[Infection-induced vascular disease: little evidence according to the Koch's postulates]

Infections with Cytomegalovirus, influenza virus, HIV and Chlamydophila pneumoniae may contribute to the development of vascular disease by infecting the vascular wall directly or by initiating and propagating low-grade chronic inflammation. Although this association appears plausible, it hardly fulfils Koch's postulates. Based on the results of large randomised trials, it appears that antibiotic treatment targeting C. pneumoniae does not reduce the incidence of new vascular events in patients with clinically manifest vascular disease. Influenza vaccination reduces the incidence of vascular disorders. Therefore efforts to optimise participation of high-risk patients in the influenza vaccination programme are advisable.