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

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.

Keywords: IgA deficiency; Immunoglobulin; Infections.