Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease.
JAMA Netw Open
; 6(7): e2324532, 2023 07 03.
Article
em En
| MEDLINE
| ID: mdl-37494043
ABSTRACT
Importance Rotavirus infection is a common cause of gastroenteritis in children that can trigger autoimmune processes, but the nature of this interaction remains poorly understood. Objective:
To estimate the association of rotavirus infection with the risk of subsequent autoimmune disease. Design, Setting, andParticipants:
This population-matched cohort study used data from children and adolescents (aged younger than 18 years) in South Korea (national registers from January 1, 2002, to December 31, 2017). The cohort consisted of 86â¯157 patients in the exposure group who had experienced rotavirus-associated hospitalization and the same number of matched patients in the unexposed group. Data analyses were from May 1, 2020, through October 20, 2022. Exposures Hospitalization for rotavirus infection. Main Outcomes andMeasures:
The main outcome was childhood autoimmune diseases during the study defined by diagnoses according to the National Health Insurance Database. Hazard ratios (HRs) with 95% CIs for autoimmune diseases were estimated using a Cox model, with multiple confounding factors controlled.Results:
This cohort study consisted of 1â¯914â¯461 individuals born in South Korea from 2002 to 2005 who were potentially eligible. After exclusions, there were 86â¯517 individuals in the exposed group and 86â¯517 in the unexposed group after 11 incidence density sampling. The study included 49â¯072 (57.0%) male patients. The median (IQR) age at diagnosis of rotavirus-associated hospitalization was 1.5 (0.9-2.7) years, and the HR for autoimmune disease in the exposed group was 1.24 (95% CI, 1.19-1.28) for a mean (SD) follow-up time of 12.1 (3.2) years. The use of more stringent definitions for exposure and outcomes in a multivariable stratified analysis also indicated that rotavirus-associated hospitalization was associated with an increased risk of subsequent autoimmune disease (HR, 1.22 [95% CI, 1.16-1.28]). Sensitivity analysis showed that individuals with rotavirus-associated hospitalization was related to multiple autoimmune syndromes (2 or more HR, 1. 51 [95% CI, 1. 31-1. 73]; 3 or more HR, 1. 79 [95% CI, 1.18-2.72]) and that the number of rotavirus-associated hospitalization were associated with higher risks for autoimmune disease in a dose-dependent manner (single hospitalization event HR, 1.20 [95% CI, 1.16-1.24]; multiple events HR, 1.60 [95% CI, 1.49-1.72]). Conclusions and Relevance Our results indicate that rotavirus-associated hospitalization is significantly associated with subsequent autoimmune disease during childhood. Clinicians should be aware of the heightened susceptibility to autoimmune disease in individuals with prior rotavirus-associated hospitalization.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Infecções por Rotavirus
/
Doenças Autoimunes
/
Rotavirus
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article