American Journal of Epidemiology Advance Access originally published online on August 19, 2008
American Journal of Epidemiology 2008 168(8):976; doi:10.1093/aje/kwn225
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LETTERS TO THE EDITOR |
RE: "GENETIC SUSCEPTIBILITY TO SEVERE INFECTION IN FAMILIES WITH INVASIVE PNEUMOCOCCAL DISEASE"
Center for Health Research, Southeast, Kaiser Permanente Georgia, 10 Piedmont Center, 3495 Piedmont Road NE, Suite 205, Atlanta, GA 30305
(e-mail: robert.l.davis{at}kp.org)
In a recent report by Hjuler et al. (1), the risk of invasive pneumococcal disease (IPD) was shown to be increased among family members during the year following the proband's infection, with the risk not persisting beyond 1 year. Additionally, relatives, who most likely did not share the household with the proband, were not at increased risk. The authors stated that the "lack of [persistent] risk suggests that the genetic contribution to... invasive infections in families with a case of IPD is at best marginal" (1, p. 816) and later that "our results strongly indicate that environmental factors dominate in the risk of these infections" (1, p. 817).
However, another explanation could be that, indeed, genetic factors are critical to most or all of these infections and, similarly, environmental influences are also critical in most or all of these infections. The data shown by Hjuler et al. are equally consistent with the interpretation that 1) genetic factors are absolutely critical but 2) only in the presence of (in this case, temporary) infectious agents.
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ACKNOWLEDGMENTS |
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Conflict of interest: none declared.
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References |
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 TOP References |
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- Hjuler T, Poulsen G, Wohlfahrt J, et al. Genetic susceptibility to severe infection in families with invasive pneumococcal disease. Am J Epidemiol. (2008) 167((7)):814–819.
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  T. Hjuler, G. Poulsen, J. Wohlfahrt, M. Kaltoft, R. J. Biggar, and M. Melbye THE AUTHORS REPLY Am. J. Epidemiol., October 15, 2008; 168(8): 976 - 976. [Full Text] [PDF]
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