Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Sci Rep. 2023 Dec 1;13(1):21251. doi: 10.1038/s41598-023-48509-3.
Infectious mononucleosis (IM) often results from late primary infection with Epstein-Barr virus (EBV). Exposure to EBV at ages 0-2 years from, e.g., siblings therefore protects against IM. Using Danish registers, we therefore followed children born in 1997 through 2015 from age 3 years for a hospital contact with an IM diagnosis as outcome with the number of antimicrobial prescriptions filled before age 3 years as a proxy of infection pressure and the main exposure in stratified Cox regressions. The main analyses used sibships as strata primarily to adjust for health-seeking behaviour with further possible adjustments for age, sex, calendar period and sibship constellation. In these analyses we followed 7087 children, exposed on average to 3.76 antimicrobials prescriptions. We observed a crude hazard ratio for IM per unit increase in cumulative antimicrobial use of 1.00 (95% confidence interval 0.99, 1.02), with similar results in adjusted analyses. The hypothesis that children with the largest use of antimicrobials at ages 0-2 years would subsequently have the lowest risk of IM within a sibship was not corroborated by the data. Furthermore, sibship-matched analyses provided no support for some common early-life immune system characteristics being predictive of IM.
传染性单核细胞增多症(IM)通常由 EBV 原发感染晚期引起。例如,0-2 岁时与兄弟姐妹接触 EBV 可预防 IM。因此,我们利用丹麦的注册资料,从 1997 年至 2015 年出生的儿童中,以 3 岁为起点,随访至其首次因 IM 住院的年龄,以 3 岁前的抗生素处方数量作为感染压力的替代指标,并在分层 Cox 回归中作为主要暴露因素。主要分析以同胞关系为分层因素,主要用于调整因健康寻求行为而导致的偏倚,进一步可能还会调整年龄、性别、日历时间和同胞关系模式。在此分析中,我们共随访了 7087 名儿童,平均暴露于 3.76 种抗生素处方。结果显示,抗生素累计使用量每增加一个单位,IM 的风险比为 1.00(95%置信区间 0.99,1.02),调整分析后结果相似。抗生素使用量最大的儿童在同胞关系中随后 IM 风险最低的假设,并未得到数据的证实。此外,同胞匹配分析并未为某些常见的早期免疫系统特征预测 IM 提供支持。
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