Asthma, Rhinitis, Other Respiratory DiseasesHay fever and asthma in relation to markers of infection in the United States☆
Section snippets
Study design
We examined a public registry of 33,994 US residents aged 1 to 90 years or older that includes clinical and laboratory data from NHANES III and analyzed the following variables: age, sex, race, urban-rural residence, census, family size, family income, education, diagnosis ever, age at first diagnosis, current status of hay fever or asthma, skin tests for 9 airborne allergens and peanut, and serology for T gondii , herpes simplex viruses type 1 (HSV-1) and 2 (HSV-2), and hepatitis A, B, and C
NHANES III
NHANES III was conducted from 1988 through 1994 by the National Center for Health Statistics of the Centers for Disease Control and Prevention, Atlanta, Ga,20 and approved by the National Center for Health Statistics' Institutional Review Board. The survey was based on a stratified multistage clustered probability design to select a representative sample of the civilian, noninstitutionalized US population. Eighty-one geographic sites were included in the final sample. All survey participants
Results
The frequency of hay fever ever diagnosed increased progressively with age up to 60 years and declined thereafter. Asthma ever diagnosed peaked in the second and sixth decades of life. The prevalence of a positive skin prick test response to at least one allergen increased with age up to values close to 60% in the 20- to 29-year age range and declined slightly across older groups (Fig 1, A ).
Discussion
This study shows that hay fever, asthma, and skin sensitization to several inhalant allergens and peanut are inversely related to serologic markers of infections (ie, HAV, T gondii , and HSV-1 antibodies) in a representative population sample of the United States. In fact, the adjusted odds of a lifetime diagnosis of hay fever or asthma in subjects seronegative for all 3 infections (HAV, T gondii , and HSV-1) were, respectively, about 4 and 2 times higher than in seropositive individuals.
In
Acknowledgements
We acknowledge the US Department of Health and Human Services, National Center for Health Statistics, as the original source of data, and we thank Jean Ann Gilder (Scientific Communication) for her help in editing the text.
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Reprint requests (present address): Paolo M. Matricardi, MD, WHO, World Health Organization, Chronic Respiratory Diseases and Arthritis Unit, 20 Avenue Appia, CH-1211 Geneve 27, Switzerland.