人类 T 细胞白血病病毒 1 阳性类风湿关节炎患者严重感染需住院治疗的发生率：一项病例对照观察性研究。

High incidence of serious infections requiring hospitalisation in human T-cell leukaemia virus type 1-positive rheumatoid arthritis: A case-controlled observational study.

机构信息

Department of Respirology, Rheumatology, Infectious Diseases and Neurology, Internal Medicine, University of Miyazaki, Miyazaki, Japan.

Institute of Rheumatology, Zenjinkai Shimin-no-Mori Hospital, Miyazaki, Japan.

出版信息

Mod Rheumatol. 2022 Aug 20;32(5):866-874. doi: 10.1093/mr/roab077.

DOI:10.1093/mr/roab077

PMID:34897491

Abstract

OBJECTIVES

We aimed to assess the clinical features of human T-cell leukaemia virus type 1 (HTLV-1)-positive rheumatoid arthritis (RA) patients. Furthermore, we investigated the impact of HTLV-1 infection on incidences of serious infections requiring hospitalisation (SIH) and malignancies.

METHODS

A total of 150 sex- and age-matched HTLV-1-negative and 50 HTLV-1-positive RA patients were enrolled from the HTLV-1 RA Miyazaki Cohort Study. Clinical and laboratory data were collected from this cohort database. The incidence rate (IR) for SIH and malignancies from 2015 to 2020 was analysed.

RESULTS

The median age and female ratio in the study population were 70 years old and 80%, respectively. Although no differences were found in inflammatory marker values between the two groups, the patient global assessment and Health Assessment Questionnaire scores were higher in HTLV-1-positive RA patients. In HTLV-1-negative RA patients, the IR for SIH was 6.37/100 person-years (PY) and 1.32/100 PY for malignancies. In HTLV-1-positive RA patients, SIH occurred in 11.1/100 PY and malignancies in 2.46/100 PY. The crude IR ratio comparing SIH between two groups was 1.74 (95% confidence interval, 1.04-2.84), which was a significant increase.

CONCLUSIONS

HTLV-1-positive RA patients may worsen RA symptoms. HTLV-1 may be a risk factor for SIH.

摘要

目的

评估人类 T 细胞白血病病毒 1（HTLV-1）阳性类风湿关节炎（RA）患者的临床特征。此外，我们还研究了 HTLV-1 感染对需要住院治疗的严重感染（SIH）和恶性肿瘤发生率的影响。

方法

从 HTLV-1 RA 宫崎队列研究中纳入了 150 名年龄和性别匹配的 HTLV-1 阴性和 50 名 HTLV-1 阳性 RA 患者。从该队列数据库中收集了临床和实验室数据。分析了 2015 年至 2020 年 SIH 和恶性肿瘤的发病率。

结果

研究人群的中位年龄和女性比例分别为 70 岁和 80%。虽然两组之间的炎症标志物值没有差异，但 HTLV-1 阳性 RA 患者的患者整体评估和健康评估问卷评分更高。在 HTLV-1 阴性 RA 患者中，SIH 的发病率为 6.37/100 人年（PY），恶性肿瘤为 1.32/100 PY。在 HTLV-1 阳性 RA 患者中，SIH 发生在 11.1/100 PY，恶性肿瘤发生在 2.46/100 PY。两组 SIH 的粗发病率比为 1.74（95%置信区间，1.04-2.84），这是显著增加。