Re-examination of the risk of autoimmune diseases after dengue virus infection: A population-based cohort study

PLoS Negl Trop Dis. 2023 Mar 7;17(3):e0011127. doi: 10.1371/journal.pntd.0011127. eCollection 2023 Mar.

Abstract

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 limitations 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 models were used to investigate the risk of autoimmune diseases after dengue infection. Dengue 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 Bonferroni 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / epidemiology
  • Cohort Studies
  • Databases, Factual
  • Encephalomyelitis*
  • Humans
  • Virus Diseases*

Grants and funding

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/.