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Viral infection increases the risk of idiopathic pulmonary fibrosis: A meta-analysis

Viral infection increases the risk of idiopathic pulmonary fibrosis: A meta-analysis
Viral infection increases the risk of idiopathic pulmonary fibrosis: A meta-analysis
Background
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic lung disease with a poor prognosis. Although many factors have been identified that possibly trigger or aggravate IPF, such as viral infection, the exact cause of IPF remains unclear. Until now, there has been no systematic review to assess the role of viral infection in IPF quantitatively.

Objective
This meta-analysis aims to present a collective view on the relationship between viral infection and IPF.

Methods
We searched studies reporting the effect of viral infection on IPF in the PubMed, Embase, Cochrane Library, Web of Science, and Wiley Online Library databases. We calculated ORs with 95% CIs to assess the risk of virus in IPF. We also estimated statistical heterogeneity by using I2 and Cochran Q tests and publication bias by using the funnel plot, Begg test, Egger test, and trim-and-fill methods. Regression, sensitivity, and subgroup analyses were performed to assess the effects of confounding factors, such as sex and age.

Results
We analyzed 20 case-control studies from 10 countries with 1,287 participants. The pooled OR of all viruses indicated that viral infection could increase the risk of IPF significantly (OR, 3.48; 95% CI, 1.61-7.52; P = .001), but not that of exacerbation of IPF (OR, 0.99; 95% CI, 0.47-2.12; P = .988). All analyzed viruses, including Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8), were associated with a significant elevation in the risk of IPF, except human herpesvirus 6 (HHV-6).

Conclusions
The presence of persistent or chronic, but not acute, viral infections, including EBV, CMV, HHV-7, and HHV-8, significantly increases the risk of developing IPF, but not exacerbation of IPF. These findings imply that viral infection could be a potential risk factor for IPF.
0012-3692
1175-1187
Sheng, Gaohong
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Chen, Peng
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Wei, Yanqiu
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Yue, Huihui
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Chu, Jiaojiao
af3ce72a-3acd-4703-bba7-e28394547154
Zhao, Jianping
fd8e4326-00d4-4c47-85f5-d1736a18e9cf
Wang, Yihua
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Zhang, Wanguang
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Zhang, Hui-Lan
7f78e69e-404e-42fd-a958-e5de6490e184
Sheng, Gaohong
621f1b85-7f78-42aa-ab0e-f44e88bcc8dc
Chen, Peng
bd31884a-90ef-4407-a57c-b58f30fbd61a
Wei, Yanqiu
3813330c-d875-414d-abad-b864c6e06269
Yue, Huihui
5dfc70bd-887f-4e04-ba8d-f3c0490e52a9
Chu, Jiaojiao
af3ce72a-3acd-4703-bba7-e28394547154
Zhao, Jianping
fd8e4326-00d4-4c47-85f5-d1736a18e9cf
Wang, Yihua
f5044a95-60a7-42d2-87d6-5f1f789e3a7e
Zhang, Wanguang
00484c62-0100-4fed-b82f-b919ff3e8ef0
Zhang, Hui-Lan
7f78e69e-404e-42fd-a958-e5de6490e184

Sheng, Gaohong, Chen, Peng, Wei, Yanqiu, Yue, Huihui, Chu, Jiaojiao, Zhao, Jianping, Wang, Yihua, Zhang, Wanguang and Zhang, Hui-Lan (2020) Viral infection increases the risk of idiopathic pulmonary fibrosis: A meta-analysis. Chest, 157 (5), 1175-1187. (doi:10.1016/j.chest.2019.10.032).

Record type: Article

Abstract

Background
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic lung disease with a poor prognosis. Although many factors have been identified that possibly trigger or aggravate IPF, such as viral infection, the exact cause of IPF remains unclear. Until now, there has been no systematic review to assess the role of viral infection in IPF quantitatively.

Objective
This meta-analysis aims to present a collective view on the relationship between viral infection and IPF.

Methods
We searched studies reporting the effect of viral infection on IPF in the PubMed, Embase, Cochrane Library, Web of Science, and Wiley Online Library databases. We calculated ORs with 95% CIs to assess the risk of virus in IPF. We also estimated statistical heterogeneity by using I2 and Cochran Q tests and publication bias by using the funnel plot, Begg test, Egger test, and trim-and-fill methods. Regression, sensitivity, and subgroup analyses were performed to assess the effects of confounding factors, such as sex and age.

Results
We analyzed 20 case-control studies from 10 countries with 1,287 participants. The pooled OR of all viruses indicated that viral infection could increase the risk of IPF significantly (OR, 3.48; 95% CI, 1.61-7.52; P = .001), but not that of exacerbation of IPF (OR, 0.99; 95% CI, 0.47-2.12; P = .988). All analyzed viruses, including Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8), were associated with a significant elevation in the risk of IPF, except human herpesvirus 6 (HHV-6).

Conclusions
The presence of persistent or chronic, but not acute, viral infections, including EBV, CMV, HHV-7, and HHV-8, significantly increases the risk of developing IPF, but not exacerbation of IPF. These findings imply that viral infection could be a potential risk factor for IPF.

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CHEST_2019 - Accepted Manuscript
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More information

Accepted/In Press date: 19 October 2019
e-pub ahead of print date: 12 November 2019
Published date: May 2020

Identifiers

Local EPrints ID: 435241
URI: http://eprints.soton.ac.uk/id/eprint/435241
ISSN: 0012-3692
PURE UUID: 383e792a-73ed-4a24-8b4c-ce37fa142318
ORCID for Yihua Wang: ORCID iD orcid.org/0000-0001-5561-0648

Catalogue record

Date deposited: 28 Oct 2019 17:30
Last modified: 26 Nov 2021 05:54

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Contributors

Author: Gaohong Sheng
Author: Peng Chen
Author: Yanqiu Wei
Author: Huihui Yue
Author: Jiaojiao Chu
Author: Jianping Zhao
Author: Yihua Wang ORCID iD
Author: Wanguang Zhang
Author: Hui-Lan Zhang

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