Risk of Uveitis in Dengue Fever Patients: A Population-Based Cohort Study in Taiwan

Abstract

Dengue-related ocular complications were considered rare, but recent evidence points to a broader spectrum of manifestations, including uveitis. This study utilized the Taiwan National Health Insurance Research Database (NHIRD) to investigate the incidence of uveitis in dengue patients, aiming to fill this research gap. This population-based, retrospective cohort study utilized the Taiwan National Health Insurance Research Database (NHIRD) and included patients with and without Dengue fever. The non-Dengue fever cohort comprised randomly selected control patients who were matched. Hazard ratios and Kaplan-Meier analysis were conducted to compare the incidence of uveitis in the Dengue and non-Dengue cohorts. Subgroup analyses were carried out based on age groups, genders, and comorbidities. A total of 26 950 patients diagnosed with Dengue fever were included in the study (49.6% female, mean age at index 41.63 years). Based on a 1:4 matching ratio, 107 800 control subjects without uveitis (50.03% female, mean age at index 41.41 years) were also included. The adjusted hazard ratio (aHR) of uveitis was higher in the Dengue fever group than in the non-Dengue fever group (aHR = 1.38, p < 0.001). A history of stroke or transient ischemic attack (TIA) was not associated with uveitis. Stratified analyses revealed that patients with Dengue fever had an increased risk regardless of their sex and age. The Kaplan-Meier method with the log-rank test showed a significantly higher cumulative incidence of uveitis in the Dengue fever cohort than in the non-Dengue fever cohort (p < 0.001). In the subgroup analysis for most major comorbidities, the significantly higher risk for uveitis in those patients with Dengue fever, was only demonstrated in the subgroups of those without these major comorbidities. Our findings showed Dengue infection to be associated with increased risk for uveitis. Clinicians should be attentive to a history of stroke or TIA in patients with Dengue fever.

Keywords: arboviral disease; dengue fever; stroke; transient ischemic attack; uveitis.