TY - JOUR
T1 - Association between nucleos(t)ide analogue therapy for hepatitis B and Sjögren’s syndrome
T2 - 15-year analysis of the national database of Taiwan
AU - Tung, Chien Hsueh
AU - Li, Chung Yi
AU - Chen, Yen Chun
AU - Chen, Yi Chun
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd
PY - 2021/5
Y1 - 2021/5
N2 - Hepatitis B virus (HBV) infection has been proposed to play a role in the development of Sjögren's syndrome. However, to date, there are no reports on the risk of SS in HBV-infected patients following nucleos(t)ide analogue therapy. Due to Taiwan has higher prevalence of HBV infection and therapy was well recorded in the Taiwan's single-payer national health insurance database, we hypothesized that a long-term retrospective analysis of the risk of Sjögren's syndrome in HBV-infected patients following nucleotide therapy will increase our understanding of Sjögren's syndrome development following HBV infection. We identified 26,147 adults diagnosed with HBV infection between 1997 and 2012 in claims data. Finally, a total of 3268 HBV-infected patients who ever received nucleotide therapy (treated cohort) were frequency-matched on age and sex at 1:4 ratios to select a control group of 13,072 counterparts without therapy (untreated cohort). To identify Sjögren's syndrome risk, competing risk analysis adjusted for all covariates was performed. The risk was significantly lower in the treated cohort (15-year cumulative incidence, 2.4%; 95% confidence interval [CI], 1.4%–3.7%) than in the untreated cohort (7.1%; 95% CI, 2.5%–15.2%) (p =.015), and the adjusted HR was 0.6 (95% CI, 0.41–0.88; p =.009). Multivariable stratified analysis further verified the consistent associations between nucleoside therapy and risk reduction of Sjögren's syndrome across all strata. Our finding suggests that HBV infection treated with nucleotides is associated with lower risk of Sjögren's syndrome, implying a potential role of HBV infection in the development of Sjögren's syndrome.
AB - Hepatitis B virus (HBV) infection has been proposed to play a role in the development of Sjögren's syndrome. However, to date, there are no reports on the risk of SS in HBV-infected patients following nucleos(t)ide analogue therapy. Due to Taiwan has higher prevalence of HBV infection and therapy was well recorded in the Taiwan's single-payer national health insurance database, we hypothesized that a long-term retrospective analysis of the risk of Sjögren's syndrome in HBV-infected patients following nucleotide therapy will increase our understanding of Sjögren's syndrome development following HBV infection. We identified 26,147 adults diagnosed with HBV infection between 1997 and 2012 in claims data. Finally, a total of 3268 HBV-infected patients who ever received nucleotide therapy (treated cohort) were frequency-matched on age and sex at 1:4 ratios to select a control group of 13,072 counterparts without therapy (untreated cohort). To identify Sjögren's syndrome risk, competing risk analysis adjusted for all covariates was performed. The risk was significantly lower in the treated cohort (15-year cumulative incidence, 2.4%; 95% confidence interval [CI], 1.4%–3.7%) than in the untreated cohort (7.1%; 95% CI, 2.5%–15.2%) (p =.015), and the adjusted HR was 0.6 (95% CI, 0.41–0.88; p =.009). Multivariable stratified analysis further verified the consistent associations between nucleoside therapy and risk reduction of Sjögren's syndrome across all strata. Our finding suggests that HBV infection treated with nucleotides is associated with lower risk of Sjögren's syndrome, implying a potential role of HBV infection in the development of Sjögren's syndrome.
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U2 - 10.1111/jvh.13481
DO - 10.1111/jvh.13481
M3 - Article
C2 - 33550705
AN - SCOPUS:85100990474
SN - 1352-0504
VL - 28
SP - 809
EP - 816
JO - Journal of Viral Hepatitis
JF - Journal of Viral Hepatitis
IS - 5
ER -