title: 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.
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  All 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).
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Stockdale
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Ivan
authors.initials: I
authors.lastname: Kasamba
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Tobias
authors.initials: T
authors.lastname: Vudriko
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Grace
authors.initials: G
authors.lastname: Tumwekwase
authors.affiliation: Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Johnston
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.|London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.affiliation: Medical Research Council, Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda.|Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.|International Agency for Research on Cancer, Lyon, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Newton
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D020521:Stroke / Q000276:immunology* / Q000821:virology*; D014454:Uganda
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Cohorte; Ictus; Ouganda; Prospectivo; Uganda; VIH; Virus de Varicela Zoster; cohort; cohorte; human immunodeficiency virus; maladies; prospective; stroke; varicella zoster virus; virus varicelle-zona