Infections as risk factor for autoimmune diseases - A nationwide study.
Viruses, bacteria and other infectious pathogens are the major postulated environmental triggers of autoimmunity. In the present nation-wide study we describe the association between infections and 29 autoimmune diseases. We used the Danish Civil Registration System to identify 4.5 million persons born between 1945 and 2000. Information on infections and autoimmune diseases was obtained from the Danish Hospital Register. The cohort was followed from 1977 to 2012. Incidence rate ratios for developing an autoimmune disease were estimated using poisson regression. We found an association between hospital admission for an infection and 29 autoimmune diseases. This study shows that infections are risk factors for a broad spectrum of autoimmune diseases in a dose-response and temporal manner, in agreement with the hypothesis that infections are an environmental risk factor contributing to the etiology of autoimmune diseases together with genetic factors.
National Center for Register-based Research, Fuglesangs Allé 4, Aarhus University, Aarhus, Denmark. Electronic address: prn@econ.au.dk.
Philip Rising
PR
Nielsen
Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Nørrebrogade 44, Aarhus, Denmark.
Tue Wenzel
TW
Kragstrup
Department of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Nørrebrogade 44, Aarhus, Denmark.
Bent Winding
BW
Deleuran
Mental Health Center Copenhagen, Copehagen University Hospital, Copenhagen, Denmark.
Michael Eriksen
ME
Benros
D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000209:etiology*; D003718:Denmark / Q000453:epidemiology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D012042:Registries; D012307:Risk Factors; D013997:Time Factors
Autoimmune disease; Epidemiology; Infections