Chronic hepatitis c virus infection is associated with the development of rheumatoid arthritis

A nationwide population-based study in taiwan

Fu-Hsiung Su, Chien Sheng Wu, Fung Chang Sung, Shih Ni Chang, Chien-Tien Su, Ying-Hua Shieh, Chih-Ching Yeh

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The association between chronic hepatitis virus infection and rheumatoid arthritis (RA) remains debatable. This nationwide population-based cohort study assessed the risk of RA among patients with a chronic infection of hepatitis B and/or C virus. Materials and Methods: We used data extracted from the claims of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance program. Among the 49,892 persons identified in 2000-2010 with chronic hepatitis virus infection, 35,652 had chronic HBV infection alone, 10,253 had chronic HCV infection alone, and 3,987 had chronic HBV/HCV dual infections. The comparison cohort comprised 199,568 persons matched on sex, age and calendar year without chronic hepatitis virus infection. All study participants were free of RA at baseline and traced through 2011 with new RA cases identified. Results: After adjusting for covariates, chronic HCV infection alone was significantly associated with an increased risk for RA (hazard ratio (HR) 52.03, 95% confidence interval (CI) 51.27-3.22). The increased risk for RA among participants with chronic HCV infection remained significant after restricting the analysis to those who were prescribed disease-modifying anti-rheumatic drugs. The corresponding HR for the overall sample was 1.89 (95% CI 51.15-3.11). However, HBV carriers did not appear to be at a significantly higher risk for RA. Funding was provided by 1. FHS: research grant from Taipei Medical University Hospital (101TMU-TMUH-13); 2. FCS: research grant from Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH102-TD-B-111-004). Both funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conclusion: Our data imply that chronic HCV infection is associated with RA development.

Original languageEnglish
Article numbere113579
JournalPLoS One
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 21 2014

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chronic hepatitis
Hepatitis Viruses
rheumatoid arthritis
Virus Diseases
Chronic Hepatitis
Taiwan
Viruses
Rheumatoid Arthritis
viruses
infection
Population
Infection
Hazards
Health insurance
Antirheumatic Agents
Organized Financing
Decision theory
National Health Programs
Research
Health

Keywords

  • Hepatitis C virus
  • rheumatoid arthritis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Chronic hepatitis c virus infection is associated with the development of rheumatoid arthritis : A nationwide population-based study in taiwan. / Su, Fu-Hsiung; Wu, Chien Sheng; Sung, Fung Chang; Chang, Shih Ni; Su, Chien-Tien; Shieh, Ying-Hua; Yeh, Chih-Ching.

In: PLoS One, Vol. 9, No. 11, e113579, 21.11.2014.

Research output: Contribution to journalArticle

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abstract = "The association between chronic hepatitis virus infection and rheumatoid arthritis (RA) remains debatable. This nationwide population-based cohort study assessed the risk of RA among patients with a chronic infection of hepatitis B and/or C virus. Materials and Methods: We used data extracted from the claims of 1,000,000 randomly sampled individuals covered under the Taiwan National Health Insurance program. Among the 49,892 persons identified in 2000-2010 with chronic hepatitis virus infection, 35,652 had chronic HBV infection alone, 10,253 had chronic HCV infection alone, and 3,987 had chronic HBV/HCV dual infections. The comparison cohort comprised 199,568 persons matched on sex, age and calendar year without chronic hepatitis virus infection. All study participants were free of RA at baseline and traced through 2011 with new RA cases identified. Results: After adjusting for covariates, chronic HCV infection alone was significantly associated with an increased risk for RA (hazard ratio (HR) 52.03, 95{\%} confidence interval (CI) 51.27-3.22). The increased risk for RA among participants with chronic HCV infection remained significant after restricting the analysis to those who were prescribed disease-modifying anti-rheumatic drugs. The corresponding HR for the overall sample was 1.89 (95{\%} CI 51.15-3.11). However, HBV carriers did not appear to be at a significantly higher risk for RA. Funding was provided by 1. FHS: research grant from Taipei Medical University Hospital (101TMU-TMUH-13); 2. FCS: research grant from Taiwan Department of Health Clinical Trial and Research Center of Excellence (DOH102-TD-B-111-004). Both funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conclusion: Our data imply that chronic HCV infection is associated with RA development.",
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