Background While persistent infection by cytomegalovirus is associated with higher mortality risk in adults, the effect of infections by other herpesviruses on long-term clinical outcomes in immunocompetent older adults is less clear. We examined the relationship between herpesvirus infections and mortality and incident frailty risks in community-dwelling older women. Design Nested prospective cohort study. Setting Women’s Health and Aging Studies I and II. Participants Community-dwelling older women (n = 633) aged 70–79 years. Measurements Baseline serum antibody (immunoglobulin G) levels against four herpesviruses (herpes simplex virus types 1 [HSV-1] and 2 [HSV-2], varicella-zoster virus [VZV], and Epstein-Barr virus [EBV]), three-year incident frailty rates, and five-year mortality rates. Results Women seropositive for HSV-1 and HSV-2, but not VZV and EBV, had higher risks of three-year incident frailty (hazard ratio, 1.90 and 2.10; 95% confidence interval [CI], 0.96–3.74 and 1.05– 4.37, respectively for HSV-1 and HSV-2) and five-year mortality (hazard ratio, 1.73 and 1.80; 95% CI, 0.93–3.20 and 0.94–3.44) than seronegative women. Incremental increases in the serum HSV-1 and HSV-2 antibody levels were associated with incrementally higher risks of incident frailty and mortality. After adjustment for potential confounders, only higher serum HSV-2 antibody levels were independently predictive of higher risks of mortality in older women (hazard ratio for each unit increase in antibody index, 1.47; 95% CI, 1.05–2.07). Conclusion HSV-1 and HSV-2 antibody levels are not independently associated with risks of incident frailty in older women. Only HSV-2 antibody level is independently predictive of five-year mortality risk, with each incremental increase in the antibody level adding further risk.
【저자키워드】 Mortality, frailty, cytomegalovirus, herpesvirus, herpes simplex virus,