Brief report: Incidence of selected opportunistic infections among children with juvenile idiopathic arthritis

Timothy Beukelman, Fenglong Xie, John W. Baddley, Lang Chen, Elizabeth Delzell, Carlos G. Grijalva, Melissa L. Mannion, Nivedita M. Patkar, Kenneth G. Saag, Kevin Winthrop, Jeffrey R. Curtis

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA). Methods Using US national Medicaid administrative claims data from 2000 through 2005, we identified a cohort of children with JIA based on physician diagnosis codes and dispensed medications. We also identified a non-JIA comparator cohort of children diagnosed as having attention deficit hyperactivity disorder (ADHD). We defined 15 types of opportunistic infection using physician diagnosis or hospital discharge codes; criteria for 7 of these types also included evidence of treatment with specific antimicrobial agents. We calculated infection incidence rates. The rates in the ADHD comparator cohort were standardized to the age, sex, and race distribution of the JIA cohort. We calculated incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) to compare infection rates. Results The JIA cohort included 8,503 children with 13,990 person-years of followup. The ADHD comparator cohort included 360,362 children with 477,050 person-years of followup. When all opportunistic infections were considered together as a single outcome, there were 42 infections in the JIA cohort (incidence rate 300 per 100,000 person-years; IRR 2.4 [95% CI 1.7-3.3] versus ADHD). The most common opportunistic infections among children with JIA were 3 cases of Coccidioides (incidence rate 21 per 100,000 person-years; IRR 101 [95% CI 8.1-5,319] versus ADHD), 5 cases of Salmonella (incidence rate 35 per 100,000 person-years; IRR 3.8 [95% CI 1.2-9.5]), and 32 cases of herpes zoster (incidence rate 225 per 100,000 person-years; IRR 2.1 [95% CI 1.4-3.0]). Conclusion Opportunistic infections are rare among children with JIA. Nevertheless, children with JIA had a higher rate of opportunistic infections, including an increased rate of Coccidioides, Salmonella, and herpes zoster compared to children with ADHD.

Original languageEnglish (US)
Pages (from-to)1384-1389
Number of pages6
JournalArthritis and Rheumatism
Volume65
Issue number5
DOIs
StatePublished - May 2013

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Juvenile Arthritis
Opportunistic Infections
Attention Deficit Disorder with Hyperactivity
Incidence
Confidence Intervals
Coccidioides
Herpes Zoster
Salmonella
Infection
Physicians
Sex Distribution
Medicaid
Anti-Infective Agents
Arthritis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology
  • Pharmacology (medical)

Cite this

Beukelman, T., Xie, F., Baddley, J. W., Chen, L., Delzell, E., Grijalva, C. G., ... Curtis, J. R. (2013). Brief report: Incidence of selected opportunistic infections among children with juvenile idiopathic arthritis. Arthritis and Rheumatism, 65(5), 1384-1389. https://doi.org/10.1002/art.37866

Brief report : Incidence of selected opportunistic infections among children with juvenile idiopathic arthritis. / Beukelman, Timothy; Xie, Fenglong; Baddley, John W.; Chen, Lang; Delzell, Elizabeth; Grijalva, Carlos G.; Mannion, Melissa L.; Patkar, Nivedita M.; Saag, Kenneth G.; Winthrop, Kevin; Curtis, Jeffrey R.

In: Arthritis and Rheumatism, Vol. 65, No. 5, 05.2013, p. 1384-1389.

Research output: Contribution to journalArticle

Beukelman, T, Xie, F, Baddley, JW, Chen, L, Delzell, E, Grijalva, CG, Mannion, ML, Patkar, NM, Saag, KG, Winthrop, K & Curtis, JR 2013, 'Brief report: Incidence of selected opportunistic infections among children with juvenile idiopathic arthritis', Arthritis and Rheumatism, vol. 65, no. 5, pp. 1384-1389. https://doi.org/10.1002/art.37866
Beukelman, Timothy ; Xie, Fenglong ; Baddley, John W. ; Chen, Lang ; Delzell, Elizabeth ; Grijalva, Carlos G. ; Mannion, Melissa L. ; Patkar, Nivedita M. ; Saag, Kenneth G. ; Winthrop, Kevin ; Curtis, Jeffrey R. / Brief report : Incidence of selected opportunistic infections among children with juvenile idiopathic arthritis. In: Arthritis and Rheumatism. 2013 ; Vol. 65, No. 5. pp. 1384-1389.
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abstract = "Objective To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA). Methods Using US national Medicaid administrative claims data from 2000 through 2005, we identified a cohort of children with JIA based on physician diagnosis codes and dispensed medications. We also identified a non-JIA comparator cohort of children diagnosed as having attention deficit hyperactivity disorder (ADHD). We defined 15 types of opportunistic infection using physician diagnosis or hospital discharge codes; criteria for 7 of these types also included evidence of treatment with specific antimicrobial agents. We calculated infection incidence rates. The rates in the ADHD comparator cohort were standardized to the age, sex, and race distribution of the JIA cohort. We calculated incidence rate ratios (IRRs) with 95{\%} confidence intervals (95{\%} CIs) to compare infection rates. Results The JIA cohort included 8,503 children with 13,990 person-years of followup. The ADHD comparator cohort included 360,362 children with 477,050 person-years of followup. When all opportunistic infections were considered together as a single outcome, there were 42 infections in the JIA cohort (incidence rate 300 per 100,000 person-years; IRR 2.4 [95{\%} CI 1.7-3.3] versus ADHD). The most common opportunistic infections among children with JIA were 3 cases of Coccidioides (incidence rate 21 per 100,000 person-years; IRR 101 [95{\%} CI 8.1-5,319] versus ADHD), 5 cases of Salmonella (incidence rate 35 per 100,000 person-years; IRR 3.8 [95{\%} CI 1.2-9.5]), and 32 cases of herpes zoster (incidence rate 225 per 100,000 person-years; IRR 2.1 [95{\%} CI 1.4-3.0]). Conclusion Opportunistic infections are rare among children with JIA. Nevertheless, children with JIA had a higher rate of opportunistic infections, including an increased rate of Coccidioides, Salmonella, and herpes zoster compared to children with ADHD.",
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AU - Beukelman, Timothy

AU - Xie, Fenglong

AU - Baddley, John W.

AU - Chen, Lang

AU - Delzell, Elizabeth

AU - Grijalva, Carlos G.

AU - Mannion, Melissa L.

AU - Patkar, Nivedita M.

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AU - Winthrop, Kevin

AU - Curtis, Jeffrey R.

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N2 - Objective To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA). Methods Using US national Medicaid administrative claims data from 2000 through 2005, we identified a cohort of children with JIA based on physician diagnosis codes and dispensed medications. We also identified a non-JIA comparator cohort of children diagnosed as having attention deficit hyperactivity disorder (ADHD). We defined 15 types of opportunistic infection using physician diagnosis or hospital discharge codes; criteria for 7 of these types also included evidence of treatment with specific antimicrobial agents. We calculated infection incidence rates. The rates in the ADHD comparator cohort were standardized to the age, sex, and race distribution of the JIA cohort. We calculated incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) to compare infection rates. Results The JIA cohort included 8,503 children with 13,990 person-years of followup. The ADHD comparator cohort included 360,362 children with 477,050 person-years of followup. When all opportunistic infections were considered together as a single outcome, there were 42 infections in the JIA cohort (incidence rate 300 per 100,000 person-years; IRR 2.4 [95% CI 1.7-3.3] versus ADHD). The most common opportunistic infections among children with JIA were 3 cases of Coccidioides (incidence rate 21 per 100,000 person-years; IRR 101 [95% CI 8.1-5,319] versus ADHD), 5 cases of Salmonella (incidence rate 35 per 100,000 person-years; IRR 3.8 [95% CI 1.2-9.5]), and 32 cases of herpes zoster (incidence rate 225 per 100,000 person-years; IRR 2.1 [95% CI 1.4-3.0]). Conclusion Opportunistic infections are rare among children with JIA. Nevertheless, children with JIA had a higher rate of opportunistic infections, including an increased rate of Coccidioides, Salmonella, and herpes zoster compared to children with ADHD.

AB - Objective To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA). Methods Using US national Medicaid administrative claims data from 2000 through 2005, we identified a cohort of children with JIA based on physician diagnosis codes and dispensed medications. We also identified a non-JIA comparator cohort of children diagnosed as having attention deficit hyperactivity disorder (ADHD). We defined 15 types of opportunistic infection using physician diagnosis or hospital discharge codes; criteria for 7 of these types also included evidence of treatment with specific antimicrobial agents. We calculated infection incidence rates. The rates in the ADHD comparator cohort were standardized to the age, sex, and race distribution of the JIA cohort. We calculated incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) to compare infection rates. Results The JIA cohort included 8,503 children with 13,990 person-years of followup. The ADHD comparator cohort included 360,362 children with 477,050 person-years of followup. When all opportunistic infections were considered together as a single outcome, there were 42 infections in the JIA cohort (incidence rate 300 per 100,000 person-years; IRR 2.4 [95% CI 1.7-3.3] versus ADHD). The most common opportunistic infections among children with JIA were 3 cases of Coccidioides (incidence rate 21 per 100,000 person-years; IRR 101 [95% CI 8.1-5,319] versus ADHD), 5 cases of Salmonella (incidence rate 35 per 100,000 person-years; IRR 3.8 [95% CI 1.2-9.5]), and 32 cases of herpes zoster (incidence rate 225 per 100,000 person-years; IRR 2.1 [95% CI 1.4-3.0]). Conclusion Opportunistic infections are rare among children with JIA. Nevertheless, children with JIA had a higher rate of opportunistic infections, including an increased rate of Coccidioides, Salmonella, and herpes zoster compared to children with ADHD.

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