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Risk of Infections Among 2100 Individuals with IgA Deficiency: a Nationwide Cohort Study

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Abstract

Purpose

To explore the risk of infections in individuals with IgA deficiency compared to general population controls.

Methods

In this nationwide prospective population-based cohort study, we used data on IgA levels (<0.07 g/L) from six university hospitals in Sweden to identify 2100 individuals with IgA deficiency. Individuals were diagnosed between 1980 and 2010. For each patient with IgA deficiency we identified 10 controls from the general population, matched on age, sex, and place of residence (n = 18,653). Data on infections were obtained from the Swedish National Patient Register (including inpatient and hospital-based outpatient care) between 2001 and 2010. We defined infections as having a record of a relevant international classification of disease (ICD) code. Prevalences and prevalence ratios (PRs) were calculated.

Results

Individuals with IgA deficiency were more likely to have a record of any infection (36.1 vs. 18.8 % in controls) corresponding to a PR of 2.4 (95%CI 2.2-2.6). We also noted statistically significant associations with IgA deficiency (all P-values <0.05) and respiratory tract infections (17.8 vs. 6.3 % in controls; PR = 3.2), gastrointestinal infections (6.0 vs. 1.8 % in controls; PR = 3.5), skin infections (4.1 vs. 2.2 % in controls; PR = 1.9), joint infections (0.48 vs. 0.24 % in controls; PR = 2.0; P = 0.052), sepsis (1.5 vs. 0.45 % in controls; PR = 3.4), meningitis (0.38 vs. 0.12 %, PR = 3.2), mastoiditis/otitis (2.1 vs. 1.1 % in controls; PR = 2.0), and urinary tract infections (6.1 vs. 3.4 % in controls; PR = 1.8).

Conclusions

Individuals with IgA deficiency are at an increased risk of infections requiring hospital care.

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Abbreviations

PR:

Prevalence ratio

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Author’s Contributions

Dr Ludvigsson and Dr Neovius had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Ludvigsson

Acquisition of data: Hammarström

Drafting of the manuscript: Ludvigsson, Neovius

Critical revision of the manuscript for important intellectual content: Hammarström, Ludvigsson, Neovius

Statistical analysis: Ludvigsson, Neovius

Obtained funding: Hammarström

Study supervision: Ludvigsson, Hammarström

Funding

JFL was supported by grants from the Swedish Research Council; MN: None; LH: Swedish Research Council.

Author information

Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Jonas F. Ludvigsson

  2. Department of Paediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden

    Jonas F. Ludvigsson

  3. Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK

    Jonas F. Ludvigsson

  4. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Martin Neovius

  5. Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

    Lennart Hammarström

Authors
  1. Jonas F. Ludvigsson
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  2. Martin Neovius
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  3. Lennart Hammarström
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Corresponding author

Correspondence to Jonas F. Ludvigsson.

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Conflict of Interest

The authors (JFL, MN, LH) declare that they have no conflicts of interest relevant to the contents of this manuscript.

Ethical Approval

This project (2011/69-31/3) was approved by the Regional Ethical Review Board in Stockholm on Feb 23, 2011. This was a register-based study and therefore all data were anonymised prior to analysis, and we were not allowed to contact the individuals.

Statement of Independence of Researchers from Funders

No person representing the funding sources read or commented on any version of the manuscript.

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Ludvigsson, J.F., Neovius, M. & Hammarström, L. Risk of Infections Among 2100 Individuals with IgA Deficiency: a Nationwide Cohort Study. J Clin Immunol 36, 134–140 (2016). https://doi.org/10.1007/s10875-015-0230-9

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  • DOI: https://doi.org/10.1007/s10875-015-0230-9

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