Association of Infection With Human Papillomavirus and Development of End-Stage Kidney Disease in Taiwan

doi:10.1001/jamanetworkopen.2020.22107

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24772

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24772

Title:	Association of Infection With Human Papillomavirus and Development of End-Stage Kidney Disease in Taiwan
Authors:	Chang, R;Chen, ML;Lin, CL;Hung, YM;Wei, JCC
Date:	2020
Issue Date:	2022-08-09T08:07:46Z (UTC)
Publisher:	AMER MEDICAL ASSOC
ISSN:	2574-3805
Abstract:	Importance The association between human papillomavirus (HPV) infection status and the natural process of kidney diseases has been neglected as an area of research. Further studies are needed to clarify factors that may alter the progression of end-stage kidney disease (ESKD). Objective To describe the rates of ESKD among patients with and without HPV infection. Design, Setting, and Participants In this nationwide, population-based retrospective cohort study, data were collected from the National Health Insurance Research Database of Taiwan. A total of 76088 individuals with HPV infection were enrolled from January 1, 2000, to December 31, 2012, and compared with a control group of 76088 individuals who had never been diagnosed with HPV infection (at a 1:1 ratio propensity-score matched by age, sex, index year, and comorbidities) in the context of the risk of developing ESKD. Statistical analysis was performed between November 2019 and July 2020. Exposures HPV infection was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Main Outcomes and Measures The main outcome was ESKD, as recorded in the Catastrophic Illness Patients database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs, with the control group as a reference. Results Of 152176 individuals (79652 [52.3%] women; mean [SD] age, 34.4 [19.1] years), 76088 individuals (50.0%) had HPV and 463 individuals (0.3%) developed ESKD. Incidence of ESKD was lower in individuals with HPV history than in those without HPV history (3.64 per 10000 person-years vs 4.80 per 10000 person-years). In the fully adjusted multivariate Cox proportional hazards regression model, individuals with a history of HPV infection had a significant decrease in risk of ESKD (adjusted HR, 0.72; 95% CI, 0.60-0.87) after adjusting for demographic characteristics, comorbidities, and comedications. In the subgroup analysis, individuals ages 50 to 64 years with HPV infection had a statistically significantly lower risk of ESKD compared with individuals ages 50 to 64 years with no HPV infection (adjusted HR, 0.48; 95% CI, 0.34-0.68; P < .001), while there was no significant reduction in risk for the other age groups (ie, 0-19, 20-49, and 65-100 years). Conclusions and Relevance In this study, a history of HPV infection was associated with a lower risk of subsequent ESKD. The mechanism behind this protective association remains uncertain. Future studies are required to clarify the possible biological mechanisms. This cohort study investigates the association of human papillomavirus infection status with development of end-stage kidney disease in Taiwan. Question What is the association of human papillomavirus (HPV) infection with subsequent development of end-stage kidney disease (ESKD) in the general population of Taiwan? Findings In this nationwide, population-based matched cohort study of 152176 individuals, HPV infection was negatively associated with development of ESKD. Meaning These findings suggest that future detailed studies of the mechanisms involved in the association between HPV infection status and decreased risk of ESKD could yield targets for interventions to delay the development of ESKD.
URI:	http://dx.doi.org/10.1001/jamanetworkopen.2020.22107 https://www.webofscience.com/wos/woscc/full-record/WOS:000586430000004 https://ir.csmu.edu.tw:8080/handle/310902500/24772
Relation:	JAMA NETWORK OPEN ,2020 ,v3 ,issue 10
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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