Association Between a History of Dengue Fever and the Risk of Systemic Autoimmune Rheumatic Diseases: A Nationwide, Population-Based Case-Control Study

Yun-Wen Chen; Tsu-Yi Hsieh; Ching-Heng Lin; Hsian-Min Chen; Chi-Chien Lin; Hsin-Hua Chen

doi:10.3389/fmed.2021.738291

Association Between a History of Dengue Fever and the Risk of Systemic Autoimmune Rheumatic Diseases: A Nationwide, Population-Based Case-Control Study

Front Med (Lausanne). 2021 Nov 3:8:738291. doi: 10.3389/fmed.2021.738291. eCollection 2021.

Authors

Yun-Wen Chen¹, Tsu-Yi Hsieh^{1

2

3

4}, Ching-Heng Lin^{5

6

7

8}, Hsian-Min Chen^{6

9

10

11}, Chi-Chien Lin^{8

9}, Hsin-Hua Chen^{1

4

5

11}

Affiliations

¹ Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
² Department of Medical Education, Taichung Veterans General Hospital, Taichung City, Taiwan.
³ Ph.D. Program of Business, Feng Chia University, Taichung City, Taiwan.
⁴ School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
⁵ Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung City, Taiwan.
⁶ Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan.
⁷ Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
⁸ Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
⁹ Center for Quantitative Imaging in Medicine (CQUIM), Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan.
¹⁰ Department of Computer Science and Information Engineering, National United University, Miaoli City, Taiwan.
¹¹ Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung Hsing University, Taichung City, Taiwan.

Abstract

Purpose: To determine the association between a history of clinically diagnosed dengue infection and the risk of systemic autoimmune rheumatic diseases (SARDs). Methods: Using claims data from the 1997-2013 Taiwanese National Health Insurance Research Database, we included 74,422 patients who were diagnosed with SARDs and 297,688 patients without SARDs who were matched (in a 1:4 ratio) for age, sex, year of SARDs index date, and city of residence. The associations between the development of SARDs and a history of dengue infection (International Classification of Diseases, Ninth Revision, Clinical Modification code 061) were investigated using conditional logistic regression analysis shown as odds ratios (ORs) with 95% confidence intervals (CIs) after adjusting for potential confounders. Results: We included 17,126 patients with systemic lupus erythematosus (SLE), 15,531 patients with Sjogren's syndrome (SS), 37,685 patients with rheumatoid arthritis (RA), 1,911 patients with systemic sclerosis (SSc), 1,277 patients with dermatomyositis (DM), and 892 patients with polymyositis (PM). SLE (OR, 4.55; 95% CI, 2.77-7.46; p <0.001) risk was significantly associated with a history of dengue infection. However, no statistically significant association was found between dengue infection and SS (OR, 1.41; 95% CI, 0.88-2.26; p = 0.155), RA (OR, 1.03; 95% CI, 0.70-1.50; p = 0.888), SSc (OR, 1.97; 95% CI, 0.38-10.29; p = 0.420), DM (OR, 0.54; 95% CI, 0.04-7.27; p = 0.641), or PM (OR, 2.08; 95% CI, 0.23-18.79; p = 0.513). Conclusion: This study revealed that a history of dengue infection was significantly associated with the risk of SLE, but not SS, RA, SSc, DM, or PM.

Keywords: claims data; dengue; history; risk; systemic autoimmune rheumatic disease (SARD).