Rotavirus-associated hospitalization is linked to increased risk for childhood autoimmune disease, according to a study published in JAMA Network Open.
Investigators assessed the relationship between rotavirus infection and risk for autoimmune disease among children.
A population-matched cohort study was conducted. A total of 86,157 children aged less than 18 years who experienced a rotavirus-associated hospitalization (exposed group) were age- and sex-matched with 86,157 patients in a control group (unexposed group). The main exposure of interest was incidence of hospitalization due to rotavirus infection.
Among the exposed and unexposed groups, 37,085 participants were girls and 49,072 were boys. Mean follow-up time for the exposed and unexposed groups was 12.05 and 12.20 years, respectively.
During the first year, the exposed group had a higher number of inpatient and outpatient hospital visits than the unexposed group. Additionally, their use of prescription medications, particularly antibiotics and systemic steroids, increased.
Newly diagnosed autoimmune disease was identified among 8.8% of patients in the exposed group vs 7.0% in the unexposed group, corresponding to a rate difference of 15.1 patients per 10,000 person years (95% CI, 12.90-17.29 per 10,000 person years).
The exposure group was associated with an overall increased risk for autoimmune disease (hazard ratio [HR], 1.24; 95% CI, 1.19-1.28), specifically among the following: inflammatory arthritis (HR, 1.36; 95% CI, 1.25-1.48), connective tissue disorders (HR, 1.29; 95% CI, 1.08-1.55), nervous system diseases (HR, 1.29; 95% CI, 1.04-1.60), endocrine diseases (HR, 1.28; 95% CI, 1.17-1.40), and vasculitis (HR, 1.20; 95% CI, 1.12-1.29).
This study was limited by potential surveillance bias and inability to determine whether the unexposed group experienced hospitalization due to other causes.
The study authors concluded, “Clinicians should be aware of the increased predisposition for autoimmune disease in individuals who experienced rotavirus associated hospitalization. Further studies are needed to understand the underlying mechanisms.”
Ha EK, Kim JH, Cha HR, et al. Rotavirus-associated hospitalization in children with subsequent autoimmune disease. JAMA Netw Open. Published online July 3, 2023. doi:10.1001/jamanetworkopen.2023.24532