Lin Herng-Ching, Xirasagar Sudha, Lee Hsin-Chien, Huang Chung-Chien, Chen Chao-Hung
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
PLoS One. 2017 Jun 16;12(6):e0179312. doi: 10.1371/journal.pone.0179312. eCollection 2017.
Associations of hepatitis C virus infection with Alzheimer's disease have not been studied among higher risk, bipolar disorder patients. This population-based case-control study investigated the risks of hepatitis C virus infection among Alzheimer's disease patients with bipolar disorder in the years preceding their Alzheimer's disease diagnosis. We used 2000-2013 data from the Longitudinal Health Insurance Database in Taiwan. Among patients with bipolar disorder, 73 were diagnosed with Alzheimer's disease (cases), who were compared with 365 individuals with bipolar disorder but without Alzheimer's disease (randomly selected controls matched on sex, age, and index year with cases). Prior claims (before the diagnosis year/index year for controls) were screened for a diagnosis of hepatitis C virus infection. Conditional logistic regression models were used for analysis. We found that 23 (31.51%) and 60 (16.44%) patients with bipolar disease were identified with a hepatitis C diagnosis among those with and without Alzheimer's disease, respectively. Compared to controls, patients with Alzheimer's disease showed 2.31-fold (95% confidence interval = 1.28-4.16) increased risk of hepatitis C infections adjusted for demographics and socio-economic status. Findings suggest an association of Alzheimer's disease with a preceding diagnosis of hepatitis C infection among patients with bipolar disorder. Findings may suggest a need for increased awareness of and appropriate surveillance for Alzheimer's disease in patients with bipolar disorder diagnosed with hepatitis C infection.
在高风险的双相情感障碍患者中，尚未对丙型肝炎病毒感染与阿尔茨海默病之间的关联进行研究。这项基于人群的病例对照研究调查了双相情感障碍患者在被诊断为阿尔茨海默病之前几年感染丙型肝炎病毒的风险。我们使用了台湾纵向健康保险数据库2000 - 2013年的数据。在双相情感障碍患者中，73人被诊断为阿尔茨海默病（病例组），将其与365名患有双相情感障碍但未患阿尔茨海默病的个体（根据性别、年龄和索引年份与病例组匹配的随机选择对照组）进行比较。筛查之前的索赔记录（对照组为诊断年份/索引年份之前）以确定丙型肝炎病毒感染的诊断。使用条件逻辑回归模型进行分析。我们发现，在患有和未患有阿尔茨海默病的双相情感障碍患者中，分别有23例（31.51%）和60例（16.44%）被确诊为丙型肝炎。与对照组相比，在调整人口统计学和社会经济状况后，阿尔茨海默病患者感染丙型肝炎的风险增加了2.31倍（95%置信区间 = 1.28 - 4.16）。研究结果表明，双相情感障碍患者中，阿尔茨海默病与先前诊断的丙型肝炎感染之间存在关联。研究结果可能表明，对于被诊断为丙型肝炎感染的双相情感障碍患者，需要提高对阿尔茨海默病的认识并进行适当监测。
