Association between a history of mycobacterial infection and the risk of newly diagnosed Sjögren's syndrome: A nationwide, population-based case-control study

• Published in: PloS one 2017-05, Vol.12 (5), p.e0176549-e0176549
• Main Authors: Chao, Wen-Cheng, Lin, Ching-Heng, Liao, Tsai-Ling, Chen, Yi-Ming, Chen, Der-Yuan, Chen, Hsin-Hua
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthritis; Biology and Life Sciences; Bronchiectasis; Case-Control Studies; Chronic conditions; Confidence intervals; Confounding Factors (Epidemiology); Critical care; Female; Health risks; Hospitals; Humans; Illnesses; Immunology; Infections; Interferon; Internal medicine; Lung diseases; Male; Medical diagnosis; Medical research; Medicine; Medicine and Health Sciences; Middle age; Middle Aged; Mycobacterium Infections - complications; Mycobacterium Infections - epidemiology; Pathogenesis; People and Places; Population; Population studies; Population-based studies; Regression analysis; Rheumatoid arthritis; Rheumatology; Risk; Risk Factors; Sjogren's syndrome; Sjogren's Syndrome - complications; Sjogren's Syndrome - epidemiology; Systemic lupus erythematosus; Taiwan - epidemiology; Tuberculosis; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0176549

To address the association between a history of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection and the risk of newly diagnosed Sjögren's syndrome (SS). Using a nationwide, population-based, claims dataset, and after excluding those who had rheumatoid arthritis or systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases during 2007-2012, and compared them to 86,265 non-SS controls matched (1:15) for age, sex, and the year of first SS diagnosis date. The association between the risk of incident SS and a history of mycobacterial infection, including TB and NTM, was quantified by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjustment for Charlson comorbidity index (CCI) and bronchiectasis. The mean age was 55±14 years, and the proportion of female gender was 87.8% in both newly diagnosed SS cases andnon-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37-53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97-1.71) after adjustment for CCI and bronchiectasis. The association between NTM and SS risk was remarkably strong among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97-387.75) and those without bronchiectasis (OR, 39.98; 95% CI, 3.83-376.92). The study reveals a significant association of newly diagnosed SS with a history NTM infection, especially among individuals aged 40-65 years or those without bronchiectasis.