Risk of primary Sjogren’s Syndrome following human papillomavirus infections: a nationwide population-based cohort study

Abstract

IntroductionViral infection is an exogeneous factor for primary Sjogren’s syndrome (pSS). This study investigated the association between human papillomavirus (HPV) infections and pSS through a nationwide population based cohort study.MethodsPatients with HPV infections between January, 1999 and December, 2013 were included. The incidence of new-onset pSS in patients with HPV infections and non-HPV controls were derived. The multiple Cox regression model derived the risk of pSS in patients with HPV infections. Subgroup analysis and sensitivity analysis were performed to validate the association.ResultsDuring a follow-up period of 12 years, the adjusted hazard ratio (aHR) of pSS in patients with HPV infections was significantly higher than that in non-HPV controls (aHR=1.64, 95% CI=1.47-1.83, P<0.001). The risk of pSS increased with age and the risk increased by 2.64-fold (95% CI= 2.37-2.93) for those older than 45 years. The significant association between HPV infections and the risk of pSS persisted in the sensitivity analysis restricted in HPV infections that lasted over 12 months (aHR=1.63, 95%CI=1.45-1.83, P<0.0001). Subgroup analyses revealed that both male (aHR=1.83, 95%CI=1.47-2.28, P<0.0001) and female (aHR=1.58, 95%CI=1.40-1.79, P<0.0001) patients with HPV infections and HPV-infected patients aged between 16 and 45 years (aHR=1.60, 95%CI=1.34-1.91, P<0.0001) and over 45 years (aHR=1.67, 95%CI=1.46-1.91, P<0.0001) were associated with a significantly greater risk of pSS.ConclusionPatients with HPV infections presented with a significantly higher risk of pSS, regardless of age and sex.

Maternal human papillomavirus infection and the risk of congenital malformations: A nationwide population‐based cohort study

“…We identified individuals diagnosed with HPV infection (ICD‐9 codes 079.4, 078.1, 078.10–78.12, 078.19, 795.05, 795.09, 795.15, 795.19, 796.75, and 796.79) 17‐20 between January 1, 2008 and December 31, 2015. Figure 1 displays the flowchart for newborns with and without maternal HPV infection.…”

Ultrasound for ankle and foot pathologies in early rheumatoid arthritis

“…Lastly, we are interested in the possibility of utilizing ultrasound to diagnose other inflammatory arthritis or autoimmune diseases and their comorbidities, [14][15][16][17][18] such as ankylosing spondylitis (AS) 19 or psoriatic arthritis (PsA), [20][21][22][23] juvenile idiopathic arthritis, 24,25 osteoarthritis, 26,27 or fibromyalgia. 28 The early signs of AS often appear as enthesis inflammation, 29,30 which may be detected by power Doppler ultrasound (PDUS) through the presence of bone erosion, pathological structural changes, and thickening of the tendon at the site of insertion.…”

Human Papillomavirus Infections and Increased Risk of Incident Osteoporosis: A Nationwide Population-Based Cohort Study

“…In the present study, patients who had been clinically diagnosed with HPV infections between 2000 and 2013 were identified using International Classification of Disease Clinical Modification codes (ICD-9-CM code 079. [26,27]. Only patients with diagnosis of HPV from at least one inpatient admission or three outpatient visits were selected.…”