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Clinical and epidemiological research
Extended report
Incidence of autoimmune diseases in a nationwide HIV/AIDS patient cohort in Taiwan, 2000–2012
  1. Yung-Feng Yen1,2,
  2. Pei-Hung Chuang3,4,
  3. I-An Jen5,
  4. Marcelo Chen6,7,
  5. Yu-Ching Lan8,
  6. Yen-Ling Liu9,
  7. Yun Lee9,
  8. Yen-Hsu Chen10,11,12,
  9. Yi-Ming Arthur Chen9,13
  1. 1Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan
  2. 2School of Medicine, National Yang-Ming University, Taipei, Taiwan
  3. 3Center for Prevention and Treatment of Occupational Injury and Diseases, Taipei Veterans General Hospital, Taipei, Taiwan
  4. 4Division of Clinical Toxicology and Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  5. 5Department and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
  6. 6Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan
  7. 7Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
  8. 8Department of Health Risk Management, China Medical University, Taichung, Taiwan
  9. 9Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
  10. 10School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  11. 11Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  12. 12Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, HsinChu, Taiwan
  13. 13Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  1. Correspondence to Professor Yi-Ming Arthur Chen, Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan; arthur{at}kmu.edu.tw and Yen-Hsu Chen, School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; d810070{at}kmu.edu.tw

Abstract

Objectives It is not known if the incidences of autoimmune diseases are higher in individuals living with HIV infection or AIDS. Our study investigated the incidences of autoimmune diseases among people living with HIV/AIDS (PLWHA) in Taiwan during 2000–2012.

Methods The Taiwan National Health Insurance Research Database was used to identify PLWHA. The incidence densities of systemic and organ-specific autoimmune diseases were calculated, and age-adjusted, sex-adjusted and period-adjusted standardised incidence rates (SIRs) were obtained by using two million people from the general population as controls. To examine the effects of highly active antiretroviral therapy (HAART) on the incidence of autoimmune diseases, the incidence densities and SIRs of autoimmune diseases were calculated after stratifying PLWHA by HAART status.

Results Of the 20 444 PLWHA identified, the overall mean (SD) age was 30.1 (11.0) years; 67.2% of the subjects received HAART. As compared with the general population, SIRs were higher for incident Sjögren syndrome (SIR=1.64; 95% CI 1.24 to 2.13), psoriasis (SIR=2.05; 95% CI 1.67 to 2.48), systemic lupus erythematosus (SLE) (SIR=2.59; 95% CI 1.53 to 4.09), autoimmune haemolytic anaemia (SIR=35.06; 95% CI 23.1 to 51.02) and uveitis (SIR=2.50; 95% CI 2.05 to 3.02), but were lower for incident ankylosing spondyloarthritis (SIR=0.70; 95% CI 0.48 to 0.99). When the effect of HAART on incident autoimmune diseases was considered, PLWHA who received HAART had higher SIRs for psoriasis, autoimmune haemolytic anaemia and uveitis, but had lower risks of rheumatoid arthritis (RA) and ankylosing spondyloarthritis. In contrast, PLWHA who did not receive HAART had higher SIRs for Sjögren syndrome, psoriasis, RA, SLE, scleroderma, polymyositis, autoimmune haemolytic anaemia and Hashimoto's thyroiditis.

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

  • Autoimmune Diseases
  • Infections
  • T Cells

https://doi.org/10.1136/annrheumdis-2016-209815

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