Background: Pulmonary tuberculosis (TB), a global health problem, is typically caused by the bacterium Mycobacterium tuberculosis. Herpes zoster (HZ) is caused by the reactivation of the varicella-zoster virus (VZV). The reactivation of VZV can be caused by stress. We investigated whether pulmonary TB increases the risk of HZ development. Methods: This study used data that sampled a population of 2 million people in 2000 from the National Health Insurance Research Database. This cohort study observed Taiwanese patients aged 20–100 years with pulmonary TB from 2000 to 2017 (tracked to 2018). Pulmonary TB was defined as having two or more outpatient diagnoses or at least one admission record. To address potential bias caused by confounding factors, the control cohort and pulmonary TB cohort were matched 1:1 by age, gender, index year, and comorbidities. Patients with HZ before the index date were excluded. Results: A total of 30,805 patients were in the pulmonary TB and control cohorts. The incidence rate of HZ in pulmonary TB and control cohorts were 12.00 and 9.66 per 1000 person-years, respectively. The risk of HZ in the pulmonary TB cohort (adjusted hazard ratios = 1.23; 95% confidence interval = 1.16–1.30) was significantly higher than that of in control cohort. Among patients without comorbidities, the patients with TB were 1.28-fold more likely to have HZ than those without TB. Conclusion: Patients with TB should be well treated to avoid the potential risk of HZ occurrence. Although we identified the association between pulmonary TB and HZ, further studies are needed to confirm the result.

Background: The association between polycystic ovary syndrome (PCOS) and the risk of herpes zoster (HZ) remains unclear. This study investigated the risk of HZ in women with PCOS. Methods: This study used data from the Longitudinal Generation Tracking Database (LGTD 2005) which contains the information of 2 million randomly selected from National Health Insurance beneficiaries. Patients who received a diagnosis of PCOS between 2000 and 2017 were included in the PCOS cohort. Patients who were not diagnosed as having PCOS were randomly selected from the LGTD 2005 and included in the control cohort. Patients who were aged <20 years and had a history of HZ before the index date were excluded. Patients who were in both the cohorts were matched at a ratio of 1:1 through propensity score matching based on age, comorbidities, and medication. The primary outcome was the diagnosis of HZ. Results: A total of 20,142 patients were included in each case and control cohorts. The incidence rates of HZ in the PCOS and control cohorts were 3.92 and 3.17 per 1000 person-years, respectively. The PCOS cohort had a significantly higher risk of HZ than did the control cohort (adjusted hazard ratios [aHR] = 1.26). Among the patients aged 30–39 years, those with PCOS had a significantly higher risk of HZ than did those without PCOS (aHR = 1.31). Among the patients without any comorbidities, those with PCOS had a significantly higher risk of HZ (aHR = 1.26) than did those without PCOS. Conclusion: PCOS is associated with the risk of HZ, especially in young women. The risk of HZ should be addressed while treating patients with PCOS. An HZ vaccine is recommended for these patients.

Background and Objectives: Obstructive sleep apnea (OSA) is a clinically relevant comorbidity in both alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). However, whether its impact differs between these etiologies remains unclear. This study directly compared OSA risk in patients with AFLD and NAFLD to elucidate its role in disease progression. Materials and Methods: We conducted a retrospective cohort study using the TriNetX research network. Adults aged ≥ 20 years with newly diagnosed AFLD or NAFLD between 2006 and 2020 were included. Propensity score matching was applied to balance demographic and clinical covariates. The primary endpoint was incident OSA, assessed at 1-, 2-, 3-, and 5-year intervals, and cumulatively through 28 September 2025. Effect estimates were expressed as relative risk, odds ratio and hazard ratio (HR). Results: Before matching, 896,302 NAFLD and 12,694 AFLD patients were identified; after 1:1 PSM, 11,583 patients remained in each group with balanced baseline characteristics. NAFLD patients consistently demonstrated higher OSA risk. Post-matching, OSA incidence became significantly elevated from year 2 onward (HR at 2 years = 1.764) and persisted at 3 years (HR = 2.078), 5 years (HR = 1.950), and cumulative follow-up (HR = 1.940). Conclusions: NAFLD confers nearly double the long-term OSA risk compared with AFLD. These findings support longitudinal OSA screening and targeted risk reduction strategies in NAFLD populations.

Background: Obstructive sleep apnea (OSA) is common in patients with chronic respiratory disease, but whether its risk differs between emphysema and bronchiectasis remains unclear. We compared the subsequent risk of OSA between these two structural lung diseases using a large real-world database. Methods: This retrospective cohort study used data from the TriNetX research network. Adults with emphysema or bronchiectasis were identified and followed for incident OSA. Baseline demographic characteristics, comorbidities, and medication use were balanced using 1:1 propensity score matching. OSA risk was evaluated at 1-, 2-, 3-, 4-, and 5-year intervals and cumulatively through 29 July 2026, using risk ratios, odds ratios, and hazard ratios (HRs). Results: Before matching, 526,877 patients with emphysema and 147,700 with bronchiectasis were included. After propensity score matching, 129,761 patients remained in each cohort, with all standardized differences below 0.10. In the matched analysis, OSA risk was modestly lower in the emphysema group at 1 year (HR = 0.829, 95% CI = 0.778–0.883), 2 years (0.885, 0.843–0.931), 3 years (0.923, 0.884–0.964), 4 years (0.946, 0.910–0.984), and 5 years (0.960, 0.925–0.995). However, the cumulative hazard did not differ significantly between groups (HR = 1.006, 95% CI = 0.976–1.038). Conclusion: After propensity score matching, bronchiectasis was associated with a modestly higher early risk of OSA, but this difference diminished over time and was absent over long-term follow-up. These findings should be considered hypothesis-generating and warrant prospective confirmation.