The risk of nontuberculous mycobacterial infection in patients with Sjögren’s syndrome: a nationwide, population-based cohort study

• Main Authors: Wen-Cheng Chao, Ching-Heng Lin, Tsai-Ling Liao, Yi-Ming Chen, Chiann-Yi Hsu, Jun-Peng Chen, Der-Yuan Chen, Hsin-Hua Chen
• Format: Article
• Language: English
• Published: BMC 2017-12-01
• Series: BMC Infectious Diseases
• Subjects: Sjögren’s syndrome; Nontuberculous mycobacteria; Immunosuppressant
• Online Access: http://link.springer.com/article/10.1186/s12879-017-2930-7

Abstract Background Nontuberculous mycobacterial (NTM) infection in immunocompromized patients is currently a growing health concern, and we aimed to examine the relative risk of NTM infection in patients with Sjögren’s syndrome (SS) compared with that in non-SS individuals. Methods We used the 2003–2012 Taiwanese National Health Insurance Research Database to identify 6554 incident SS cases during 2007–2012 and selected 98,310 non-SS controls matched (1:15) for age, gender, and the year of first SS diagnosis date after excluding those who had rheumatoid arthritis or systemic lupus erythematosus. Results We identified four NTM-infected patients in the SS group (three in the first year) and nine in the non-SS group (three in the first year). SS patients had a higher incidence rate of NTM infection than that in non-SS individuals (IRR, 7.56; 95% CI, 2.33–24.55), especially during the first year (IRR, 16.05; 95% CI, 3.24–79.51). After adjusting for potential confounders, the risk of NTM infection was not increased in SS patients during the entire follow-up period or during the first year, but the risk increased in SS patients treated with immunosuppressants during the entire follow-up period (HR, 17.77; 95% CI, 4.53–69.61), especially during the first year (HR, 33.33; 95% CI, 4.37–254.23). Conclusion An increased risk of NTM infection was found in SS patients treated with immunosuppressants during the first year after SS diagnosis.