人类乳头瘤病毒感染后原发性干燥综合征的发病风险：一项全国基于人群的队列研究。
Risk of primary Sjogren's Syndrome following human papillomavirus infections: a nationwide population-based cohort study.
机构信息
Division of Allergy, Immunology, and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
出版信息
Front Immunol. 2022 Aug 16;13:967040. doi: 10.3389/fimmu.2022.967040. eCollection 2022.
INTRODUCTION
Viral infection is an exogeneous factor for primary Sjogren's syndrome (pSS). This study investigated the association between human papillomavirus (HPV) infections and pSS through a nationwide population based cohort study.
METHODS
Patients with HPV infections between January, 1999 and December, 2013 were included. The incidence of new-onset pSS in patients with HPV infections and non-HPV controls were derived. The multiple Cox regression model derived the risk of pSS in patients with HPV infections. Subgroup analysis and sensitivity analysis were performed to validate the association.
RESULTS
During a follow-up period of 12 years, the adjusted hazard ratio (aHR) of pSS in patients with HPV infections was significantly higher than that in non-HPV controls (aHR=1.64, 95% CI=1.47-1.83, P<0.001). The risk of pSS increased with age and the risk increased by 2.64-fold (95% CI= 2.37-2.93) for those older than 45 years. The significant association between HPV infections and the risk of pSS persisted in the sensitivity analysis restricted in HPV infections that lasted over 12 months (aHR=1.63, 95%CI=1.45-1.83, P<0.0001). Subgroup analyses revealed that both male (aHR=1.83, 95%CI=1.47-2.28, P<0.0001) and female (aHR=1.58, 95%CI=1.40-1.79, P<0.0001) patients with HPV infections and HPV-infected patients aged between 16 and 45 years (aHR=1.60, 95%CI=1.34-1.91, P<0.0001) and over 45 years (aHR=1.67, 95%CI=1.46-1.91, P<0.0001) were associated with a significantly greater risk of pSS.
CONCLUSION
Patients with HPV infections presented with a significantly higher risk of pSS, regardless of age and sex.
简介
病毒感染是原发性干燥综合征（pSS）的外源性因素。本研究通过全国性的队列研究调查了人乳头瘤病毒（HPV）感染与 pSS 之间的关系。
方法
纳入 1999 年 1 月至 2013 年 12 月期间 HPV 感染者。从 HPV 感染者和非 HPV 对照组中得出新发 pSS 的发生率。多 Cox 回归模型得出 HPV 感染者患 pSS 的风险。进行亚组分析和敏感性分析以验证相关性。
结果
在 12 年的随访期间，HPV 感染者发生 pSS 的调整后危险比（aHR）明显高于非 HPV 对照组（aHR=1.64，95%CI=1.47-1.83，P<0.001）。pSS 的风险随年龄增长而增加，对于年龄大于 45 岁的患者，风险增加 2.64 倍（95%CI=2.37-2.93）。HPV 感染与 pSS 风险之间的显著相关性在仅纳入 HPV 持续感染超过 12 个月的敏感性分析中仍然存在（aHR=1.63，95%CI=1.45-1.83，P<0.0001）。亚组分析显示，男性（aHR=1.83，95%CI=1.47-2.28，P<0.0001）和女性（aHR=1.58，95%CI=1.40-1.79，P<0.0001）HPV 感染者以及 16-45 岁（aHR=1.60，95%CI=1.34-1.91，P<0.0001）和大于 45 岁（aHR=1.67，95%CI=1.46-1.91，P<0.0001）的 HPV 感染者均与 pSS 的风险显著增加相关。
结论
无论年龄和性别如何，HPV 感染者发生 pSS 的风险明显更高。
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