Abstract
The data concerning the association between dengue viruses (DV) infection and autoimmune diseases (ADs) remain unclear and are scarce. This nationwide population-based cohort study assessed the risk of ADs among patients with DV infection. We analyzed Taiwanese medical data from the Registry of the National Notifiable Disease Reporting System of Taiwan’s Centers for Disease Control between 1998 and 2015 and identified patients with DV infection. From the entire general population data in the National Health Insurance Research Database, we randomly selected a comparison cohort that was individual matching by age, sex, residence, and index date. We analyzed the risk of ADs using a Cox proportional hazards regression model stratified by sex, age, and residence. We enrolled 29,365 patients with DV infection (50.68% men; mean age, 44.13 years) and 117,460 age-, sex-, and residence-matched controls in the present study. The incidence rates of organ-specific ADs were nonsignificantly higher in the DV cohort than in the non-DV control cohort. An approximately 70% lower risk of primary Sjogren syndrome (pSS) was evident in the DV cohort than in the non-DV control cohort with an adjusted hazard ratio of 0.30 (95% confidence interval 0.13–0.67) after adjusting for comorbidities in matched design. By contrast, the other systemic ADs were nonsignificantly lower in the DV cohort than in the non-DV control cohort. This nationwide long-term cohort study demonstrated that patients with DV infection had a lower risk of primary Sjogren syndrome than those without DV infection.Key Points• This retrospective, longitudinal cohort observational study shows that patients with DV infection had a lower risk of pSS than those without DV infection.• The DV cohort had an approximately 70% lower risk of pSS than the control group, with a multivariate-adjusted HR of 0.30.• On the basis of this result, we contended that DV infection has a protective effect that reduces the risk of pSS.
Highlights
Dengue viruses (DVs), a group of four serologically distinct but related flaviviruses, are responsible for a major emerging viral disease [1]
On the basis of this result, we contended that DV infection has a protective effect that reduces the risk of primary Sjogren syndrome (pSS)
A total of 29,365 patients with DV infection were selected from the Registry of Disease Reporting System of the Taiwan CDC and 117,460 control subjects were selected from the NHIRD
Summary
Dengue viruses (DVs), a group of four serologically distinct but related flaviviruses, are responsible for a major emerging viral disease [1]. Infection with one of the four serotypes of DVs results in symptoms ranging from an acute self-limiting febrile illness, dengue fever, to severe dengue hemorrhagic fever or dengue shock syndrome [3, 4]. The sequential infection with different DV serotypes may alter the cytokine response of cross-reactive CD4+ T
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