Abstract
Recent data suggests that herpes zoster (HZ) and herpes simplex virus (HSV) may be one of the underlying immunological triggers for giant cell arteritis (GCA). However, there is limited population-based data to support this. Our goal was to determine if herpetic infections increase the likelihood of GCA in the British Columbia (BC) population. The background prevalence of GCA was compared to the prevalence of GCA in subjects with HZ and HSV using diagnostic billing code data from an online BC database (BC Data ScoutTM). BC residents ≥30 years old at the time of diagnosis from January 2000 to January 2019 were included. The relevant International Classification of Disease codes was used to identify patients with GCA, HZ, and HSV. Comparisons were made using two-sample Z tests. There were 4315 GCA diagnoses, from a total population of 3,026,005 subjects. The prevalence of GCA was 143 per 100,000 people. In terms of herpetic infections, 850 GCA cases were identified in 249,900 subjects with HZ versus 310 diagnoses of GCA in 163,170 subjects with HSV. The prevalence of GCA in subjects with HZ (0.340%) was significantly higher than the prevalence of GCA (0.143%) in the general population (p < 0.00001). The prevalence of GCA in HSV subjects (0.190%) was also significantly higher (p < 0.00001) than the population prevalence but lower than (p < 0.00001) the GCA with HZ prevalence. The likelihood of GCA appears to increase with herpetic infections, more significantly with HZ.
Highlights
Giant cell arteritis (GCA), known as temporal arteritis, is a chronic granulomatous medium and large vessel vasculitis which can have devastating vision and life threatening consequences [1]
The population-level data extracted from BC Data ScoutTM showed a total population of 3,026,005 British Columbia (BC) residents who were ≥30 years old by January 1, 2000
The number of giant cell arteritis (GCA) diagnoses were the same, illustrating that all patients were diagnosed with GCA after 50 years of age
Summary
Giant cell arteritis (GCA), known as temporal arteritis, is a chronic granulomatous medium and large vessel vasculitis which can have devastating vision and life threatening consequences [1]. Antigens and DNA for VZV and HSV were found in GCA positive temporal artery biopsies in multiple studies [5,6,7,8], more convincingly in the case of VZV than HSV. These studies remain inconclusive as there are similar studies which show little to no relationship to the same agents [8,9,10,11,12]. VZV studies that were identified by the same research group may be due to non-specific background immunostaining rather than a true positive finding [13]. Columbia (BC), Canada, to determine if HZ or HSV infection correlates with GCA
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