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Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan

BACKGROUND: Infectious agents have been shown to contribute to the development of lymphoid malignancies. The different distribution of lymphoid malignancies in Asian and Western populations suggests possibly different etiologies in Asian populations. Herpes zoster infection, commonly seen in immunoc...

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Autores principales: Liu, Yi-Chang, Yang, Yi-Hsin, Hsiao, Hui-Hua, Yang, Wen-Chi, Liu, Ta-Chih, Chang, Chao-Sung, Yang, Ming-Yu, Lin, Pai-Mei, Hsu, Jui-Feng, Chang, Pi-Yu, Lin, Sheng-Fung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531246/
https://www.ncbi.nlm.nih.gov/pubmed/23114019
http://dx.doi.org/10.1186/1471-2407-12-503
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author Liu, Yi-Chang
Yang, Yi-Hsin
Hsiao, Hui-Hua
Yang, Wen-Chi
Liu, Ta-Chih
Chang, Chao-Sung
Yang, Ming-Yu
Lin, Pai-Mei
Hsu, Jui-Feng
Chang, Pi-Yu
Lin, Sheng-Fung
author_facet Liu, Yi-Chang
Yang, Yi-Hsin
Hsiao, Hui-Hua
Yang, Wen-Chi
Liu, Ta-Chih
Chang, Chao-Sung
Yang, Ming-Yu
Lin, Pai-Mei
Hsu, Jui-Feng
Chang, Pi-Yu
Lin, Sheng-Fung
author_sort Liu, Yi-Chang
collection PubMed
description BACKGROUND: Infectious agents have been shown to contribute to the development of lymphoid malignancies. The different distribution of lymphoid malignancies in Asian and Western populations suggests possibly different etiologies in Asian populations. Herpes zoster infection, commonly seen in immunocompromised persons, has been reported to be associated with lymphoid malignancies in retrospective case–control studies from Western populations, but the results are controversial and large-scale prospective studies from Asian populations are lacking. METHODS: A nationwide population-based matched-controlled prospective study on Taiwanese patients was performed using the National Health Insurance Research Database from 1996 to 2007. Herpes zoster and malignancies were defined by compatible ICD-9-CM (International Classification of Disease, 9(th) Revision, Clinical Modification) codes. Patients who had been diagnosed with any malignancies before herpes zoster, with known viral infections including human immunodeficiency virus, and duration from herpes zoster to diagnosis of malignancies less than 6 months were excluded. RESULTS: Of 42,498 patients with herpes zoster prior to the diagnosis of any malignancies, the cumulative incidence for lymphoid malignancies was 0.11% (n = 48), compared with 0.06% (n = 106) in 169,983 age- and gender-matched controls (univariate hazard ratio (HR): 1.82, 95%CI: 1.29-2.55). The most common lymphoid malignancy was non-Hodgkin’s lymphoma (60.4%, n = 29), followed by multiple myeloma (27.1%, n = 13). Risk for developing lymphoid malignancies is significantly higher in herpes zoster patients (log rank P = 0.005). After adjusting for presence of any comorbidities in Charlson comorbidity index, time-dependent covariate for herpes group, and income category using Cox proportional hazard regressions, herpes zoster patients had an increased risk of developing lymphoid malignancies (adjusted HR: 1.68, 95%CI: 1.35-2.42, P = 0.0026), but did not have an increased risk of developing non-lymphoid malignancies (adjusted HR: 1.00, 95%CI: 0.91-1.05, P = 0.872). CONCLUSION: Preceding herpes zoster infection is an independent risk marker for subsequent lymphoid malignancies in Taiwanese subjects. Further studies are warranted for pathogenesis exploration and preventive strategies in Asian populations.
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spelling pubmed-35312462013-01-10 Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan Liu, Yi-Chang Yang, Yi-Hsin Hsiao, Hui-Hua Yang, Wen-Chi Liu, Ta-Chih Chang, Chao-Sung Yang, Ming-Yu Lin, Pai-Mei Hsu, Jui-Feng Chang, Pi-Yu Lin, Sheng-Fung BMC Cancer Research Article BACKGROUND: Infectious agents have been shown to contribute to the development of lymphoid malignancies. The different distribution of lymphoid malignancies in Asian and Western populations suggests possibly different etiologies in Asian populations. Herpes zoster infection, commonly seen in immunocompromised persons, has been reported to be associated with lymphoid malignancies in retrospective case–control studies from Western populations, but the results are controversial and large-scale prospective studies from Asian populations are lacking. METHODS: A nationwide population-based matched-controlled prospective study on Taiwanese patients was performed using the National Health Insurance Research Database from 1996 to 2007. Herpes zoster and malignancies were defined by compatible ICD-9-CM (International Classification of Disease, 9(th) Revision, Clinical Modification) codes. Patients who had been diagnosed with any malignancies before herpes zoster, with known viral infections including human immunodeficiency virus, and duration from herpes zoster to diagnosis of malignancies less than 6 months were excluded. RESULTS: Of 42,498 patients with herpes zoster prior to the diagnosis of any malignancies, the cumulative incidence for lymphoid malignancies was 0.11% (n = 48), compared with 0.06% (n = 106) in 169,983 age- and gender-matched controls (univariate hazard ratio (HR): 1.82, 95%CI: 1.29-2.55). The most common lymphoid malignancy was non-Hodgkin’s lymphoma (60.4%, n = 29), followed by multiple myeloma (27.1%, n = 13). Risk for developing lymphoid malignancies is significantly higher in herpes zoster patients (log rank P = 0.005). After adjusting for presence of any comorbidities in Charlson comorbidity index, time-dependent covariate for herpes group, and income category using Cox proportional hazard regressions, herpes zoster patients had an increased risk of developing lymphoid malignancies (adjusted HR: 1.68, 95%CI: 1.35-2.42, P = 0.0026), but did not have an increased risk of developing non-lymphoid malignancies (adjusted HR: 1.00, 95%CI: 0.91-1.05, P = 0.872). CONCLUSION: Preceding herpes zoster infection is an independent risk marker for subsequent lymphoid malignancies in Taiwanese subjects. Further studies are warranted for pathogenesis exploration and preventive strategies in Asian populations. BioMed Central 2012-10-31 /pmc/articles/PMC3531246/ /pubmed/23114019 http://dx.doi.org/10.1186/1471-2407-12-503 Text en Copyright ©2012 Liu et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Liu, Yi-Chang
Yang, Yi-Hsin
Hsiao, Hui-Hua
Yang, Wen-Chi
Liu, Ta-Chih
Chang, Chao-Sung
Yang, Ming-Yu
Lin, Pai-Mei
Hsu, Jui-Feng
Chang, Pi-Yu
Lin, Sheng-Fung
Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title_full Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title_fullStr Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title_full_unstemmed Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title_short Herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - A nationwide population-based matched-control study in Taiwan
title_sort herpes zoster is associated with an increased risk of subsequent lymphoid malignancies - a nationwide population-based matched-control study in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531246/
https://www.ncbi.nlm.nih.gov/pubmed/23114019
http://dx.doi.org/10.1186/1471-2407-12-503
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