Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Varicella-Zoster Virus Reactivation and Increased Vascular Risk in People Living With HIV: Data From a Retrospective Cohort Study

Deborah Fiordelisi
,
Mariacristina Poliseno
* ORCID logo ,
Nicolo' De Gennaro
,
Eugenio Milano
ORCID logo ,
Carmen Rita Santoro
,
Francesco Vladimiro Segala
ORCID logo ,
Carlo Felice Franco
,
Giorgia Manco Cesari
,
Luisa Frallonardo
,
Giacomo Guido
,
Giuliana Metrangolo
,
Greta Romita
,
Francesco Di Gennaro
,
Annalisa Saracino
Version 1 : Received: 5 October 2023 / Approved: 6 October 2023 / Online: 6 October 2023 (06:16:58 CEST)

A peer-reviewed article of this Preprint also exists.

Fiordelisi, D.; Poliseno, M.; De Gennaro, N.; Milano, E.; Santoro, C.R.; Segala, F.V.; Franco, C.F.; Manco Cesari, G.; Frallonardo, L.; Guido, G.; Metrangolo, G.; Romita, G.; Di Gennaro, F.; Saracino, A. Varicella-Zoster Virus Reactivation and Increased Vascular Risk in People Living with HIV: Data from a Retrospective Cohort Study. Viruses 2023, 15, 2217. Fiordelisi, D.; Poliseno, M.; De Gennaro, N.; Milano, E.; Santoro, C.R.; Segala, F.V.; Franco, C.F.; Manco Cesari, G.; Frallonardo, L.; Guido, G.; Metrangolo, G.; Romita, G.; Di Gennaro, F.; Saracino, A. Varicella-Zoster Virus Reactivation and Increased Vascular Risk in People Living with HIV: Data from a Retrospective Cohort Study. Viruses 2023, 15, 2217.

Abstract

Background: The increased vascular risk associated to Varicella- Zoster Virus (VZV) reactivation is extensively established in the general population. This retrospective cohort study investigates whether this observation holds true for People Living With HIV (PLWH), a group already con-fronting heightened cardiovascular risk. Methods: Among PLWH who initiated antiretroviral therapy (ART) at our center and have been under our care for > 24 months since January 1st, 2005, individuals with a history of Herpes Zoster (HZ) were identified and compared their features with those of PLWH with no history of HZ. The prevalence of ischemic events (Deep Venous Thrombosis, Stroke, Acute Myocardial Infarction) was calculated and compared using Chi Square. Odds Ratios (O.R.) with 95% Confidence Intervals (C.I.) for ischemic events following HZ were evaluated through univariate and multivariate logistic regression. Results: Overall, 45/581 PLWH reported HZ. Ischemic events followed HZ significantly more often than the other group (13% vs. 5%, p=0.01). Both positive serology for VZV and HZ correlated with increased ischemic risk (O.R. 4.01, 95% C.I. 1.38-11.6, p=0.01 and O.R. 3.14, 95% C.I. 1.12-7.68, p=0.02, respectively), though pre-existing heart disease demonstrated stronger predictive value in multivariate analysis(O.R. 8.68, 95% C.I. 2.49-29.50, p=0.001). Conclusions: VZV potentially exacerbates vascular risk for PLWH, particularly in the presence of other predisposing factors. Further research is needed to confirm our data.

Keywords

Varicella-Zoster Virus; VZV; HIV; Stroke; Vascular risk

Subject

Medicine and Pharmacology, Clinical Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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