying evident signs of herpes infection. Conversely, a meta-analysis comprising nine studies found no significant association between herpes zoster and the incidence of dementia or Alzheimer’s disease [ 64 ]. However, it did reveal a noteworthy association between herpes zoster opthalmicus and the incidence of dementia [ 64 , 65 ].…”

“…Conversely, a meta-analysis comprising nine studies found no significant association between herpes zoster and the incidence of dementia or Alzheimer’s disease [ 64 ]. However, it did reveal a noteworthy association between herpes zoster opthalmicus and the incidence of dementia [ 64 , 65 ].…”

Viral Infections, Are They a Trigger and Risk Factor of Alzheimer’s Disease?

“…As shown in Figure 1 above, there are several other viruses, including human herpesvirus-6 (HHV-6), -7 (HHV-7) [ 43 , 128 , 129 , 130 , 131 , 132 ], Epstein–Barr virus (EBV) [ 133 , 134 , 135 , 136 , 137 , 138 , 139 ], cytomegalovirus (CMV) [ 33 , 140 , 141 , 142 , 143 ], varicella zoster virus (VZV) [ 144 , 145 , 146 , 147 ], human immunodeficiency virus [ 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 ], hepatitis C virus (HCV) [ 163 ], enterovirus [ 164 , 165 , 166 ], influenza A virus (IAV) [ 167 , 168 , 169 , 170 , 171 ], and measles [ 172 , 173 , 174 , 175 ], which have ...…”