SAN DIEGO — A combination of the two known asthma criteria, the Asthma Predictive Index and the Predetermined Asthma Criteria, identified a unique asthma phenotype that indicated which patients were at risk for microbial infections, such as herpes zoster, according to data presented here.
“Asthma is a complex and heterogeneous disease caused by multiple factors. There are several different phenotypes of asthma – allergic, non-allergic and intrinsic – and in some patients these forms can coexist,” Chung-Il Wi, MD, from the Mayo Clinic Rochester, Minn., told Infectious Diseases in Children. “Given the heterogeneity of asthma, as well as increased risk of common and serious microbial infection among children with asthma, it would be important to determine which subgroup among children with asthma is at risk of microbial infections.”
To assess the link between asthma status determined by both the Asthma Predictive Index and the Predetermined Asthma Criteria and the risk of herpes zoster, Wi and colleagues examined data from a population-based case-control study which assessed asthma and the risk of herpes zoster among children (n=459,221) in Olmsted County, MN.
After calculating odds ratios and confidence intervals using logistic regression analysis, the researchers attempted to categorize the children into four groups, including:
- Group 1: Positive for both criteria;
- Group 2: Positive for only Predetermined Asthma Criteria;
- Group 3: Positive for only Asthma Predictive Index; and
- Group 4: Negative for both criteria.
According to study results, 5.4% of patients met both asthma criteria, 16.8% met only Predetermined Asthma Criteria, and 77.8% did not meet any criteria. Researchers noted that no patients met the Asthma Predictive Index only.
In addition, the researchers found that patients in Group 1, 2 and 4 exhibited higher risks of herpes zoster after adjusting for age, gender, atopic status and a history of varicella vaccine. Group 1 (OR = 2.71; 95% CI, 1.13-7.01)) demonstrated a stronger association with the risk of herpes zoster than Group 2 (OR = 1.65; 95% CI, 0.99-2.78) controlling for the same variables.
“The ACIP recommends all adults with asthma (19-64 years) to receive a single dose of 23-valent pneumococcal polysaccharide vaccine in order to prevent invasive pneumococcal disease given the evidence suggesting that patients with asthma are at a significantly increased risk of invasive pneumococcal disease,” Wi told Infectious Diseases in Children.
“However, for more accurate and cost-effective individualized medicine, it would be important to determine which subgroup among children with asthma is at risk of a certain vaccine-preventable infection when public health policy makers prioritize subpopulation at risk for vaccine. Also, in practice, primary health care providers who care for children with asthma may pay attention to potential patients’ comorbidities related with asthma and identify those with comorbidities earlier, or even prevent them using timely vaccine schedules.”– by Bob Stott
Wi C-I, et al. Abstract #2851.17. Presented at: Pediatric Academic Societies 2015; April 25-28, 2015; San Diego.
Disclosure: The researchers report no relevant financial disclosures.