Association between psoriasis and viral infections in the United States: focusing on hepatitis B, hepatitis C and human immunodeficiency virus

Kanada, K.N.; Schupp, Clayton W.; Armstrong, Adam W.

doi:10.1111/j.1468-3083.2012.04563.x

Cited by 24 publications

(24 citation statements)

References 17 publications

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“…Studies have previously linked psoriasis with increased risks non-alcoholic fatty liver disease independent of alcohol intake, obesity, and hepatotoxic medications, 34, 35 but yielded inconsistent results with chronic hepatitis B and C risks. 13, 36–38 Subclinical hepatic inflammation noted on advanced imaging studies in patients with psoriasis also provided potential mechanisms for liver dysfunction. 30 Our data did not reveal any association with moderate to severe liver disease, such as cirrhosis and liver failure, but the small number of detected cases precluded our ability to reach firm conclusions.…”

Section: Discussionmentioning

confidence: 99%

Psoriasis Severity and the Prevalence of Major Medical Comorbidity

et al. 2013

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Importance Despite the growing literature on co-morbidity risks in psoriasis, there remains a critical knowledge gap on the degree to which objectively measured psoriasis severity may affect the prevalence of major medical co-morbidities. Objective To examine the prevalence of major medical co-morbidities in patients with mild, moderate, and severe psoriasis, classified objectively based on body surface area involvement, compared to patients without psoriasis. Design Population-based, cross-sectional study. Setting United Kingdom-based electronic medical records. Participants 9,035 patients aged 25 to 64 years with psoriasis and 90,350 age- and practice-matched patients without psoriasis. Exposures Psoriasis diagnosis and severity, based on body surface area involvement, as determined by provider-based questionnaires. Main Outcomes and Measures Prevalence of major co-morbidities comprising the Charlson co-morbidity index. Results Among patients with psoriasis, 51.8%, 35.8%, and 12.4% respectively had mild, moderate, and severe disease. Mean Charlson co-morbidity index was increasingly higher in patients with mild (0.375 vs. 0.347), moderate (0.398 vs. 0.342), and severe psoriasis (0.450 vs. 0.348) compared to respective controls (each p < 0.05). Psoriasis overall was associated with higher prevalence of chronic pulmonary disease (adjusted odds ratio 1.08; 95% CI, 1.02–1.15), diabetes (1.22; 1.11–1.35), diabetes with systemic complications (1.34; 1.11–1.62), mild liver disease (1.41; 1.12–1.76), myocardial infarction (1.34; 1.07–1.69), peptic ulcer disease (1.27; 1.03–1.58), peripheral vascular disease (1.38; 1.07–1.77), renal disease (1.28; 1.11–1.48), and rheumatologic disease (2.04; 1.71–2.42). Trend analysis revealed significant associations between psoriasis severity and each of above co-morbidities (each p < 0.05). Conclusions and Relevance The burdens of overall medical co-morbidity and of specific co-morbid diseases are greater among psoriasis patients with increasing disease severity. Physicians should be aware of these associations in providing comprehensive care to patients with psoriasis, especially those presenting with more severe disease.

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Section: Discussionmentioning

confidence: 99%

Psoriasis Severity and the Prevalence of Major Medical Comorbidity

et al. 2013

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“…HIV has been shown to be an independent risk factor for the development of psoriasis . Previous studies found conflicting results of whether hepatitis B or C are associated with higher rates of psoriasis . However, chronic infections such as HIV and hepatitis may increase risk for HS owing to immune dysregulation, shared lifestyle factors and/or health behaviours.…”

Section: Discussionmentioning

confidence: 99%

“…26 Previous studies found conflicting results of whether hepatitis B or C are associated with higher rates of psoriasis. [27][28][29][30][31] However, chronic infections such as HIV and hepatitis may increase risk for HS owing to immune dysregulation, shared lifestyle factors and/or health behaviours. Future studies are needed to confirm these associations and determine the precise mechanism(s) of association between HS and serious infections.…”

Section: Discussionmentioning

confidence: 99%

Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults

et al. 2019

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Summary Background Hidradenitis suppurativa (HS) is associated with bacterial colonization, skin‐barrier disruption, immune dysregulation and treatments that can increase infection risk. Objectives To determine whether HS is associated with cutaneous and extracutaneous infections and related outcomes. Methods Data from the 2002–2012 National Inpatient Sample were analysed, including a 20% sample of U.S. hospitalizations (n = 87 053 155). Results The prevalence (with 95% confidence interval) of infections was higher in adults (34·0%, 33·2–34·7% vs. 23·4%, 23·2–23·6%) and children (31·8%, 28·7–34·9% vs. 12·6% (12·1–13·1%) with vs. without HS. Inpatients with HS had higher prevalences of infections overall (excluding cellulitis and erysipelas) than those with psoriasis, but lower than those with atopic dermatitis. In multivariable logistic regression models adjusting for sociodemographics, HS was associated with 18 of 45 infections examined (adults: 16 of 45; children: six of 45), including acute infections (herpes simplex virus, herpes zoster, necrotizing fasciitis, septicaemia, bone infection, Clostridium difficile, methicillin‐sensitive and methicillin‐resistant Staphylococcus aureus, Streptococcus, Pseudomonas, mycobacterial, fungal, viral), chronic infections (HIV, hepatitis B) and antibiotic‐resistant infections. HS alone was associated with increased infections. Patients with comorbid cancer; HIV; cardiometabolic, autoimmune or mental health diagnoses or acne had even higher odds of infections. Inpatients with HS with vs. without serious infection had increased inpatient mortality (0·71% vs. 0·16%), mean length of stay (7·3 vs. 4·8 days) and cost of care (US$13 578 vs. $9242), with a mean annual excess 41 050 days and $71 622 339 cost of hospitalization. Conclusions Adults and children with HS had increased acute and chronic, cutaneous, extracutaneous and systemic infections, which were associated with increased mortality and cost. What's already known about this topic? Little is known about the risk of infection in patients with hidradenitis suppurativa (HS). What does this study add? Adults and children with HS had increased cutaneous, extracutaneous and systemic infections, at even higher rates than in patients with psoriasis and atopic dermatitis. These infections were associated with increased inpatient mortality and cost. Respond to this article

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“…An association between hepatitis C and psoriasis was first noted in 1995 by Yamamoto et al 24 While the prevalence of psoriasis in hepatitis C patients has not been shown to be significantly increased, 21,[25][26][27] there is conflicting data on the prevalence of HCV infection in psoriasis and psoriatic arthropathy patients (Table 3). Studies have found no increase in the rate of HCV infection in patients with psoriasis or psoriatic arthropathy, [28][29][30][31] while others have found increased HCV infection in patients with psoriatic arthropathy, but not psoriasis. 32 In contrast, multiple studies have found a statistically higher prevalence of HCV infection in patients with psoriasis.…”

Section: Discussionmentioning

confidence: 99%