Associations of Helicobacter pylori and hepatitis A seropositivity with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): addressing the hygiene hypothesis

Christian S. Alvarez, M. Larissa Avilés-Santa, Neal D. Freedman, Krista M. Perreira, Olga Garcia-Bedoya, Robert C. Kaplan, Martha L. Daviglus, Barry I. Graubard, Gregory A. Talavera, Bharat Thyagarajan, M. Constanza Camargo

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Abstract

Background: The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal–oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. Results: The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. Conclusion: Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL.

Original languageEnglish (US)
Article number120
JournalAllergy, Asthma and Clinical Immunology
Volume17
Issue number1
DOIs
StatePublished - Dec 2021

Bibliographical note

Funding Information:
The authors thank the staff and participants of HCHS/SOL for their important contributions. A complete list of staff and investigators has been provided by Sorlie et al. [9 ] and is also available on the study website http://www.cscc.unc.edu/hchs/. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official views of the National Cancer Institute, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, or the US federal government.

Funding Information:
The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), San Diego State University (N01-HC65237), and University of Illinois at Chicago (HHSN268201300003I). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. This study was also funded in part by the Intramural Research Program of the National Cancer Institute.

Funding Information:
Dr. Daviglus reports research grants from the National Institutes of Health (NIH) during the conduct of the study. Dr. Garcia-Bedoya reports grants from NIH/NHLBI during the conduct of the study. Dr. Perreira reports grants from NIH/NHLBI outside the submitted work. Dr. Talavera reports grants and personal fees from NIH/NHLBI during the conduct of the study. The other authors have no competing interests.

Publisher Copyright:
© 2021, The Author(s).

Keywords

  • Asthma
  • Helicobacter pylori
  • Hepatitis A virus
  • Mexicans
  • Puerto Ricans

PubMed: MeSH publication types

  • Journal Article

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