Table 2.
Adjusted hazard rate ratios (95% confidence intervals) [reference non-atopic dermatitis (AD) group] of infectious outcomes among children and adults with AD in The Health Improvement Network® (THIN®) database, 1994–2015
| Infectious outcome | Paediatric cohorta (aged < 18 years) |
Adult cohortb (aged ≥ 18 years) |
||||||
|---|---|---|---|---|---|---|---|---|
| Overall AD | Mild AD | Moderate AD | Severe AD | Overall AD | Mild AD | Moderate AD | Severe AD | |
| Herpesvirus | 1·37 (1·36–1·38) | 1·34 (1·33–1·36) | 1·65 (1·60–1·70) | 1·81 (1·72–1·91) | 1·26 (1·25–1·28) | 1·22 (1·20–1·25) | 1·28 (1·26–1·31) | 1·60 (1·53–1·68) |
| CMV | 2·50 (1·38–4·54) | 2·33 (1·22–4·43) | 2·30 (0·54–9·84) | 7·62 (1·66–35·0) | 1·41 (0·92–2·17) | 1·00 (0·54–1·84) | 1·63 (0·88–3·01) | 4·45 (1·76–11·25) |
| EBV | 1·04 (0·98–1·09) | 1·09 (1·04–1·16) | 0·88 (0·78–0·99) | 0·57 (0·42–0·78) | 1·13 (1·03–1·24) | 1·09 (0·98–1·22) | 1·15 (0·98–1·33) | 1·54 (1·09–2·19) |
| HSV | 1·52 (1·48–1·56) | 1·44 (1·40–1·48) | 1·83 (1·72–1·94) | 2·66 (2·40–2·95) | 1·50 (1·46–1·53) | 1·41 (1·38–1·46) | 1·57 (1·52–1·63) | 1·95 (1·80–2·11) |
| EH | 32·7 (24·3–43·9) | 20·7 (15·3–28·2) | 125·7 (89·3–176·9) | 252·9 (174·3–366·9) | 19·9 (12·9–30·5) | 7·42 (4·31–12·78) | 28·3 (17·8–45·0) | 115·6 (68·4,195·4) |
| Non-EH | 1·46 (1·42–1·50) | 1·40 (1·36–1·44) | 1·68 (1·58–1·79) | 2·29 (2·04–2·56) | 1·49 (1·45–1·52) | 1·41 (1·37–1·45) | 1·56 (1·51–1·62) | 1·89 (1·75–2·05) |
| VZV | 1·33 (1·32–1·35) | 1·31 (1·30–1·32) | 1·59 (1·53–1·64) | 1·70 (1·60–1·80) | 1·18 (1·16–1·19) | 1·14 (1·12–1·16) | 1·18 (1·15–1·21) | 1·52 (1·44–1·61) |
| Herpes zoster | 1·10 (1·07–1·13) | 1·07 (1·04–1·11) | 1·17 (1·09–1·27) | 1·57 (1·38–1·79) | 1·17 (1·15–1·19) | 1·13 (1·11–1·16) | 1·18 (1·16–1·21) | 1·53 (1·44–1·62) |
| Opportunistic infectionc | 1·09 (0·94–1·28) | 1·06 (0·90–1·25) | 1·27 (0·86–1·88) | 1·36 (0·64–2·86) | 1·31 (1·20–1·42) | 1·12 (1·001–1·26) | 1·41 (1·25–1·59) | 2·54 (2·01–3·23) |
| Serious infectiond | 1·40 (1·38–1·43) | 1·34 (1·32–1·37) | 1·86 (1·77–1·95) | 2·01 (1·84–2·19) | 1·26 (1·24–1·27) | 1·17 (1·15–1·19) | 1·31 (1·28–1·33) | 1·68 (1·61–1·76) |
CMV, cytomegalovirus; EBV, Epstein–Barr virus; HSV, herpes simplex virus; EH, eczema herpeticum; VZV, varicella zoster virus. Tests for trend with P < 0·001 for all outcomes except EBV in the paediatric cohort (P = 0·42) and opportunistic infection in the paediatric cohort (P = 0·16).
Adjusted for age, sex, Townsend score, allergic rhinitis, asthma, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, depression, diabetes, inflammatory bowel disease, liver disease, and vaccinations for influenza, meningococcus and pneumococcus.
Adjusted for same covariates as paediatric cohort as well as body mass index, smoking and alcohol status.
Opportunistic infection includes actinomycosis/nocardiosis, aspergillosis, BK virus, cryptococcosis, cytomegalovirus, mucormycosis, other mycoses (blastomycosis, coccidioidomycosis, histoplasmosis and paracoccidioidomycosis), pneumocystis, progressive multifocal leukoencephalopathy, tuberculosis and toxoplasmosis.
Serious infection includes infections of respiratory tract, urinary tract, gastrointestinal tract/abdominal cavity, bone or joints, central nervous system or meninges, heart, skin or soft tissue, prostate, breast, and eyes and sepsis requiring hospitalization. Statistically significant hazard rate ratios with P < 0·05 are in bold.