Risk of diffuse infiltrative lymphocytosis syndrome in HIV-infected patients: A nationwide population-based cohort study

Marcelo Chen, Yung Feng Yen, Yu Ching Lan, I. An Jen, Pei Hung Chuang, Chun Yuan Lee, Yun Lee, Yu An Lin, Yi Ming Arthur Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Diffuse infiltrative lymphocytosis syndrome (DILS) is the term used for sicca syndrome in HIV patients and has similar clinical manifestations as Sjögren syndrome. In this nationwide population-based study, we aimed to determine the association between HIV infection and DILS in the Taiwanese population. Methods: The National Health Insurance Research Database was searched for cases of DILS in HIV-infected individuals diagnosed between January 1, 2000, and December 31, 2012. The incidence of DILS and the factors associated with DILS in people living with HIV/AIDS (PLWHA) were determined. Results: A total of 20,364 PLWHA were followed, and 57 (0.28%) individuals had new-onset DILS. The incidence rate of DILS in PLWHA was 0.56/1000 person-years. One (0.11%) female HIV patient with highly active antiretroviral therapy (HAART) and 24 (2.99%) without HAART had incident DILS, whereas 22 (0.17%) male HIV patients with HAART and 10 (0.17%) without HAART had incident DILS. Hypertension increased the risk of incident DILS. HAART decreased the risk of DILS, but this relationship somewhat attenuated in an adjusted model. None of the patients taking emtricitabine, raltegravir, darunavir, enfuvirtide, or tipranavir developed DILS. Lopinavir was associated with a decreased risk of DILS (adjusted hazard ratio = 0.10, 95% confidence interval: 0.01 to 0.84), whereas zalcitabine was associated with an increased risk of DILS (adjusted hazard ratio = 13.7, 95% confidence interval: 2.18 to 85.9). Conclusions: DILS is a rare disease found in PLWHA. Hypertension is a risk factor for incident DILS, and HAART could affect the pathogenesis of DILS. Zalcitabine was the only antiretroviral agent found to increase the risk of DILS.

Original languageEnglish
Pages (from-to)158-163
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Volume79
Issue number2
DOIs
Publication statusPublished - Jan 1 2018
Externally publishedYes

Fingerprint

Lymphocytosis
Cohort Studies
HIV
Population
Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
Zalcitabine
Confidence Intervals
Lopinavir
Anti-Retroviral Agents
Hypertension

Keywords

  • Antiretroviral agent
  • Diffuse infiltrative lymphocytosis syndrome
  • Epidemiology
  • Human immunodeficiency virus
  • Risk

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Risk of diffuse infiltrative lymphocytosis syndrome in HIV-infected patients : A nationwide population-based cohort study. / Chen, Marcelo; Yen, Yung Feng; Lan, Yu Ching; Jen, I. An; Chuang, Pei Hung; Lee, Chun Yuan; Lee, Yun; Lin, Yu An; Chen, Yi Ming Arthur.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 79, No. 2, 01.01.2018, p. 158-163.

Research output: Contribution to journalArticle

Chen, Marcelo ; Yen, Yung Feng ; Lan, Yu Ching ; Jen, I. An ; Chuang, Pei Hung ; Lee, Chun Yuan ; Lee, Yun ; Lin, Yu An ; Chen, Yi Ming Arthur. / Risk of diffuse infiltrative lymphocytosis syndrome in HIV-infected patients : A nationwide population-based cohort study. In: Journal of Acquired Immune Deficiency Syndromes. 2018 ; Vol. 79, No. 2. pp. 158-163.
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abstract = "Objective: Diffuse infiltrative lymphocytosis syndrome (DILS) is the term used for sicca syndrome in HIV patients and has similar clinical manifestations as Sj{\"o}gren syndrome. In this nationwide population-based study, we aimed to determine the association between HIV infection and DILS in the Taiwanese population. Methods: The National Health Insurance Research Database was searched for cases of DILS in HIV-infected individuals diagnosed between January 1, 2000, and December 31, 2012. The incidence of DILS and the factors associated with DILS in people living with HIV/AIDS (PLWHA) were determined. Results: A total of 20,364 PLWHA were followed, and 57 (0.28{\%}) individuals had new-onset DILS. The incidence rate of DILS in PLWHA was 0.56/1000 person-years. One (0.11{\%}) female HIV patient with highly active antiretroviral therapy (HAART) and 24 (2.99{\%}) without HAART had incident DILS, whereas 22 (0.17{\%}) male HIV patients with HAART and 10 (0.17{\%}) without HAART had incident DILS. Hypertension increased the risk of incident DILS. HAART decreased the risk of DILS, but this relationship somewhat attenuated in an adjusted model. None of the patients taking emtricitabine, raltegravir, darunavir, enfuvirtide, or tipranavir developed DILS. Lopinavir was associated with a decreased risk of DILS (adjusted hazard ratio = 0.10, 95{\%} confidence interval: 0.01 to 0.84), whereas zalcitabine was associated with an increased risk of DILS (adjusted hazard ratio = 13.7, 95{\%} confidence interval: 2.18 to 85.9). Conclusions: DILS is a rare disease found in PLWHA. Hypertension is a risk factor for incident DILS, and HAART could affect the pathogenesis of DILS. Zalcitabine was the only antiretroviral agent found to increase the risk of DILS.",
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T2 - A nationwide population-based cohort study

AU - Chen, Marcelo

AU - Yen, Yung Feng

AU - Lan, Yu Ching

AU - Jen, I. An

AU - Chuang, Pei Hung

AU - Lee, Chun Yuan

AU - Lee, Yun

AU - Lin, Yu An

AU - Chen, Yi Ming Arthur

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N2 - Objective: Diffuse infiltrative lymphocytosis syndrome (DILS) is the term used for sicca syndrome in HIV patients and has similar clinical manifestations as Sjögren syndrome. In this nationwide population-based study, we aimed to determine the association between HIV infection and DILS in the Taiwanese population. Methods: The National Health Insurance Research Database was searched for cases of DILS in HIV-infected individuals diagnosed between January 1, 2000, and December 31, 2012. The incidence of DILS and the factors associated with DILS in people living with HIV/AIDS (PLWHA) were determined. Results: A total of 20,364 PLWHA were followed, and 57 (0.28%) individuals had new-onset DILS. The incidence rate of DILS in PLWHA was 0.56/1000 person-years. One (0.11%) female HIV patient with highly active antiretroviral therapy (HAART) and 24 (2.99%) without HAART had incident DILS, whereas 22 (0.17%) male HIV patients with HAART and 10 (0.17%) without HAART had incident DILS. Hypertension increased the risk of incident DILS. HAART decreased the risk of DILS, but this relationship somewhat attenuated in an adjusted model. None of the patients taking emtricitabine, raltegravir, darunavir, enfuvirtide, or tipranavir developed DILS. Lopinavir was associated with a decreased risk of DILS (adjusted hazard ratio = 0.10, 95% confidence interval: 0.01 to 0.84), whereas zalcitabine was associated with an increased risk of DILS (adjusted hazard ratio = 13.7, 95% confidence interval: 2.18 to 85.9). Conclusions: DILS is a rare disease found in PLWHA. Hypertension is a risk factor for incident DILS, and HAART could affect the pathogenesis of DILS. Zalcitabine was the only antiretroviral agent found to increase the risk of DILS.

AB - Objective: Diffuse infiltrative lymphocytosis syndrome (DILS) is the term used for sicca syndrome in HIV patients and has similar clinical manifestations as Sjögren syndrome. In this nationwide population-based study, we aimed to determine the association between HIV infection and DILS in the Taiwanese population. Methods: The National Health Insurance Research Database was searched for cases of DILS in HIV-infected individuals diagnosed between January 1, 2000, and December 31, 2012. The incidence of DILS and the factors associated with DILS in people living with HIV/AIDS (PLWHA) were determined. Results: A total of 20,364 PLWHA were followed, and 57 (0.28%) individuals had new-onset DILS. The incidence rate of DILS in PLWHA was 0.56/1000 person-years. One (0.11%) female HIV patient with highly active antiretroviral therapy (HAART) and 24 (2.99%) without HAART had incident DILS, whereas 22 (0.17%) male HIV patients with HAART and 10 (0.17%) without HAART had incident DILS. Hypertension increased the risk of incident DILS. HAART decreased the risk of DILS, but this relationship somewhat attenuated in an adjusted model. None of the patients taking emtricitabine, raltegravir, darunavir, enfuvirtide, or tipranavir developed DILS. Lopinavir was associated with a decreased risk of DILS (adjusted hazard ratio = 0.10, 95% confidence interval: 0.01 to 0.84), whereas zalcitabine was associated with an increased risk of DILS (adjusted hazard ratio = 13.7, 95% confidence interval: 2.18 to 85.9). Conclusions: DILS is a rare disease found in PLWHA. Hypertension is a risk factor for incident DILS, and HAART could affect the pathogenesis of DILS. Zalcitabine was the only antiretroviral agent found to increase the risk of DILS.

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