Aging
Life Course Educational Trajectories and Persistent Infections in Young Adulthood Jennifer Momkus* Jennifer Momkus Kathleen Mullan Harris Y. Claire Yang Chantel Martin Jessie K. Edwards Allison E. Aiello
Background: Persistent infections including cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1), Epstein-Barr Virus (EBV), and Helicobacter pylori (H. Pylori) may accelerate aging and alter immunity across the life course. Educational trajectories may strongly shape the risk of exposures and responses to these infections.
Methods: We analyzed data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Using parental education from Wave I and participant education from Wave IV, we created a life course education trajectory measure wherein a high school degree or less was considered low. The resulting four trajectories included low-low (persistently low), low-high (upward mobility), high-low (downward mobility), and high-high (persistently high). We tested Wave IV blood spots for HSV-1, EBV, CMV, and H. Pylori IgG antibodies. Logistic regression models were used to calculate odds ratios (OR) for associations between intergenerational education and infection seropositivity, adjusting for age, sex, immigrant generation, and race/ethnicity. For those who were seropositive, linear regression was used to estimate the average differences in antibody concentration, adjusting for the same covariates. Survey weights were incorporated in all analyses.
Results: Associations varied by infection and trajectory type. For example, the ORs for HSV-1 seropositivity were similar for the upward mobility (OR=2.08, 95%CI: 1.72, 2.52) and persistently low education trajectories (OR=2.04, 95%CI: 1.60, 2.59), but weaker for the downward mobility trajectory (OR=1.50, 95%CI: 1.09, 2.06). The persistently low education trajectory (i.e. low-low) was the only category significantly associated with increased antibody concentrations for CMV (β=10.2 U/mL, 95%CI: 4.3, 16.1), HSV-1 (β=0.48 U/mL, 95%CI: 0.03, 0.93), and H. Pylori (β=20.5 U/mL, 95%CI: 10.2, 30.8).
Conclusions: Low education is linked to elevated odds of persistent infection and poorer immune response to infection, with differential effects based on the life course trajectory and the infection type. Understanding the temporal dynamics underlying these associations, particularly the timing and length of exposure, is essential for addressing health disparities across the life course.
