Abstract
To investigate the risk of haematologic and solid organ malignancies in patients with haemorrhagic fever with renal syndrome (HFRS) compared with the general population. This propensity-score-matched cohort study was conducted using data collected from the Korean national health insurance service (NHIS) between January 2003 and December 2017. The HFRS cohort included 5888 newly diagnosed cases of HFRS, and 412,804 general participants from the NHIS database were included as the control cohort. The incidence rate of malignancies was assessed and compared between the HFRS and control cohorts. There were 64 cases of haematologic malignancy in 236,286 person-years of observation, and 1245 cases of solid organ cancer in 209,333 person-years. The risks of haematologic malignancy and solid organ cancer were significantly higher in the HFRS cohort [adjusted hazards ratio (aHR) 4.10, 95% confidence interval (CI) 2.36-7.14] than the control cohort [aHR 2.97, 95% CI 2.60-3.38). In subgroup analysis, the HFRS cohort was associated with high hazard ratios for leukaemia and non-Hodgkin lymphoma. The HFRS cohort also had increased aHRs for all types of solid organ cancer. Patients with HFRS are at increased risk of both haematologic and solid organ malignancies compared with the general population, and this increased proportionally over time. Careful monitoring for malignancy after the onset of HFRS may be necessary.
Highlights
Haemorrhagic fever with renal syndrome (HFRS) is a clinical syndrome characterized by fever, capillary haemorrhage and acute renal impairment
This study was conducted to investigate the risk of malignancies associated with HFRS
This nationwide PSM cohort study investigated the association between a history of hospitalization due to HFRS and the risk of malignancy compared with the general population
Summary
Haemorrhagic fever with renal syndrome (HFRS) is a clinical syndrome characterized by fever, capillary haemorrhage and acute renal impairment. HFRS is well known to have an acute clinical course with minimal sequelae after recovery (Outinen et al, 2015), a few recent studies have suggested that hantavirus infection may be associated with increased risk of chronic diseases (Vaheri et al, 2013). In a long-term cohort study, 46 patients with hantavirus infection showed higher ambulatory blood pressure and higher glomerular filtration than healthy controls (Mäkelä et al, 2000). Another prospective study, conducted in the USA, found increased proteinuria (15/30 patients) and decreased creatinine clearance (9/30 patients) for up to 5 years of follow-up in a cohort of patients with hantavirus cardiopulmonary syndrome (Pergam et al, 2009)
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