Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/6867
Towards an age-dependent transmission model of acquired and sporadic Creutzfeldt-Jakob disease
Pedro-Cuesta, Jesus de ISCIII | Mahillo-Fernandez, Ignacio ISCIII | Calero, Miguel ISCIII | Rábano, Alberto | Cruz, Mabel | Siden, Åke | Martinez-Martin, Pablo ISCIII | Laursen, Henning | Ruiz-Tovar, Maria ISCIII | Mølbak, Kåre
PLoS One. 2014; 9(10):e109412
INTRODUCTION: Sporadic Creutzfeldt-Jakob disease (sCJD) might be transmitted by surgery. The purpose of this study was to investigate potential susceptibility to sCJD from surgery at juvenile age and in early adulthood. METHODS: From Danish and Swedish national registries we identified 167 definite and probable sCJD cases with onset from 1987 through 2003, and 835 age-, sex- and residence-matched controls along with their surgical histories. Main, anatomically or etiologically classified surgical procedures followed by a ≥20-year lag were analyzed using logistic regression, and stratified by age at first-registered surgical discharge. RESULTS: The risk of having a diagnosis of CJD depended strongly on age at first surgery with odds ratio (OR) of 12.80 (95% CI 2.56-64.0) in patients <30 years, 3.04 (95% 1.26-7.33) in 30-39 years, and 1.75 (95% CI 0.89-3.45) in ≥40 years, for anatomically classified surgical procedures. Similar figures were obtained for etiologically classified surgical procedures. CONCLUSIONS: Risk of surgical-acquired sCJD depends on age at exposure; this pattern is similar to age-specific profiles reported for CJD accidentally transmitted by human pituitary-derived growth hormone and susceptibility curves for variant CJD estimated after adjustment for dietary exposure to bovine spongiform encephalopathy. There might be an age-at-exposure-related susceptibility to acquire all CJD forms, including sCJD from routine surgery.
Adult | Age Factors | Case-Control Studies | Creutzfeldt-Jakob Syndrome | Data Interpretation, Statistical | Female | Humans | Logistic Models | Male | Middle Aged | Models, Statistical | Registries | Risk Factors | Young Adult
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