Abstract：
This study aims to investigate the significant relationship between serum heavy metals (lead [Pb], cadmium [Cd], mercury [Hg]) and the risk of herpes simplex virus type 1 (HSV-1) infection. Data were derived from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 2007 to 2016. This nationally representative survey, conducted by the National Center for Health Statistics, assessed the health status of participants through interviews, physical examinations, and laboratory tests. After excluding participants lacking serum Pb, Cd, and Hg data, as well as those missing HSV-1 testing data and pregnant women, the analysis included 13 772 participants, among whom 3363 were adolescents. A survey-weighted multivariate logistic regression model was used to evaluate the association between heavy metal exposure and the risk of HSV-1 infection, and to explore the dose-response relationship between them. In adults and adolescents, serum concentrations of Pb and Cd were higher in those infected with HSV-1 than in those not infected. However, an increase in serum Hg concentration was observed only in infected adolescents. After adjusting for potential confounders, elevated serum Pb and Cd concentrations in adults were associated with an increased risk of HSV-1 infection. Higher serum Pb and Cd concentrations were associated with an increased risk of HSV-2 infection, irrespective of HSV-1 infection status. In adults, serum concentrations of Pb and Hg showed an approximately linear relationship with HSV-1 infection risk (p for nonlinearity > 0.05), whereas the dose-response relationship between serum Cd concentration and HSV-1 infection was nonlinear (p for nonlinearity = 0.004). In adolescents, serum concentrations of heavy metals (Pb, Cd, Hg) showed an approximately linear relationship with HSV-1 infection (p for nonlinearity > 0.05). Furthermore, the study examined the relationship between serum heavy metal levels and the risk of HSV-1 infection across different genders, races, income levels, weight statuses, and immune statuses. In conclusion, there is a significant association between serum heavy metal concentrations and HSV-1 infection, which warrants further investigation into the causal relationship between them.
摘要：
本研究旨在探讨血清重金属(铅[Pb]，镉[Cd],汞[Hg]）和1型单纯疱疹病毒（HSV-1）感染的风险。数据来自2007年至2016年在美国进行的国家健康和营养检查调查（NHANES）。这项具有全国代表性的调查，由国家卫生统计中心进行，通过访谈评估参与者的健康状况，体检,和实验室测试。排除缺乏血清铅的参与者后，Cd,汞数据，以及那些缺少HSV-1检测数据和孕妇，分析包括13772名参与者，其中青少年3363人。使用调查加权多变量逻辑回归模型评估重金属暴露与HSV-1感染风险之间的关系。并探讨它们之间的剂量-反应关系。在成人和青少年中，感染HSV-1的人的血清Pb和Cd浓度高于未感染的人。然而,仅在受感染的青少年中观察到血清Hg浓度升高。在调整了潜在的混杂因素后，成人血清Pb和Cd浓度升高与HSV-1感染风险增加相关.较高的血清铅和镉浓度与HSV-2感染的风险增加有关。与HSV-1感染状态无关。在成年人中,血清Pb和Hg浓度与HSV-1感染风险呈近似线性关系(P表示非线性>0.05),而血清Cd浓度与HSV-1感染之间的剂量-反应关系是非线性的（非线性p=0.004）。在青少年中,血清重金属浓度(Pb，Cd,Hg）与HSV-1感染呈近似线性关系（p表示非线性>0.05）。此外，该研究检查了血清重金属水平与不同性别的HSV-1感染风险之间的关系，种族,收入水平,重量状态,和免疫状态。总之,血清重金属浓度与HSV-1感染之间存在显著关联，这需要进一步调查它们之间的因果关系。
