Ⅰ型单纯疱疹病毒感染危险因素的Meta分析

Meta-analysis of risk factors of herpes simplex virus type 1 infection

目的研究全球Ⅰ型单纯疱疹病毒(herpes simplex virus type 1,HSV-1)感染的危险因素,以期为我国HSV-1的流行病学研究和防御控制提供参考。方法运用Meta分析方法对全球范围内1980—2018年发表的HSV-1新发感染及危险因素相关研究结果进行汇总和定量综合分析;采用Review Manager 5.3软件进行异质性检验、效应量合并统计分析、偏倚性检验和敏感性分析。结果女性(OR=1.33,95%CI:1.20~1.47,P<0.001)、年龄超过40岁(OR=2.99,95%CI:1.84~4.86,P<0.001)、初次性交年龄偏低(OR=1.22,95%CI:1.09~1.36,P<0.001)、受教育水平较低(OR=1.68,95%CI:1.23~2.29,P=0.001)、低收入(OR=2.25,95%CI:1.38~3.66,P=0.001)是HSV-1感染的危险因素。既往HSV-2(OR=0.96,95%CI:0.84~1.11,P>0.5)的感染与HSV-1的新发感染无关。结论应重点加强女性、青少年、社会底层人群的性知识及包括HSV-1在内病毒感染的宣传教育,并可根据不同年龄感染HSV-1的危险程度,制定候选疫苗临床试验的接种计划。

Objective To explore the global risk factors of herpes simplex virus type 1(HSV-1)infection so as to provide a reference for the epidemiological research and defense control of HSV-1 in China. Methods The research results of new HSV-1 infections and risk factors published worldside from 1980 to 2018 were summarized and analyzed comprehensively by meta-analysis. Heterogeneity test,combined effect quantity statistics analysis,bias test and sensitivity analysis were performed by using Review Manager5.3 software. Results The risk factors of HSV-1 infection included female(OR = 1. 33,95% CI:1. 20 ~ 1. 47,P < 0. 001),age of more than 40 years(OR = 2. 99,95% CI:1. 84 ~ 4. 86,P < 0. 001),low age of first sexual intercourse(OR = 1. 22,95% CI:1. 09 ~ 1. 36,P < 0. 001),low educational level(OR = 1. 68,95% CI:1. 23 ~ 2. 29,P = 0. 001),low income(OR = 2. 25,95% CI:1. 38 ~ 3. 66,P = 0. 001).Previous infection with HSV-2(OR = 0. 96,95% CI:0. 84 ~ 1. 11,P > 0. 5) was unrelated to the new infection.Conclusion Education on sexual knowledge and viral infection including HSV-1 should be strengthened in women,adolescents and population at the bottom of society. According to the risk degree of HSV-1 infection at different ages,a vaccination plan for clinical trials of candidate vaccines may be formulated.