Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study
| Autor: | Anne-Louise Ponsonby, Bruce V. Taylor, Keith Dear, Ann Maree Hughes, Patricia C. Valery, Terence Dwyer, I van der Mei, Robyn M. Lucas |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Risk Pediatrics medicine.medical_specialty Adolescent CNS demyelination medicine.medical_treatment Population Demyelinating Autoimmune Diseases CNS Young Adult 03 medical and health sciences Rubella vaccine 0302 clinical medicine medicine Humans Rubella Vaccine Infectious Mononucleosis 030212 general & internal medicine Young adult Child education Tonsillectomy education.field_of_study business.industry Vaccination Age Factors Australia Case-control study Infant General Medicine Odds ratio Middle Aged Health Surveys Poliovirus Vaccines Neurology Virus Diseases Case-Control Studies Child Preschool Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Popis: | Background The association between childhood vaccinations and infections and risk of multiple sclerosis is unclear; few studies have considered age at vaccination/infection. Objective To explore age-related associations between childhood vaccinations, infection and tonsillectomy and risk of a first clinical diagnosis of CNS demyelination. Methods Data on case (n=275, 76.6% female; mean age 38.6 years) and age- and sex-matched control (n=529) participants in an incident population-based case-control study included self-reported age at time of childhood vaccinations, infections, and tonsillectomy. Conditional logistic regression models were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results Poliomyelitis vaccination prior to school-age was associated with increased risk of a first clinical diagnosis of CNS demyelination (AOR=2.60, 95%CI 1.02–6.68), based on a very small unvaccinated reference group. Late (11–15 years) rubella vaccination (compared to none) was associated with lower odds of being a case (AOR=0.47, 95%CI 0.27–0.83). Past infectious mononucleosis at 11–15 years (AOR=2.84, 95%CI 1.0–7.57) and 16–20 years (AOR=1.92, 95%CI 1.12–3.27) or tonsillectomy in adolescence (11–15 years: AOR=2.45, 95%CI 1.12–5.35), including after adjustment for IM, were associated with increased risk of a first clinical diagnosis of CNS demyelination. Conclusions Age at vaccination, infection or tonsillectomy may alter the risk of subsequent CNS demyelination. Failing to account for age effects may explain inconsistencies in past findings. |
| Databáze: | OpenAIRE |
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