Population-Wide Associations between Common Viral Pathogens and Self-Reported Arthritis: NHANES 2009-2012.

IF 2.3 Q2 RHEUMATOLOGY International Journal of Rheumatology Pub Date : 2018-10-01 eCollection Date: 2018-01-01 DOI:10.1155/2018/7684942
Anna Shmagel, Grace Skemp-Dymond, Lisa Langsetmo, John T Schousboe, Kristine Ensrud, Robert Foley
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Abstract

Objective: Persistent infectious agents have been implicated in chronic and recurrent inflammation, which may trigger or worsen many types of arthritis. Our objective was to determine whether exposure to herpes simplex virus (HSV) and human papillomavirus (HPV) is associated with self-reported arthritis among US adults.

Methods: We used data from two consecutive cycles of the National Health and Nutrition Examination Survey (NHANES) from 2009 until 2012 (N of examined adults ages 20-69 = 9483). Participants were classified as having arthritis by self-report. Viral serology for HSV-1 and HSV-2 and HPV PCR studies from oral rinse and vaginal swabs were available for analysis. We compared HSV-1 and HSV-2 seropositivity as well as oral and vaginal HPV DNA positivity between participants with self-reported arthritis vs. those without, adjusting for age, gender, race, income, education, BMI, and the use of immunosuppressive medications. We used three comparator outcomes, gout, kidney stones, and hypertension, to evaluate whether the associations were specific or not to arthritis.

Results: Arthritis was associated with older age, female gender, non-Hispanic White and Non-Hispanic Black race, higher BMI, and lower socioeconomic status. HSV-2 seropositivity, but not HSV-1 seropositivity, was independently associated with arthritis after adjustment for age, gender, race, income, education, BMI, and the use of immunosuppressive medications: AOR 1.48 (1.10-1.99). Oral HPV DNA positivity was also independently associated with arthritis: AOR 1.63 (1.17-2.28). After adjustment, there was no statistically significant difference in vaginal HPV DNA positivity between those with vs. those without arthritis: AOR 1.22 (0.90-1.66). There were no significant associations between viral exposures and any of the comparator outcomes.

Conclusions: HSV-2 seropositivity and oral HPV DNA positivity were associated with self-reported arthritis and not with comparator outcomes, after adjustment for multiple potential confounders. These findings should be confirmed in longitudinal studies.

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常见病毒病原体与自我报告的关节炎之间的人群相关性:NHANES 2009-2012。
目的:持久性感染源与慢性和复发性炎症有关,这些炎症可能引发或加重多种类型的关节炎。我们的目的是确定暴露于单纯疱疹病毒(HSV)和人乳头瘤病毒(HPV)是否与美国成年人自我报告的关节炎有关。方法:我们使用了2009年至2012年连续两个周期的国家健康和营养检查调查(NHANES)的数据(20-69岁接受检查的成年人的N=9483)。参与者通过自我报告被归类为患有关节炎。HSV-1和HSV-2的病毒血清学以及口腔冲洗液和阴道拭子的HPV PCR研究可用于分析。我们根据年龄、性别、种族、收入、教育程度、BMI和免疫抑制药物的使用情况,比较了自我报告患有关节炎的参与者与未患有关节炎参与者之间的HSV-1和HSV-2血清阳性以及口腔和阴道HPV DNA阳性。我们使用了三种比较结果,痛风、肾结石和高血压,来评估这些相关性是否与关节炎有关。结果:关节炎与年龄较大、女性、非西班牙裔白人和非西班牙裔黑人、较高的BMI和较低的社会经济地位有关。在调整了年龄、性别、种族、收入、教育程度、BMI和免疫抑制药物的使用后,HSV-2血清阳性(而不是HSV-1血清阳性)与关节炎独立相关:AOR 1.48(1.10-1.99)。口腔HPV DNA阳性也与关节炎独立相关:AOR1.63(1.17-2.28)。调整后,关节炎患者与非关节炎患者的阴道HPV DNA阳性率没有统计学上的显著差异:AOR 1.22(0.90-1.66)。病毒暴露与任何对照结果之间没有显著关联。结论:在对多种潜在混杂因素进行校正后,HSV-2血清阳性和口腔HPV DNA阳性与自我报告的关节炎相关,而与对照结果无关。这些发现应该在纵向研究中得到证实。
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
9
审稿时长
24 weeks
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