Risk of haematologic cancers among individuals tested for Borrelia burgdorferi antibodies, and Borrelia burgdorferi seropositive individuals: a nationwide population-based matched cohort study

Malte M Tetens*, Lars Haukali Omland, Ram Dessau, Svend Ellermann-Eriksen, Nanna S Andersen, Charlotte Sværke Jørgensen, Christian Østergaard, Jacob Bodilsen, Kirstine K Søgaard, Jette Bangsborg, Alex Christian Nielsen, Jens Kjølseth Møller, Ming Chen, Carsten Utoft Niemann, Anne-Mette Lebech, Niels Obel

*Corresponding author for this work

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Abstract

OBJECTIVES: In a nationwide, matched cohort study, we aimed to investigate risks of haematologic cancers among individuals tested for Borrelia burgdorferi (Bb) antibodies, and among serum Bb seropositive individuals.

METHODS: We identified all Bb seropositive individuals in Denmark (1993-2020) (n = 52 200) and constructed two age- and sex-matched comparison cohorts: (a) Bb seronegative controls (n = 104 400) and (b) background population controls (n = 261 000). We calculated short-term OR (aOR) (<1 month of study inclusion), and long-term hazard ratios (aHR) (>1 month after study inclusion) adjusted for age and sex. We stratified seropositive individuals on only Bb-IgM seropositive (n = 26 103), only Bb-IgG seropositive (n = 18 698), and Bb-IgM-and-IgG seropositive (n = 7399).

RESULTS: Compared with the background population, individuals tested for Bb antibodies had increased short-term (aOR: 12.6, 95% CI: 10.1-15.6) and long-term (aHR: 1.3, 95% CI: 1.2-1.4) risk of haematologic cancers. The Bb seropositive individuals had no increased risk of haematologic cancers compared with those who tested negative for Bb, except that Bb-IgM-and-IgG seropositive individuals had increased long-term risk of chronic lymphatic leukaemia (aHR: 2.0, 95% CI: 1.2-3.4).

DISCUSSION: Our results suggest that Bb antibody testing is included in the work-up of unspecific symptoms preceding diagnosis of haematologic cancers. Bb-IgM-and-IgG seropositivity was associated with a two-fold increased long-term risk of chronic lymphatic leukaemia, which warrants further investigation.

Original languageEnglish
JournalClinical Microbiology and Infection
Volume30
Issue number2
Pages (from-to)231-239
ISSN1198-743X
DOIs
Publication statusPublished - Feb 2024

Keywords

  • Antibodies, Bacterial
  • Borrelia burgdorferi
  • Borrelia burgdorferi Group
  • Cohort Studies
  • Hematologic Neoplasms/epidemiology
  • Humans
  • Immunoglobulin G
  • Immunoglobulin M
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Lyme Disease/diagnosis

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