Exposure to rotavirus-associated hospitalization tied to heightened autoimmune disease risk

This study is published in JAMA Network Open.

The study was conducted to determine if Rotavirus infection causing gastroenteritis in children is associated with further autoimmune processes.

In this study of 2 million Korean children, the occurrence of rotavirus-associated hospitalization was tied to a 1.24-fold higher risk of autoimmune disease when compared with controls.

It is already known that in children, Rotavirus infection commonly causes gastroenteritis in children, and it can trigger autoimmune processes. There needs to be more understanding of the nature of this interaction.

In this study, researchers estimated the association of rotavirus infection with the risk of subsequent autoimmune disease in a population-matched cohort study using data from children and adolescents in South Korea.

The cohort had 86 157 patients in the exposure group who had experienced rotavirus-associated hospitalization and the same number of matched patients in the unexposed group. The primary outcome was childhood autoimmune diseases.

The key results of this study are:

• The study had 1 914 461 individuals born in South Korea from 2002 to 2005.

• The number of individuals in exposed and unexposed groups was 86 517 and 86 517, respectively.

• The study had 49 072 male patients constituting 57 %.

• The median age was 1.5 years at the time of diagnosis of rotavirus-associated hospitalization.

• For a mean follow-up duration of 12.1 years, HR for autoimmune disease in the exposed group was 1.24.

• Rotavirus-associated hospitalization was associated with an increased risk of subsequent autoimmune disease with HR of 1.22.

• Those with rotavirus-associated hospitalization were related to multiple autoimmune syndromes, and the number of rotavirus-associated hospitalization were associated with higher risks for autoimmune disease in a dose-dependent manner.

• The HR for single hospitalization and multiple events was 1.20 and 1.60, respectively.

They noted a significant association of rotavirus-associated hospitalization with subsequent autoimmune disease during childhood.

The team put forth an important clinical implication that Clinicians should be aware of the heightened susceptibility to autoimmune disease in those with prior rotavirus-associated hospitalization.

To the best of our knowledge, this is the first study to examine the association of rotavirus infection with major autoimmune diseases in children using a population-based comparison they highlighted.

Some of the study’s strengths were a population-based cohort, complete follow-up, large sample size, and multiple outcome measures.

Further reading:

Ha EK, Kim JH, Cha HR, et al. Rotavirus-Associated Hospitalization in Children With Subsequent Autoimmune Disease. JAMA Netw Open. 2023;6(7):e2324532. doi:10.1001/jamanetworkopen.2023.24532