TY - JOUR
T1 - Re-examination of the risk of autoimmune diseases after dengue virus infection
T2 - A population-based cohort study
AU - Shihid, Hsin I.
AU - Chi, Chia Yu
AU - Tsai, Pei Fang
AU - Wang, Yu Ping
AU - Chien, Yu Wen
N1 - Funding Information:
This study was partially supported by grants from the Ministry of Science and Technology, Taiwan (MOST 107-2314-B-006-075-MY3[YWC], MOST 110-2625-M-006-009-[HIS], MOST 111-2625-M-006-016 [HIS]), National Health Research Institute (MR-108-GP-03 [CYC], MR-110-GP-03 [CYC], and MR-111-GP-05 [CYC]), and National Cheng Kung University Hospital (NCKUH-11103007[HIS]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funder’s website: Ministry of Science and Technology, Taiwan: https://www.most.gov. tw/ National Health Research Institutes: https:// www.nhri.edu.tw/.
Publisher Copyright:
© 2023 Shih et al.
PY - 2023/3
Y1 - 2023/3
N2 - Previous studies suggested that dengue was associated with an increased risk of several autoimmune diseases. However, this association still needs to be explored due to the limita-tions of these studies. A population-based cohort study was conducted using national health databases in Taiwan and included 63,814 newly diagnosed, laboratory-confirmed dengue patients between 2002 and 2015 and 1:4 controls (n = 255,256) matched by age, sex, area of residence and symptom onset time. Multivariate Cox proportional hazard regression mod-els were used to investigate the risk of autoimmune diseases after dengue infection. Den-gue patients had a slightly higher risk of overall autoimmune diseases than non-dengue controls (aHR 1.16; P = 0.0002). Stratified analyses by specific autoimmune diseases showed that only autoimmune encephalomyelitis remained statistically significant after Bon-ferroni correction for multiple testing (aHR 2.72; P < 0.0001). Sixteen (0.025%) dengue patients and no (0%) controls developed autoimmune encephalomyelitis in the first month of follow-up (HR >9999, P < 0.0001), but the risk between groups was not significantly different thereafter. Contrary to previous studies, our findings showed that dengue was associated with an increased short-term risk of a rare complication, autoimmune encephalomyelitis, but not associated with other autoimmune diseases.
AB - Previous studies suggested that dengue was associated with an increased risk of several autoimmune diseases. However, this association still needs to be explored due to the limita-tions of these studies. A population-based cohort study was conducted using national health databases in Taiwan and included 63,814 newly diagnosed, laboratory-confirmed dengue patients between 2002 and 2015 and 1:4 controls (n = 255,256) matched by age, sex, area of residence and symptom onset time. Multivariate Cox proportional hazard regression mod-els were used to investigate the risk of autoimmune diseases after dengue infection. Den-gue patients had a slightly higher risk of overall autoimmune diseases than non-dengue controls (aHR 1.16; P = 0.0002). Stratified analyses by specific autoimmune diseases showed that only autoimmune encephalomyelitis remained statistically significant after Bon-ferroni correction for multiple testing (aHR 2.72; P < 0.0001). Sixteen (0.025%) dengue patients and no (0%) controls developed autoimmune encephalomyelitis in the first month of follow-up (HR >9999, P < 0.0001), but the risk between groups was not significantly different thereafter. Contrary to previous studies, our findings showed that dengue was associated with an increased short-term risk of a rare complication, autoimmune encephalomyelitis, but not associated with other autoimmune diseases.
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U2 - 10.1371/journal.pntd.0011127
DO - 10.1371/journal.pntd.0011127
M3 - Article
C2 - 36881559
AN - SCOPUS:85149493384
SN - 1935-2727
VL - 17
JO - PLoS neglected tropical diseases
JF - PLoS neglected tropical diseases
IS - 3
M1 - e0011127
ER -