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Meta-Analysis
. 2020 Mar;10(3):e01549.
doi: 10.1002/brb3.1549. Epub 2020 Feb 4.

Bacterial, viral, and fungal infection-related risk of Parkinson's disease: Meta-analysis of cohort and case-control studies

Hui Wang  1 , Xi Liu  1 , Changhong Tan  1 , Wen Zhou  1 , Jin Jiang  1 , Wuxue Peng  1 , Xuan Zhou  1 , Lijuan Mo  1 , Lifen Chen  1
Affiliations
Meta-Analysis

Bacterial, viral, and fungal infection-related risk of Parkinson's disease: Meta-analysis of cohort and case-control studies

Hui Wang et al. Brain Behav. 2020 Mar.

Abstract

Aims: Recent studies showed that patients with various bacterial, viral, and fungal infections might be at increased risk of Parkinson's disease (PD). However, the risk of PD in patients with each specific infection varied. This meta-analysis estimated the association between various infections and PD risk.

Methods: Literature published from January 1965 to October 2019 in PubMed and EMBASE databases was searched. Data were extracted and pooled using random/fixed effects model. Sensitivity analysis and meta-regression were also performed to analyze the source of heterogeneity. Publication bias was estimated by the trim and fill.

Results: Twenty-three out of 6,609 studies were included. Helicobacter pylori (HP; pooled OR = 1.653, 1.426-1.915, p < .001), hepatitis C virus (HCV; pooled OR = 1.195, 1.012-1.410, p = .035), Malassezia (pooled OR = 1.694, 1.367-2.100, p < .001), and pneumoniae (pooled OR = 1.595, 1.020-2.493, p = .041) infection were associated with increased PD risk. Influenza virus, herpes virus, hepatitis B virus, scarlet fever, mumps virus, chicken pox, pertussis, German measles, and measles were not associated with PD risk. After antiviral treatment against HCV reduced the risk of PD in patients with HCV infection (OR = 0.672, 0.571-0.791, p < .001). Significant heterogeneity exists among the included studies.

Conclusion: Patients with infection of HP, HCV, Malassezia, pneumoniae might be an increased risk of PD. Antiviral treatment of HCV could reduce the risk of PD.

Keywords: Helicobacter pylori; Malassezia; Parkinson disease; hepatitis C virus; infection; meta-analysis; pneumoniae; risk.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of literature screening
Figure 2
Figure 2
Forest plot for the pooled odds ratios (ORs) showed positive association between Helicobacter pylori (HP; a), hepatitis C virus (HCV; b), Malassezia (c), pneumoniae (d), and measles (f) the risk of Parkinson's disease (PD). Pooled OR of measles showed significant association with risk of PD after excluding one study that was responsible for heterogeneity (e)
Figure 3
Figure 3
Forest plot for the pooled odds ratios (ORs) of antiviral treatment against hepatitis C virus (HCV) showed antiviral treatment against HCV significant reduced the risk of Parkinson's disease (PD)
Figure 4
Figure 4
Forest plot for the pooled odds ratios (ORs) showed that hepatitis B virus (HBV; a), chicken pox (b), German measles (c), herpes virus (HSV; d), influenza virus (e), mumps (f),scarlet fever (g), and whooping cough (pertussis; h) infection had no association with the risk of Parkinson's disease (PD)
Figure 5
Figure 5
Sensitivity analysis for studies on hepatitis B virus (HBV; a), herpes virus (HSV; b), influenza virus (c), measles (d), mumps (e), and hepatitis C virus (HCV; f) for the risk of Parkinson's disease (PD)
Figure 6
Figure 6
Meta‐regression analysis for studies on hepatitis B virus (HBV; a), herpes virus (HSV; b), and influenza virus (c) based on year of publication, study design, sample type, infection detection methods, and diagnostic criteria of Parkinson's disease (PD)
Figure 7
Figure 7
Publication bias analysis of studies on Helicobacter pylori (HP; a), hepatitis C virus (HCV; b), Malassezia (c), pneumoniae (d), and measles (e) infection estimated by Trill and Filled methods showed significant publication bias
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