Dr. Beukelman has received consulting fees from Novartis and Genentech (less than $10,000 each).
Brief Report: Incidence of Selected Opportunistic Infections Among Children With Juvenile Idiopathic Arthritis†
Article first published online: 23 APR 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 65, Issue 5, pages 1384–1389, May 2013
How to Cite
Beukelman, T., Xie, F., Baddley, J. W., Chen, L., Delzell, E., Grijalva, C. G., Mannion, M. L., Patkar, N. M., Saag, K. G., Winthrop, K. L., Curtis, J. R. and on behalf of the SABER Collaboration (2013), Brief Report: Incidence of Selected Opportunistic Infections Among Children With Juvenile Idiopathic Arthritis. Arthritis & Rheumatism, 65: 1384–1389. doi: 10.1002/art.37866
Statements in this report should not be construed as endorsement by the Agency for Healthcare Research and Quality (AHRQ), FDA, or US Department of Health and Human Services (DHHS).
- Issue published online: 23 APR 2013
- Article first published online: 23 APR 2013
- Accepted manuscript online: 4 MAR 2013 11:39AM EST
- Manuscript Accepted: 8 JAN 2013
- Manuscript Received: 26 OCT 2012
- AHRQ. Grant Number: R01-HS-018517
- DHHS. Grant Number: 1U18-HS-017919-0
- AHRQ Centers for Education and Research on Therapeutics Program
- NIH. Grant Numbers: 5KL2-RR-025776, 5P60-AR-56116, AR-053351
- University of Alabama at Birmingham Center for Clinical and Translational Science
To compare incidence rates of selected opportunistic infections among children with and children without juvenile idiopathic arthritis (JIA).
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.
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]).
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.