Association between infections and signs and symptoms of ‘atopic’ hypersensitivity – results of a cross-sectional survey among first-year university students in Germany and Spain


Wolfgang Uter, MD
Department of Medical Informatics, Biometry and Epidemiology
University of Erlangen-Nürnberg
Waldstr. 6, 91054 Erlangen


Background: This study assessed the hypothesis that a decreased exposure to childhood infectious diseases is associated with signs and symptoms of ‘atopic’ hypersensitivity diseases.

Methods: A cross-sectional survey was performed among 1368 Spanish and German first-year university students between 1997 and 1999, including self-administered questionnaire data and serological tests.

Results: No association between the disease outcomes and hepatitis A, Helicobacter pylori infection and herpes simplex infection was observed in logistic regression analyses, adjusting for potential confounders (centre, sex, smoking, parental education). In contrast, vaccination against hepatitis B was associated with a decreased risk for the outcomes allergic rhinitis (OR 0.63, 95% CI: 0.42–0.95) and total serum IgE above 100 U/ml (OR 0.56, 95% CI: 0.39–0.81). Conversely, seropositivity to HBc antigen was significantly associated with high total serum IgE (OR 2.04, 95% CI: 1.34–3.06).

Conclusions: Our study partly confirmed and partly contradicted previous evidence and hypotheses, respectively, concerning the role of the infections considered. The observation of a decreased risk in persons vaccinated against hepatitis B warrants further, prospective investigation.