Prospective study of enteroviral infections and development of beta-cell autoimmunity. Diabetes autoimmunity study in the young (DAISY).
OBJECTIVE
To determine whether there is association between infection with enteroviruses and beta-cell autoimmunity in children at elevated risk of developing type 1 diabetes.


BACKGROUND
Recent prospective and case-control studies of children who are at high risk of developing type 1 diabetes have suggested that enterovirus (EV) infections are a risk factor for beta-cell autoimmunity and type 1 diabetes.


METHODS
A nested matched case-control study of incident cases of beta-cell autoimmunity within two prospective cohorts of genetically high-risk children (cases=26, controls=39). EV infection was detected by PCR of serum, saliva and rectal swab samples.


RESULTS
Prior to autoimmunity conversion (or the equivalent age in controls), 11.5% of cases and 17.9% of controls were positive for EV infection. EV was detected in 19.5% of cases and 25.6% of controls over the whole follow-up period. Conditional logistic regression gave no evidence that the frequency of EV infection was associated with beta-cell autoimmunity. There was a trend for the mean number of EV infections found in EV-positive cases (2.2/case) to be higher than in EV-positive controls (1.2/control, P=0.08). However, there were no multiple infections prior to conversion in either cases or controls.


CONCLUSIONS
There is no evidence from this study that EV infection is a risk factor for development of beta-cell autoimmunity. Further study is needed to assess whether persistent or repeated EV infections occur frequently in individuals with beta-cell autoimmunity.
Graves
Patricia M
PM
Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
Rotbart
Harley A
HA
Nix
William A
WA
Pallansch
Mark A
MA
Erlich
Henry A
HA
Norris
Jill M
JM
Hoffman
Michelle
M
Eisenbarth
George S
GS
Rewers
Marian
M
D001323:Autoantibodies / Q000032:analysis; D015551:Autoimmunity; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics*; D004769:Enterovirus Infections / Q000453:epidemiology / Q000276:immunology*; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology*; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors
D001323:Autoantibodies