Increased risk of autoimmune diseases in dengue patients: A population-based cohort study

  • Author Footnotes
    1 Both authors contributed equally to the manuscript.
    Hao-Ming Li
    1 Both authors contributed equally to the manuscript.
    Department of Radiology, E-Da Hospital, No.1, Yida Road, Kaohsiung 824, Taiwan
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  • Author Footnotes
    1 Both authors contributed equally to the manuscript.
    Ying-Kai Huang
    1 Both authors contributed equally to the manuscript.
    Department of Radiology, Kaohsiung Municipal Min-Sheng Hospital, No. 134, Kaisyuan 2nd Rd, Kaohsiung 802, Taiwan
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  • Yuan-Chih Su
    Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    College of Medicine, China Medical University, Taichung, Taiwan
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  • Chia-Hung Kao
    Corresponding author at: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan.
    Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan

    Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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  • Author Footnotes
    1 Both authors contributed equally to the manuscript.


      • Dengue patients are associated with higher risks of autoimmune diseases.
      • Clinicians should be aware of such possibility, especially in those with persistent symptoms.



      To investigate the risk of autoimmune diseases in dengue patients.


      We conducted a population-based cohort study by the Taiwan National Health Insurance Research Database, including a total of 12,506 newly diagnosed dengue patients and 112,554 control subjects between 2000 and 2010, matched by gender, age, income, urbanization, and comorbidities. Both cohorts were followed for a 3-year period to examine the incidence of autoimmune diseases. A Cox proportional hazards regression analysis was applied to calculate the risk of autoimmune diseases between both groups.


      The dengue group showed an overall increased risk for 21 autoimmune diseases, with an adjusted hazard ratio (aHR) of 1.88 (95% confidence interval [CI], 1.49–2.37, p < 0.001). Compared with the control group, the dengue group had higher risks of Reiter's syndrome (aHR 14.03, 95 % CI 1.63–120.58), multiple sclerosis (aHR 11.57, 95 % CI 1.8–74.4), myasthenia gravis (aHR 5.35, 95 % CI 1.43–20.02), autoimmune encephalomyelitis (aHR 3.8, 95% CI 1.85–7.8), systemic vasculitis (aHR 3.7, 95 % CI 1.11–12.28), systemic lupus erythematosus (aHR 3.5, 95% CI 1.85–6.63), and primary adrenocortical insufficiency (aHR 2.05, 95% CI 1.25–3.35).


      Dengue patients were associated with an increased risk of autoimmune diseases.


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