Herpes Zoster Is Associated with An Increased Risk of Subsequent Lymphoid Malignancies — A Population-Based Matched-Control Study in Taiwan

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1599-1599
Author(s):  
Yi-Chang Liu ◽  
Yi-Hsin Yang ◽  
Hui-Hua Hsiao ◽  
Ming-Yu Yang ◽  
Wen-Chi Yang ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Conflicts Of Interest ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Lymphoid Malignancy ◽  
Herpes Zoster Infection ◽  
Lymphoid Malignancies ◽  
Asian Populations ◽  
Increased Risk

Abstract Abstract 1599 Infectious agents have been shown to contribute to the development of certain lymphoid malignancies. The different distribution of lymphoid malignancies in Asian and Western populations suggests possibly different etiologies in lymphomagenesis in Asian populations. Herpes zoster infection, commonly seen in immunocompromised persons, has been reported to be associated with lymphoid malignancies, but the results are controversial and large-scale studies from Asian populations are lacking. In this study we performed a population-based matched-controlled prospective study on Taiwanese patients using the National Health Insurance Research Database which provided 1,000,000 random subjects from 1996 to 2007. We defined herpes zoster by compatible ICD-9-CM (International Classification of Disease, 9th Revision, Clinical Modification) codes of herpes zoster (053.0–053.9) on at least one service claim for inpatient or outpatient care. The cases were identified by compatible ICD-9-CM codes including Hodgkin's disease (code 201.0–201.9), non-Hodgkin's lymphoma (code 200.0–200.8, 202.0–202.9), multiple myeloma (code 203.0–203.1), and lymphoid leukemia (code 204.0–204.9). Patients who had been diagnosed with any lymphoid malignancies or any cancers (code 140.0–199.1) before herpes zoster, and who had been diagnosed with other viral infections (code 045.0–052.9, 054.0–066.9, 071–079.9) and HIV infection (code 042) before the diagnosis of lymphoid malignancies were excluded. We randomly selected 169,983 control subjects (4 for every herpes zoster patient), matched with the study group in terms of age, sex and the year and month of index visit. Of 42,498 patients with herpes zoster prior to the diagnosis of any malignancies, the mean age was 48.92 years (± 20.67 years), with a mild female predominance (52.4%). Patients with herpes zoster infection had a lower monthly income (p < 0.001), and tended to live in urban areas (p < 0.001). Among the patients with herpes zoster, 2.42% subsequently developed cancer, and 0.11% lymphoid malignancy. Among the controls, 2.26% of the patients subsequently developed cancer, and 0.06% lymphoid malignancy. Patients with herpes zoster had a significantly increased risk of developing any cancers (excluding lymphoid malignancies, crude HR: 1.07, 95% CI: 1.01–1.15), and lymphoid malignancies (crude HR: 1.82, 95% CI: 1.29–2.55) compared with the control group. After adjusting for Charlson disease index, income category, and residence using Cox proportional hazard regressions, patients with herpes zoster had an increased risk of developing lymphoid malignancies (adjusted HR: 1.72, 95% CI: 1.22–2.42, p = 0.0019), but did not have an increased risk of developing non-lymphoid malignancies (adjusted HR: 1.00, 95% CI: 0.93–1.07, p = 0.895). These data suggest that preceding herpes zoster infection is an independent risk factor for the subsequent development of lymphoid malignancies in Taiwanese subjects. Further studies are warranted to explore the role of herpes zoster in the pathogenesis. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Association between de Quervain syndrome and herpes zoster: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046891
Author(s):  
Chao-Yu Hsu ◽  
Der-Shin Ke ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Herpes Zoster ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Increased Risk ◽  
De Quervain

ObjectiveBoth physical diseases such as infection and chronic pain and psychological disorders such as depression have been associated with herpes zoster (HZ) reactivation. However, the relationship between de Quervain syndrome (DQS), a painful tenosynovitis and HZ remains unclear. We investigated whether DQS increases the risk of HZ reactivation.DesignA retrospective population-based cohort study.SettingTaiwan.ParticipantsWe used a subset of Taiwan’s National Health Insurance Research Database, the Longitudinal Health Insurance Database which contains the registration files and original claims data of 1 million randomly selected individuals from the National Health Insurance programme. The case group in this study comprised patients newly diagnosed with DQS between 2000 and 2012. Individuals without DQS comprised the control group. Cases and controls were 1:1 matched by age, sex and index year (defined as the year of DQS diagnosis).ResultsApproximately 55% of the participants were ≤49 years. Most participants were women (77%). The incidence rate of HZ in the DQS group was 8.39 per 1000 person years. After adjustments for age, sex and comorbidities, patients with DQS had a 1.30 times higher risk of HZ reactivation than the control group. Stratification analysis revealed taht DQS increases the HZ risk in individuals ≤64 years, women, and patients without comorbidities.ConclusionDQS is associated with an increased risk of HZ. Clinicians should be aware of this risk when dealing with patients with DQS, particularly in young adults.

scholarly journals Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sze-Wen Ting ◽  
Sze-Ya Ting ◽  
Yu-Sheng Lin ◽  
Ming-Shyan Lin ◽  
George Kuo
Keyword(s):  
Cohort Study ◽  
Herpes Zoster ◽  
Population Based ◽  
Research Database ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Reduced Risk ◽  
Systemic Therapies

AbstractThe incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.

scholarly journals Prevalence of autoimmune diseases in in-patients with schizophrenia: nationwide population-based study

2012 ◽  
Vol 200 (5) ◽  
pp. 374-380 ◽  
Author(s):  
Shaw-Ji Chen ◽  
Yu-Lin Chao ◽  
Chuan-Yu Chen ◽  
Chia-Ming Chang ◽  
Erin Chia-Hsuan Wu ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Multiple Testing ◽  
Pernicious Anaemia ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Population Based Study ◽  
Hypersensitivity Vasculitis ◽  
Increased Risk ◽  
Specific Variation

BackgroundThe association between autoimmune diseases and schizophrenia has rarely been systematically investigated.AimsTo investigate the association between schizophrenia and a variety of autoimmune diseases and to explore possible gender variation in any such association.MethodTaiwan's National Health Insurance Research Database was used to identify 10 811 hospital in-patients with schizophrenia and 108 110 age-matched controls. Univariate and multiple logistic regression analyses were performed, separately, to evaluate the association between autoimmune diseases and schizophrenia. We applied the false discovery rate to correct for multiple testing.ResultsWhen compared with the control group, the in-patients with schizophrenia had an increased risk of Graves' disease (odds ratio (OR) = 1.32, 95% CI 1.04–1.67), psoriasis (OR = 1.48, 95% CI 1.07–2.04), pernicious anaemia (OR = 1.71, 95% CI 1.04–2.80), celiac disease (OR = 2.43, 95% CI 1.12–5.27) and hypersensitivity vasculitis (OR = 5.00, 95% CI 1.64–15.26), whereas a reverse association with rheumatoid arthritis (OR = 0.52, 95% CI 0.35–0.76) was also observed. Gender-specific variation was found for Sjögren syndrome, hereditary haemolytic anaemia, myasthenia gravis, polymyalgia rheumatica and dermatomyositis.ConclusionsSchizophrenia was associated with a greater variety of autoimmune diseases than was anticipated. Further investigation is needed to gain a better understanding of the aetiology of schizophrenia and autoimmune diseases.

scholarly journals Incidence and time trends of herpes zoster among patients with head and neck cancer who did and did not undergo radiotherapy: A population-based cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250724
Author(s):  
Peng-Yi Lee ◽  
Jung-Nien Lai ◽  
Lu-Ting Chiu ◽  
Yu-Ting Wei
Keyword(s):  
Head And Neck Cancer ◽  
Herpes Zoster ◽  
High Risk ◽  
Head And Neck ◽  
Neck Cancer ◽  
Time Trends ◽  
Population Based ◽  
Research Database ◽  
Oncological Surgery ◽  
Increased Risk

Purpose This study aimed to determine the risk and time trends of herpes zoster among patients with head and neck cancer, with or without radiotherapy. Methods A total of 2160 patients with head and neck cancer were enrolled. The radiotherapy and non- radiotherapy cohorts were frequency-matched at a 1:1 ratio according to sex, age, and index date. Moreover, 1080 matched non-cancer individuals were considered normal controls. Data were obtained from the National Health Insurance Research Database and Cancer Registry. The primary end point was the incidence of herpes zoster, and the adjusted confounding factors were age, sex, comorbidities, oncological surgery, and chemotherapy. Results The incidence of herpes zoster was higher in cancer patients than in non-cancer individuals but did not significantly differ (13.67 vs. 8.06 per 1,000 person-years, p = 0.18). The risk of herpes zoster was significantly higher in the radiotherapy cohort than in the non-radiotherapy cohort (18.55 vs. 9.06 per 1,000 person-years, p = 0.03). The 5-year incidence rates in the radiotherapy and non-radiotherapy cohorts were 8.9% and 5%, respectively (p < 0.0001). Survival analysis indicated there was no immortal time bias. The time trends in the radiotherapy cohort persistently showed a high risk within the first 2 years, which decreased thereafter. Only patients with comorbid rheumatoid arthritis showed a significantly high risk of herpes zoster (p = 0.02). Oncological surgery and chemotherapy had no impact on the development of herpes zoster. Conclusions This nationwide population-based study showed that patients with head and neck cancer receiving radiotherapy are at an increased risk of herpes zoster. Health care professionals should pay more attention to this vulnerable group to improve their quality of life.

scholarly journals Increased Risk of Kawasaki Disease in Infants Born of Mothers With Immune Disorders

2021 ◽  
Vol 9 ◽  
Author(s):  
Hsiao-Wen Chu ◽  
Chien-Heng Lin ◽  
Ming-Chih Lin ◽  
Ya-Chi Hsu
Keyword(s):  
Kawasaki Disease ◽  
Autoimmune Disorder ◽  
Allergic Diseases ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Immune Disorders ◽  
Immune Disorder ◽  
Inherited Susceptibility ◽  
Increased Risk

Introduction: Genetic susceptibility and immune dysregulation play important roles in the pathogenesis of Kawasaki disease (KD). However, it is still unclear whether KD causes immune disorder later in life or whether inherited susceptibility to immune disorders causes KD. The aim of this study was to elucidate whether inherited immune disease properties from mothers increase the risk of KD from a population-based perspective.Method: Taiwan's National Health Insurance Research Database was the main data source in this study. Parents and children were linked using the Taiwan Maternal and Child Health Database. Patients diagnosed with KD and younger than 18 years from 2004 to 2015 were enrolled as the study population. The control group was randomly selected from individuals without the diagnosis of KD matched by age, index year, sex, and urbanization level at a ratio of 1 to 10. The prevalence of maternal autoimmune and allergic diseases was compared between groups.Results: In total, 7,178 children were found to have been diagnosed with Kawasaki disease. Then 71,780 children matched by index year, gender, and urbanization were randomly selected to serve as the control group. Children born from mothers with asthma and allergic rhinitis had a higher risk of developing KD. Children of mothers with an autoimmune disorder had a significantly increased tendency to develop KD. Maternal numbers of autoimmune disorders showed a dose-dependent relationship with KD incidence.Conclusion: This is the first population-based study to investigate maternal immune diseases and the risk of KD in their children. Children of mothers with immune disorders tend to have a higher risk of KD.

scholarly journals Increased Risk of Ulcerative Colitis in Patients with Periodontal Disease: A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 15 (11) ◽  
pp. 2602 ◽  
Author(s):  
Chien-Yu Lin ◽  
Kuo-Sen Tseng ◽  
Jui-Ming Liu ◽  
Heng-Chang Chuang ◽  
Chi-Hone Lien ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Periodontal Disease ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Immune Mediated ◽  
Increased Risk ◽  
Inflammatory Processes

Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94–1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13–2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC.

Risk of Stroke with Antivenom Usage after Venomous Snakebite in Taiwan: A Population-Based Cohort Study

QJM ◽  
2021 ◽  
Author(s):  
Wei-Hsin Hung ◽  
Jie Sung ◽  
Wen-Yee Chen ◽  
Lu-Ting Chiu ◽  
Hei-Tung Yip ◽  
...  
Keyword(s):  
Cohort Study ◽  
Acute Stroke ◽  
Hemorrhagic Stroke ◽  
Risk Model ◽  
Rare Complication ◽  
Underlying Mechanism ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Increased Risk

Abstract Background and Purpose Stroke is a rare complication of snakebites, but may lead to serious sequelae. We aimed to explore the relationship between venomous snakebite and the risk for acute stroke, in a nationwide population-based cohort study. Methods This retrospective cohort study used claims data between January 1, 2000 and December 31, 2012, from the Taiwan National Health Insurance Research Database. The study included data of patients aged 18 years or older with venomous snakebite (N = 535), matched for propensity score with controls without venomous snakebite (N = 2140). The follow-up period was the duration from the initial diagnosis of venomous snakebite and administration of antivenom to the date of an acute stroke, or until December 31, 2013. The competing risk model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of stroke, ischemic stroke, and hemorrhagic stroke, after adjusting for demographic and other possible stroke risk factors. Result The adjusted HR for the venomous snakebite group compared with the control group was 2.72 for hemorrhagic stroke (95% CI: 1.41, 5.26). Stratified analysis showed that the older age group (&gt;65 years old) had a higher risk of hemorrhagic stroke. A 2.68-fold significant increase in the risk for hemorrhagic stroke was observed following venomous snakebite with antivenom usage (95% CI = 1.46, 26.63). Conclusion Venomous snakebite is associated with an increased risk of hemorrhagic stroke after the use of an antivenom. Further study of the underlying mechanism is warranted.

Risk of dementia after charcoal-burning suicide attempts: a nationwide cohort study in Taiwan

2018 ◽  
Vol 66 (7) ◽  
pp. 1070-1082 ◽  
Author(s):  
Shan-Yueh Chang ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Hsin-An Chang ◽  
Yu-Chen Kao ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Geographic Area ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Population Based Study ◽  
Charcoal Burning ◽  
Increased Risk ◽  
Degenerative Dementia

This study aimed to investigate the association between charcoal-burning suicide attempts and the risk of developing dementia. A nationwide, matched cohort, population-based study enrolled a total of 4103 patients with newly diagnosed charcoal-burning suicide attempts, between 2000 and 2010, which were selected from the National Health Insurance Research Database of Taiwan, along with 12,309 controls matched for sex and age. After adjusting for confounding factors, Fine and Gray’s competing risk analysis was used to compare the risk of developing dementia during the 10-year follow-up period. Of the enrolled patients (n=16,412), dementia developed in 303 (1.85%), including 2.56% in the study group (105 in 4103) and 1.61% (198 in 12,309) in the control group. The Fine and Gray’s survival analysis revealed that the patients with charcoal-burning suicide attempts were likely to develop dementia, with a crude HR of 5.170 (95% CI 4.022 to 6.644, p<0.001). After adjusting for age, sex, comorbidity, geographic area and urbanization level of residence, and monthly insured premium, the adjusted HR was 4.220 (95% CI 3.188 to 5.586, p<0.001). Suicide attempts were associated with an increased risk of degenerative dementia in this study. Patients with charcoal-burning suicide attempts had a fourfold risk of dementia than the control group.

scholarly journals Uterine Fibroids Increase the Risk of Thyroid Cancer

2020 ◽  
Vol 17 (11) ◽  
pp. 3821
Author(s):  
Li-Min Sun ◽  
Li-Min Chung ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Thyroid Cancer ◽  
Common Factor ◽  
Uterine Fibroids ◽  
Population Based ◽  
Hazard Ratio ◽  
Control Group ◽  
Research Database ◽  
Control Groups ◽  
Increased Risk ◽  
And Control

Objectives: The formation of uterine fibroids (UF) is potentially linked to the development of thyroid cancer through a common factor: female sex hormones. Methods: We conducted a nationwide population-based cohort study to determine whether Taiwanese women with UF have an increased risk of thyroid cancer. The data of both the UF and control groups were derived from the National Health Insurance Research Database (NHIRD) of Taiwan. Groups were matched by the year of UF diagnosis, age, income, urbanization level, occupation, and comorbidities. A Cox proportional hazard regression model was used to compare the incidence of thyroid cancer between the UF and control groups. In addition, the model was used to determine the hazard ratio of thyroid cancer in the UF group in comparison with the control group. Results: Women with UF had a statistically significantly increased risk of thyroid cancer compared with controls (adjusted hazard ratio (aHR): 1.64, 95% confidence interval (CI): 1.26–2.13). Stratified analyses showed that women with UF who had a significantly increased risk of thyroid cancer were more likely to be middle aged, have middle and higher income levels, and a medium follow-up period (1–5 years) of UF. No other UF patient characteristics and comorbidities showed association with the risk of thyroid cancer. In addition, UF patients had a significantly increased risk of thyroid cancer regardless of whether or not they underwent myomectomy. Conclusions: The results suggest that women with UF have an increased risk of subsequent thyroid cancer. Further research is needed to explore whether surveillance strategies for the early detection of thyroid cancer using ultrasonography should be implemented among patients with UF.

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