Pm. Matricardi et al., CROSS-SECTIONAL RETROSPECTIVE STUDY OF PREVALENCE OF ATOPY AMONG ITALIAN MILITARY STUDENTS WITH ANTIBODIES AGAINST HEPATITIS-A VIRUS, BMJ. British medical journal, 314(7086), 1997, pp. 999-1003
Objective: To investigate the working hypothesis that common infection
s occurring early in life prevent atopy. Design: Cross sectional, retr
ospective study of young Italian men with results for hepatitis A sero
logy and atopy. Setting: Air force school for military students in Cas
erta Italy. Subjects: 1659 male students aged 17-24, most of whom (90%
) were from central and southern Italy. Main outcome measures: Skin se
nsitisation and specific IgE antibodies to locally relevant airborne a
llergens; diagnosis of respiratory allergy (asthma or rhinitis, or bot
h); hepatitis A seropositivity. Results: 443 of the 1659 subjects (26.
7%) were positive for hepatitis A virus antibody. Atopy was less commo
n among seropositive than seronegative subjects according to skin sens
itization (weal reaction greater than or equal to 3 mm) to one or more
allergens (21.9% (97/443) v 30.2% (367/1216), P<0.001); polysensitisa
tion (sensitive to three or more allergens) (2.7% (12/443) v 6.4% (78/
1216), P<0.01); high specific IgE concentration (9.7% (43/443) v 18.4%
(224/1216), P<0.00005); and lifetime prevalence of allergic rhinitis
or asthma, or both (8.4% (37/443) v 16.7% (203/1216), P<0.001). Hepati
tis A seropositivity remained inversely associated with atopy after ad
justing for father's education, the number of older siblings, and the
area of residence (based on the number of inhabitants). The prevalence
of atopy was constantly low among seropositive subjects, whatever the
number of older siblings; by contrast, it increased with a decreasing
number of older siblings among seronegative subjects. Conclusion: Ind
irect but important evidence is added to the working hypothesis as com
mon infections acquired early in life because of the presence of many
older siblings (among seronegative subjects) or because of unhygienic
living conditions (among seropositive subjects) may have reduced the r
isk of developing atopy.