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Article: Effect of clinical and virological parameters on the level of neutralizing antibody against pandemic influenza A virus H1N1 2009

TitleEffect of clinical and virological parameters on the level of neutralizing antibody against pandemic influenza A virus H1N1 2009
Authors
Issue Date2010
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2010, v. 51 n. 3, p. 274-279 How to Cite?
Abstract
Background. Little is known about the antibody response in natural infection by the novel 2009 influenza A (H1N1) virus and its relationship with clinical and virological parameters. The relative lack of background neutralizing antibody against this novel virus provides a unique opportunity for understanding this issue. Methods. Case patients presenting with influenza-like illness who were positive for the pandemic H1 gene by reverse transcription polymerase chain reaction were identified. The serum antibody response was assayed by neutralizing antibody titer (NAT) against the virus in 881 convalescent donors. We retrospectively analyzed clinical parameters and viral load. Results. Ninety percent of the 881 convalescent donors had seroprotective titer of 1:40 or greater. The geometric mean titer of donors with convalescent NAT measured between day 21 and 42 was 1:101.1. Multivariate analysis by ordinal regression showed that pneumonia (odds ratio, 3.39; 95% confidence interval, 1.49-9-7.61; P=.004) and sputum production (odds ratio, 1.75; 95% CI, 1.01-3.01; P=.046) were the 2 independent factors associated with a higher level of convalescent NAT. Being afebrile on influenza presentation was associated with subsequent poor NAT (<1:40) response (P = .04). A positive correlation between the nasopharyngeal viral load on presentation and the convalescent NAT was demonstrated (Spearman correlation r, 0.238; P = .026). Conclusions. About 10% of these convalescent patients do not have a seroprotective NAT and may benefit from vaccination to prevent reinfection. The convalescent NAT correlated well with the initial viral load and was independently associated with severity of the viral illness, including pneumonia. The findings provide both the clinical and virological markers for identifying potential convalescent plasma donors with high serum NAT, which can be used to produce hyperimmune intravenous immunoglobulin in a randomized treatment trial for patients with severe pandemic H1N1 infection. © 2010 by the Infectious Diseases Society of America. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/125016
ISSN
2013 Impact Factor: 9.416
ISI Accession Number ID
Funding AgencyGrant Number
HKSAR
Funding Information:

Research Fund for the Control of Infectious Diseases of the Food and Health Bureau of the HKSAR. In memory of the late Mr Ted Sun, we would like to express our gratitude to him and his family for their generous support for research on emerging infectious diseases.

References

 

DC FieldValueLanguage
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorTo, KKWen_HK
dc.contributor.authorLee, CKen_HK
dc.contributor.authorLin, CKen_HK
dc.contributor.authorChan, JFWen_HK
dc.contributor.authorTse, Hen_HK
dc.contributor.authorCheng, VCCen_HK
dc.contributor.authorChen, Hen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorTse, CWSen_HK
dc.contributor.authorNg, TKen_HK
dc.contributor.authorQue, TLen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2010-10-31T11:06:47Z-
dc.date.available2010-10-31T11:06:47Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical Infectious Diseases, 2010, v. 51 n. 3, p. 274-279en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125016-
dc.description.abstractBackground. Little is known about the antibody response in natural infection by the novel 2009 influenza A (H1N1) virus and its relationship with clinical and virological parameters. The relative lack of background neutralizing antibody against this novel virus provides a unique opportunity for understanding this issue. Methods. Case patients presenting with influenza-like illness who were positive for the pandemic H1 gene by reverse transcription polymerase chain reaction were identified. The serum antibody response was assayed by neutralizing antibody titer (NAT) against the virus in 881 convalescent donors. We retrospectively analyzed clinical parameters and viral load. Results. Ninety percent of the 881 convalescent donors had seroprotective titer of 1:40 or greater. The geometric mean titer of donors with convalescent NAT measured between day 21 and 42 was 1:101.1. Multivariate analysis by ordinal regression showed that pneumonia (odds ratio, 3.39; 95% confidence interval, 1.49-9-7.61; P=.004) and sputum production (odds ratio, 1.75; 95% CI, 1.01-3.01; P=.046) were the 2 independent factors associated with a higher level of convalescent NAT. Being afebrile on influenza presentation was associated with subsequent poor NAT (<1:40) response (P = .04). A positive correlation between the nasopharyngeal viral load on presentation and the convalescent NAT was demonstrated (Spearman correlation r, 0.238; P = .026). Conclusions. About 10% of these convalescent patients do not have a seroprotective NAT and may benefit from vaccination to prevent reinfection. The convalescent NAT correlated well with the initial viral load and was independently associated with severity of the viral illness, including pneumonia. The findings provide both the clinical and virological markers for identifying potential convalescent plasma donors with high serum NAT, which can be used to produce hyperimmune intravenous immunoglobulin in a randomized treatment trial for patients with severe pandemic H1N1 infection. © 2010 by the Infectious Diseases Society of America. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAntibodies, Neutralizing - blood-
dc.subject.meshAntibodies, Viral - blood-
dc.subject.meshInfluenza A Virus, H1N1 Subtype - genetics - immunology - isolation and purification-
dc.subject.meshInfluenza, Human - immunology - pathology - virology-
dc.subject.meshRNA, Viral - genetics-
dc.titleEffect of clinical and virological parameters on the level of neutralizing antibody against pandemic influenza A virus H1N1 2009en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1058-4838&volume=51&issue=3&spage=274&epage=279&date=2010&atitle=Effect+of+clinical+and+virological+parameters+on+the+level+of+neutralizing+antibody+against+pandemic+influenza+A+virus+H1N1+2009-
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hken_HK
dc.identifier.emailChan, JFW: jfwchan@hku.hken_HK
dc.identifier.emailTse, H: htse@hkucc.hku.hken_HK
dc.identifier.emailChen, H: hlchen@hku.hken_HK
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityTo, KKW=rp01384en_HK
dc.identifier.authorityChan, JFW=rp01736en_HK
dc.identifier.authorityTse, H=rp00519en_HK
dc.identifier.authorityChen, H=rp00383en_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1086/653940en_HK
dc.identifier.pmid20575664en_HK
dc.identifier.scopuseid_2-s2.0-77954695237en_HK
dc.identifier.hkuros173890en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77954695237&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume51en_HK
dc.identifier.issue3en_HK
dc.identifier.spage274en_HK
dc.identifier.epage279en_HK
dc.identifier.eissn1537-6591-
dc.identifier.isiWOS:000280193800004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridTo, KKW=14323807300en_HK
dc.identifier.scopusauthoridLee, CK=36882460100en_HK
dc.identifier.scopusauthoridLin, CK=15034856400en_HK
dc.identifier.scopusauthoridChan, JFW=24278817900en_HK
dc.identifier.scopusauthoridTse, H=7006070596en_HK
dc.identifier.scopusauthoridCheng, VCC=23670479400en_HK
dc.identifier.scopusauthoridChen, H=26643315400en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridTse, CWS=7103295064en_HK
dc.identifier.scopusauthoridNg, TK=7402229817en_HK
dc.identifier.scopusauthoridQue, TL=7003786628en_HK
dc.identifier.scopusauthoridChan, KH=7406034307en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.citeulike7412871-

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