Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Vinmec Healthcare System, Hanoi, Vietnam.
BMC Infect Dis. 2021 Dec 14;21(1):1249. doi: 10.1186/s12879-021-06930-x.
Infection with measles virus (MeV) causes immunosuppression and increased susceptibility to other infectious diseases. Only few studies reported a duration of immunosuppression, with varying results. We investigated the effect of immunosuppression on the incidence of hospital admissions for infectious diseases in Vietnamese children.
We used retrospective data (2005 to 2015; N = 4419) from the two pediatric hospitals in Ho Chi Minh City, Vietnam. We compared the age-specific incidence of hospital admission for infectious diseases before and after hospitalization for measles. We fitted a Poisson regression model that included gender, current age, and time since measles to obtain a multiplicative effect measure. Estimates were transformed to the additive scale.
We observed two phases in the incidence of hospital admission after measles. The first phase started with a fourfold increased rate of admissions during the first month after measles, dropping to a level quite comparable to children of the same age before measles. In the second phase, lasting until at least 6 years after measles, the admission rate decreased further, with values up to 20 times lower than in children of the same age before measles. However, on the additive scale the effect size in the second phase was much smaller than in the first phase.
The first phase highlights the public health benefits of measles vaccination by preventing measles and immune amnesia. The beneficial second phase is interesting, but its strength strongly depends on the scale. It suggests a complicated interaction between MeV infection and the host immunity.
麻疹病毒（MeV）感染会导致免疫抑制，增加感染其他传染病的易感性。只有少数研究报告了免疫抑制的持续时间，但结果各不相同。我们调查了免疫抑制对越南儿童因传染病住院的发生率的影响。
我们使用了来自越南胡志明市的两家儿科医院的回顾性数据（2005 年至 2015 年；N=4419）。我们比较了麻疹住院前后因传染病住院的年龄特异性发病率。我们拟合了一个泊松回归模型，其中包括性别、当前年龄和距麻疹的时间，以获得乘法效应度量。估计值转换为加法尺度。
我们观察到麻疹后住院的发病率有两个阶段。第一阶段在麻疹后第一个月开始，住院率增加了四倍，下降到与麻疹前同龄儿童相当的水平。在第二阶段，至少持续到麻疹后 6 年，住院率进一步下降，与麻疹前同龄儿童相比，发病率低至 20 倍。然而，在加法尺度上，第二阶段的效应大小比第一阶段小得多。
第一阶段通过预防麻疹和免疫遗忘突出了麻疹疫苗接种的公共卫生效益。有益的第二阶段很有趣，但它的强度强烈取决于规模。这表明 MeV 感染和宿主免疫之间存在复杂的相互作用。
