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Does Hepatitis A Offer Protection against Asthma or Does Asthma Offer Protection Against Hepatitis A? pp. 1-9 $100.00
Authors:  (Lars-Georg Hersoug, Research Centre for Prevention and Health, Copenhagen County, Denmark, Jose Arnau, Unizyme Laboratories, Denmark)
Abstract:
In several studies, primarily from developed countries, an association between
hepatitis A virus (HAV) and atopic diseases, including asthma, allergic rhinitis, and
atopic dermatitis has been found. Whereas such an association has not been found in
other studies, but thise studies primary came from underdeveloped countries. The finding
that being seropositive to HAV is associated with a lower prevalence of atopy and
respiratory allergies has been interpreted as HAV infection protecting against atopy. But
this assumption can only be true if the HAV infection precedes the establishment of the
atopic phenotype. If the atopic phenotype precedes the HAV infection, then the opposite
assumption must be true i.e., it is the atopic phenotype that protects against HAV
infections. An HAV infection is of short duration, and the virus is permanently cleared
from the body. The finding of an association between atopy and HAV was taken as an
indirect evidence for “the hygiene hypothesis”. Recently, by studying different
polymorphisms in the TIM-1 allele and their interactions with HAV it was argued that a
special insertion variant in combination with HAV infection protects against atopy and that this was the first genetic evidence for the hygiene hypothesis. In this study, we
discuss these findings and show that the interaction with HAV and the TIM-1 alleles
cannot be taken as a genetic evidence for the hygiene hypothesis. Because atopy and the
TIM-1 alleles are not independent variables, the argument, that the insertion variant in
combination with HAV infection protecting against atopy, is not valid. Additionally,
despite epidemiological findings of an interaction between HAV infections and atopy
there is not necessarily a causal relationship to the development of atopy. Indeed, the
opposite assumption could be true, that the atopic condition protects or is associated with
mechanisms that protect against HAV infections. 


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Does Hepatitis A Offer Protection against Asthma or Does Asthma Offer Protection Against Hepatitis A? pp. 1-9