Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Oct 27;102(43):e34503.
doi: 10.1097/MD.0000000000034503.

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

Rowan H Elhalag  1 , Karam R Motawea  1 , Nesreen Elsayed Talat  1 , Samah S Rouzan  1 , Sarraa M Reyad  1 , Soliman M Elsayed  1 , Pensée Chébl  1 , Marwan Abowafia  1 , Jaffer Shah  2
Affiliations
Meta-Analysis

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

Rowan H Elhalag et al. Medicine (Baltimore). .

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.

PubMed Disclaimer

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Prisma flow diagram.
Figure 2.
Figure 2.
Forest plot explaining the incidences of dementia in the HZV group compared with the no HZV group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 3.
Figure 3.
Forest plot explaining the incidences of AD in the HZV group compared with the no HZV group. AD = Alzheimer’s disease, CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 4.
Figure 4.
Forest plot explaining the presence of Amylin in the HZV group compared with the no HZV group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 5.
Figure 5.
Forest plot explaining the presence of Aβ40 in the HZV group compared with the no HZV group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 6.
Figure 6.
Forest plot explaining the presence of Aβ42 in the HZV group compared with the no HZV group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 7.
Figure 7.
Forest plot explaining the presence of Amyloid in the HZV group compared with the no HZV group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 8.
Figure 8.
Forest plot explaining the incidence of HZV in the dementia group compared with the no dementia group. CI = confidence interval, HZV = Herpes Zoster Virus.
Figure 9.
Figure 9.
Forest plot explaining the association between patients who have HZO and the incidence of dementia. CI = confidence interval, HZO = Herpes Zoster Ophthalmicus.
See this image and copyright information in PMC

References

    1. Sacks D, Baxter B, Campbell BCV, et al.; From the American Association of Neurological Surgeons (AANS), American Society of Neuroradiology (ASNR), Cardiovascular and Interventional Radiology Society of Europe (CIRSE), Canadian Interventional Radiology Association (CIRA), Congress of Neurological Surgeons (CNS), European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), European Stroke Organization (ESO), Society for Cardiovascular Angiography and Interventions (SCAI), Society of Interventional Radiology (SIR), Society of NeuroInterventional Surgery (SNIS), and World Stroke Organization (WSO). Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute ischemic stroke. Int J Stroke. 2018;13:612–32. - PubMed
    1. Organization WH. Dementia: A Public Health Priority. World Health Organization. 2012.
    1. Elahi FM, Miller BL. A clinicopathological approach to the diagnosis of dementia. Nat Rev Neurol. 2017;13:457–76. - PMC - PubMed
    1. Prince MJ, Wimo A, Guerchet MM, et al. World Alzheimer Report 2015-The Global Impact of Dementia: an analysis of prevalence, incidence, cost and trends. 2015. (Doctoral dissertation, Alzheimer's Disease International)
    1. Crous-Bou M, Minguillón C, Gramunt N, et al. Alzheimer’s disease prevention: from risk factors to early intervention. Alzheimer’s Res Ther. 2017;9:1–9. - PMC - PubMed