No abstract

Background: To investigate the impact of recombinant human interferon α1b (rhIFNα1b) treatment of infants hospitalized with lower respiratory tract infections on subsequent wheezing.Methods: The clinical data of infants in 19 hospitals with viral pneumonia, wheezy bronchitis, or bronchiolitis were retrospectively reviewed from June 2009 to June 2015 (age, gender, diagnosis, the use of rhIFNα1b when in hospital). Age at follow-up, birth weight, gestation age, childhood and family history of allergy, feeding history, family environment, and the number of wheezing episodes within the last year were obtained by telephone and questionnaires. Based on the use of rhIFNα1b in hospital, the subjects were divided into two groups: the rhIFNα1b treatment group (253 cases) and the control group (287 cases). A comparison was made between the two groups in terms of wheezing episodes within the last year. Based on the number of wheezing episodes within the last year, the subjects were divided into two groups, the wheezing group (95 cases) and the non-wheezing group (445 cases). Comparisons were made between the 2 groups in terms of age, diagnosis, the use of rhIFNα1b in hospital, gender, age at follow-up, birth weight, gestation age, childhood and family history of allergy, feeding history, and family environment. If the result of single factor comparison showed that P was <0.05, the indicators were analysed by binary logistic regression. The receiver operator characteristic (ROC) curve was drawn to evaluate the prediction ability of logistic regression models.Results: (1) Of a total of 813 cases for which follow-up data were available, 273 cases were excluded because of incomplete questionnaires, a dosage of rhIFN a1 b < 1 ug/kg.d or a treatment duration < 3 days, a date in hospital beyond the scope of the follow-up, or because the patient’s age when in hospital was > 3 years old. Finally, 540 patients were included in the analysis.(2) A total of 95 (17.6%) out of 540 cases had experienced wheezing episodes within the last year; 35 (13.8%) out of 253 cases that were treated with rhIFN a1 b and 60 cases (20.9%) out of 287 cases without rhIFN a1 b treatment had wheezing episodes within the last year. The difference in wheezing episodes within the last year between the rhIFNα1b treatment group and the control group was statistically significant (P=0.031). (3)The result of single factor regression indicated that the differences between the two groups of wheezing and non-wheezing in terms of age, the use of rhIFNα1b in hospital, a childhood and family history of allergy, housing situation, and feeding history were all statistically significant (all P<0.05). The result of binary logistic regression showed that a childhood history of allergy (OR=2.14, P=0.004), no use of rhIFNα1b therapy (OR=1.70, P=0.028) and living in a crowded house (OR=1.92, P=0.012) were risk factors of subsequent wheezing. Breastfeeding (OR=0.44, P=0.008) and an age of £1year old at the time of hospitalization (OR=0.58, P=0.024) were protective factors. The area under the ROC curve was 0.68, P=0.00, which indicated that the regression model had greater than medium diagnostic accuracy. Conclusions: Early use of rhIFNα1b treatment for infants hospitalized with lower respiratory tract infections and breastfeeding could prevent subsequent wheezing. An atopic constitution and living in a crowded house could promote subsequent wheezing.