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Article: Effect of clinical and virological parameters on the level of neutralizing antibody against pandemic influenza A virus H1N1 2009
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TitleEffect of clinical and virological parameters on the level of neutralizing antibody against pandemic influenza A virus H1N1 2009
 
AuthorsHung, IFN2
To, KKW2
Lee, CK4
Lin, CK4
Chan, JFW2
Tse, H2
Cheng, VCC2
Chen, H2
Ho, PL2
Tse, CWS1
Ng, TK5
Que, TL3
Chan, KH2
Yuen, KY2
 
Issue Date2010
 
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
CitationClinical Infectious Diseases, 2010, v. 51 n. 3, p. 274-279 [How to Cite?]
DOI: http://dx.doi.org/10.1086/653940
 
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.
 
ISSN1058-4838
2013 Impact Factor: 9.416
 
DOIhttp://dx.doi.org/10.1086/653940
 
ISI Accession Number IDWOS:000280193800004
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.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorHung, IFN
 
dc.contributor.authorTo, KKW
 
dc.contributor.authorLee, CK
 
dc.contributor.authorLin, CK
 
dc.contributor.authorChan, JFW
 
dc.contributor.authorTse, H
 
dc.contributor.authorCheng, VCC
 
dc.contributor.authorChen, H
 
dc.contributor.authorHo, PL
 
dc.contributor.authorTse, CWS
 
dc.contributor.authorNg, TK
 
dc.contributor.authorQue, TL
 
dc.contributor.authorChan, KH
 
dc.contributor.authorYuen, KY
 
dc.date.accessioned2010-10-31T11:06:47Z
 
dc.date.available2010-10-31T11:06:47Z
 
dc.date.issued2010
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationClinical Infectious Diseases, 2010, v. 51 n. 3, p. 274-279 [How to Cite?]
DOI: http://dx.doi.org/10.1086/653940
 
dc.identifier.citeulike7412871
 
dc.identifier.doihttp://dx.doi.org/10.1086/653940
 
dc.identifier.eissn1537-6591
 
dc.identifier.epage279
 
dc.identifier.hkuros173890
 
dc.identifier.isiWOS:000280193800004
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.

 
dc.identifier.issn1058-4838
2013 Impact Factor: 9.416
 
dc.identifier.issue3
 
dc.identifier.openurl
 
dc.identifier.pmid20575664
 
dc.identifier.scopuseid_2-s2.0-77954695237
 
dc.identifier.spage274
 
dc.identifier.urihttp://hdl.handle.net/10722/125016
 
dc.identifier.volume51
 
dc.languageeng
 
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofClinical Infectious Diseases
 
dc.relation.referencesReferences in Scopus
 
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 2009
 
dc.typeArticle
 
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Author Affiliations
  1. Kwong Wah Hospital
  2. The University of Hong Kong
  3. Tuen Mun Hospital
  4. Hong Kong Red Cross Blood Transfusion Service
  5. Princess Margaret Hospital