Incidence of autoimmune diseases in a nationwide HIV/AIDS patient cohort in Taiwan, 2000–2012

Yen, Yung‐Feng; Chuang, Pei-Hung; Jen, Ian; Chen, Marcelo; Lan, Yu Ching; Liu, Yen-Ling; Lee, Yun; Chen, Yen-Hsu; Chen, Yi-Ming Arthur

doi:10.1136/annrheumdis-2016-209815

Cited by 66 publications

(58 citation statements)

References 26 publications

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“…The following comorbidities were defined using ICD-9-CM codes recorded in the claims data: DM (ICD-9-CM code: 250), hypertension (ICD-9-CM codes: 401–405), liver cirrhosis (CD-9-CM codes: 571.2, 571.5–571.6), systemic autoimmune disease (ICD-9-CM codes: 443.1, 446.0, 446.2, 446.4–446.5, 446.7, 696.0–696.1, 710.0–710.4, 714.0–714.4), chronic obstructive pulmonary disease (COPD) (ICD-9-CM codes: 491,492,496), coronary artery disease (CAD) (ICD-9-CM codes: 410–414), and cerebrovascular accident (CVA) (ICD-9-CM codes: 430–438) [28, 31, 32]. Medical comorbidities were included if they appeared one or more times in the diagnoses of inpatients or three or more times in the diagnoses of outpatients.…”

Section: Methodsmentioning

confidence: 99%

End-stage renal disease: a risk factor of deep neck infection – a nationwide follow-up study in Taiwan

et al. 2017

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BackgroundUremia is likely a risk factor for deep neck infection (DNI). However, only a few relevant cases have been reported, and evidence sufficient to support this hypothesis is lacking. The aim of the study is to investigate the effects of end-stage renal disease (ESRD) on DNI.MethodsWe used the database of the Registry for Catastrophic Illness Patients (RFCIP), a subset of the National Health Insurance Research Database (NHIRD) in Taiwan, to conduct a retrospective follow-up study. Between 1997 and 2013, a total of 157,340 patients in Taiwan with ESRD who received dialysis were registered in the RFCIP, whom were matched with a database consisting of 1,000,000 randomly selected patients who represented the national population, to conduct the follow-up study for investigating the incidence of DNI in the ESRD and control cohorts.ResultsIn the ESRD group, 280 DNIs were identified with an incidence rate of 43 per 100,000 person-years. In the comparison group, 194 DNIs were identified with an incidence rate of 20 per 100,000 person-years. The incidence rate ratio was 2.16 (p < 0.001). Kaplan–Meier analysis indicated that the ESRD group had a significantly higher cumulative incidence of DNI (p < 0.001). According to Cox regression analysis, the hazard ratio of ESRD for DNI was 2.23 (p < 0.001). The therapeutic methods (non-surgery and surgery), performance of tracheostomy, duration of hospitalization did not differ significantly between the two groups, except more ESRD-DNI patients were admitted to intensive care units. The mortality rate of patients with DNI in the ESRD group was significantly higher than that in the control group (8.6% for ESRD vs 3.6% for control, p = 0.032). Furthermore, the Kaplan–Meier analysis demonstrated a poorer survival outcome in the ESRD group (p = 0.029). However, the individual survival outcomes following non-surgical and surgical therapies in the ESRD group did not differ significantly (p = 0.31).ConclusionsESRD is a predisposing factor for DNI, increasing its risk by twofold. In the patients with ESRD, DNI was not associated with higher rates of surgical debridement, tracheostomy, and mediastinal complications or longer hospital stays; however, it was associated with poorer survival outcomes, regardless of the therapeutic method.

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Section: Methodsmentioning

confidence: 99%

End-stage renal disease: a risk factor of deep neck infection – a nationwide follow-up study in Taiwan

et al. 2017

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“…HIV patients have a higher incidence of systemic autoimmune diseases, even on highly active antiretroviral therapy (HAART) [4]. On the other hand, immunosuppressive therapy (IST) poses a not unreasonable fear of further immune dysfunction/immunodeficiency.…”

Section: Introductionmentioning

confidence: 99%

Anti-N-Methyl-D-Aspartate Receptor Encephalitis in HIV Infection

et al. 2016

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Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated. Without evidence of infection, the presence of anti-NMDAR antibodies both in serum and cerebrospinal fluid clinched the diagnosis of autoimmune encephalitis. No evidence of neoplastic disease was found, and the beneficial response to immunosuppressive therapy was exceptional. This is the first report of anti-NMDAR encephalitis in an HIV-infected individual, reminding us that autoimmune encephalitis should be included in the differential diagnosis of a young patient presenting in an acute confusional state.

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“…All the same, the treatment of this inflammatory rheumatism remains a challenge dominated by the interactions between theART and the immunosuppressive treatment [20,21]. Unlike the West, where they appear as frequently associated with HIV and its treatment [22][23][24][25][26], no case of connectivity and vasculitis was found in our study.The rarity of these affections in the black race would be the main reason. The osteonecrosis are therefore now associated with HIV and/or with its treatment [9,[27][28][29] and they tend to be bilateral in our study.…”

Section: Discussionmentioning

confidence: 56%

Rheumatic Diseases in HIV-Positive Patients in Kara (Togo)

Houzou¹,

Kakpovi²,

Abass³

et al. 2017

J AIDS Clin Res

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Incidence of autoimmune diseases in a nationwide HIV/AIDS patient cohort in Taiwan, 2000–2012

Abstract: PLWHA had higher risks of incident Sjögren syndrome, psoriasis, SLE, autoimmune haemolytic anaemia and uveitis.

Cited by 66 publications

References 26 publications

End-stage renal disease: a risk factor of deep neck infection – a nationwide follow-up study in Taiwan

End-stage renal disease: a risk factor of deep neck infection – a nationwide follow-up study in Taiwan

Anti-N-Methyl-D-Aspartate Receptor Encephalitis in HIV Infection

Rheumatic Diseases in HIV-Positive Patients in Kara (Togo)

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