Document Detail

Brief report: incidence of selected opportunistic infections among children with juvenile idiopathic arthritis.
MedLine Citation:
PMID:  23460423     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA).
METHODS: Using U.S. 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.
Timothy Beukelman; Fenglong Xie; John W Baddley; Lang Chen; Elizabeth Delzell; Carlos G Grijalva; Melissa L Mannion; Nivedita M Patkar; Kenneth G Saag; Kevin L Winthrop; Jeffrey R Curtis;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  65     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-24     Completed Date:  2013-06-18     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1384-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 by the American College of Rheumatology.
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MeSH Terms
Antirheumatic Agents / adverse effects
Arthritis, Juvenile / diagnosis,  drug therapy,  epidemiology*
Coccidiosis / epidemiology
Cohort Studies
Databases, Factual
Herpes Zoster / epidemiology
Immunosuppressive Agents / adverse effects
Opportunistic Infections / diagnosis,  epidemiology*,  etiology
Salmonella Infections / epidemiology
United States / epidemiology
Grant Support
1U18-HS-017919-0/HS/AHRQ HHS; 5KL2-RR-025776/RR/NCRR NIH HHS; 5P60-AR-56116/AR/NIAMS NIH HHS; AR 053351/AR/NIAMS NIH HHS; K24 AR052361/AR/NIAMS NIH HHS; KL2 RR025776/RR/NCRR NIH HHS; R01-HS-018517/HS/AHRQ HHS
Reg. No./Substance:
0/Antirheumatic Agents; 0/Immunosuppressive Agents
Parivash Nourjah / ; Robert Glynn / ; Mary Kowal / ; Joyce Lii / ; Jeremy Rassen / ; Sebastian Schneeweiss / ; Daniel Solomon / ; Leslie Harrold / ; David Graham / ; Carolyn McCloskey / ; Rita Ouellet-Hellstrom / ; Kristin Phucas / ; Kristin Lisa Herrinton / ; Liyan Liu / ; Marcia Raebel / ; Kevin Haynes / ; James Lewis / ; Marie Griffin / ; Ed Mitchel /

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