Pilot study of antibodies against varicella zoster virus and human immunodeficiency virus in relation to the risk of developing stroke, nested within a rural cohort in Uganda

• DOI: 10.1111/tmi.12556
• Publication Date: 2015-06-17T14:41:20Z
• Authors: Gershim Asiki; Lisa Stockdale; Ivan Kasamba; Tobias Vudriko; Grace Tumwekwase; Tom Johnston; Pontiano Kaleebu; Anatoli Kamali; Janet Seeley; Robert Newton
• Keywords: Male; Herpesvirus 3, Human; HIV; Pilot Projects; Middle Aged; 3. Good health; Stroke; 03 medical and health sciences; 0302 clinical medicine; Immunoglobulin M; Case-Control Studies; Immunoglobulin G; Humans; Female; Uganda; Prospective Studies; Aged

AbstractObjectiveThe risk of stroke rises after episodes of herpes zoster and chickenpox, which are caused by varicella zoster virus (VZV). We conducted a pilot case–control study of stroke, nested within a long‐standing cohort in Uganda (the General Population Cohort), to examine antibodies against VZV prior to diagnosis.MethodsWe used stored sera to examine the evolution of IgG and IgM antibodies against VZV among 31 clinically confirmed cases of stroke and 132 matched controls. For each participant, three samples of sera were identified: one each, taken at or near the time of (pseudo)diagnosis, between 5 and 10 years prior to diagnosis and at 15 years prior to diagnosis.ResultsAll participants had detectable antibodies against VZV, but there were no significant differences between cases and controls in the 15 years prior to diagnosis. As a secondary finding, 16% (5/31) of cases and 6% (8/132) of controls had HIV (OR 3.0; 95% CI 0.8–10.1; P = 0.06).ConclusionsThis is the first prospective study to examine a biological measure of exposure to VZV prior to diagnosis of stroke and although we identified no significant association, in this small pilot, with limited characterisation of cases, we cannot exclude the possibility that the virus is causal for a subset. The impact of HIV on risk of stroke has not been well characterised and warrants further study.