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Article: Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection
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TitleConvalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection
 
AuthorsHung, IFN4
To, KKW4
Lee, CK8
Lee, KL10
Chan, K9
Yan, WW9
Liu, R12
Watt, CL1
Chan, WM13
Lai, KY7
Koo, CK6
Buckley, T5
Chow, FL15
Wong, KK11
Chan, HS14
Ching, CK3
Tang, BSF16
Lau, CCY4
Li, IWS4
Liu, SH2
Chan, KH4
Lin, CK8
Yuen, KY4
 
Issue Date2011
 
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
CitationClinical Infectious Diseases, 2011, v. 52 n. 4, p. 447-456 [How to Cite?]
DOI: http://dx.doi.org/10.1093/cid/ciq106
 
AbstractBackground: Experience from treating patients with Spanish influenza and influenza A(H5N1) suggested that convalescent plasma therapy might be beneficial. However, its efficacy in patients with severe pandemic influenza A(H1N1) 2009 virus (H1N1 2009) infection remained unknown. Methods: During the period from 1 September 2009 through 30 June 2010, we conducted a prospective cohort study by recruiting patients aged ≥18 years with severe H1N1 2009 infection requiring intensive care. Patients were offered treatment with convalescent plasma with a neutralizing antibody titer of ≥1:160, harvested by apheresis from patients recovering from H1N1 2009 infection. Clinical outcome was compared with that of patients who declined plasma treatment as the untreated controls. Results: Ninety-three patients with severe H1N1 2009 infection requiring intensive care were recruited. Twenty patients (21.5%) received plasma treatment. The treatment and control groups were matched by age, sex, and disease severity scores. Mortality in the treatment group was significantly lower than in the nontreatment group (20.0% vs 54.8%; P =.01). Multivariate analysis showed that plasma treatment reduced mortality (odds ratio [OR],.20; 95% confidence interval [CI],.06-.69; P =.011), whereas complication of acute renal failure was independently associated with death (OR, 3.79; 95% CI, 1.15-12.4; P =.028). Subgroup analysis of 44 patients with serial respiratory tract viral load and cytokine level demonstrated that plasma treatment was associated with significantly lower day 3, 5, and 7 viral load, compared with the control group (P <.05). The corresponding temporal levels of interleukin 6, interleukin 10, and tumor necrosis factor α (P <.05) were also lower in the treatment group. Conclusions: Treatment of severe H1N1 2009 infection with convalescent plasma reduced respiratory tract viral load, serum cytokine response, and mortality. © The Author 2011.
 
ISSN1058-4838
2013 Impact Factor: 9.416
 
DOIhttp://dx.doi.org/10.1093/cid/ciq106
 
ISI Accession Number IDWOS:000286677800008
Funding AgencyGrant Number
Ted Sun Foundation
Food and Health Bureau
Hospital Authority of the Hong Kong Special Administrative Region
Funding Information:

This work was supported by the Ted Sun Foundation; the Research Fund for the Control of Infectious Diseases of the Food and Health Bureau; and the Hospital Authority of the Hong Kong Special Administrative Region.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorHung, IFN
 
dc.contributor.authorTo, KKW
 
dc.contributor.authorLee, CK
 
dc.contributor.authorLee, KL
 
dc.contributor.authorChan, K
 
dc.contributor.authorYan, WW
 
dc.contributor.authorLiu, R
 
dc.contributor.authorWatt, CL
 
dc.contributor.authorChan, WM
 
dc.contributor.authorLai, KY
 
dc.contributor.authorKoo, CK
 
dc.contributor.authorBuckley, T
 
dc.contributor.authorChow, FL
 
dc.contributor.authorWong, KK
 
dc.contributor.authorChan, HS
 
dc.contributor.authorChing, CK
 
dc.contributor.authorTang, BSF
 
dc.contributor.authorLau, CCY
 
dc.contributor.authorLi, IWS
 
dc.contributor.authorLiu, SH
 
dc.contributor.authorChan, KH
 
dc.contributor.authorLin, CK
 
dc.contributor.authorYuen, KY
 
dc.date.accessioned2011-05-24T02:12:40Z
 
dc.date.available2011-05-24T02:12:40Z
 
dc.date.issued2011
 
dc.description.abstractBackground: Experience from treating patients with Spanish influenza and influenza A(H5N1) suggested that convalescent plasma therapy might be beneficial. However, its efficacy in patients with severe pandemic influenza A(H1N1) 2009 virus (H1N1 2009) infection remained unknown. Methods: During the period from 1 September 2009 through 30 June 2010, we conducted a prospective cohort study by recruiting patients aged ≥18 years with severe H1N1 2009 infection requiring intensive care. Patients were offered treatment with convalescent plasma with a neutralizing antibody titer of ≥1:160, harvested by apheresis from patients recovering from H1N1 2009 infection. Clinical outcome was compared with that of patients who declined plasma treatment as the untreated controls. Results: Ninety-three patients with severe H1N1 2009 infection requiring intensive care were recruited. Twenty patients (21.5%) received plasma treatment. The treatment and control groups were matched by age, sex, and disease severity scores. Mortality in the treatment group was significantly lower than in the nontreatment group (20.0% vs 54.8%; P =.01). Multivariate analysis showed that plasma treatment reduced mortality (odds ratio [OR],.20; 95% confidence interval [CI],.06-.69; P =.011), whereas complication of acute renal failure was independently associated with death (OR, 3.79; 95% CI, 1.15-12.4; P =.028). Subgroup analysis of 44 patients with serial respiratory tract viral load and cytokine level demonstrated that plasma treatment was associated with significantly lower day 3, 5, and 7 viral load, compared with the control group (P <.05). The corresponding temporal levels of interleukin 6, interleukin 10, and tumor necrosis factor α (P <.05) were also lower in the treatment group. Conclusions: Treatment of severe H1N1 2009 infection with convalescent plasma reduced respiratory tract viral load, serum cytokine response, and mortality. © The Author 2011.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationClinical Infectious Diseases, 2011, v. 52 n. 4, p. 447-456 [How to Cite?]
DOI: http://dx.doi.org/10.1093/cid/ciq106
 
dc.identifier.doihttp://dx.doi.org/10.1093/cid/ciq106
 
dc.identifier.eissn1537-6591
 
dc.identifier.epage456
 
dc.identifier.hkuros185095
 
dc.identifier.isiWOS:000286677800008
Funding AgencyGrant Number
Ted Sun Foundation
Food and Health Bureau
Hospital Authority of the Hong Kong Special Administrative Region
Funding Information:

This work was supported by the Ted Sun Foundation; the Research Fund for the Control of Infectious Diseases of the Food and Health Bureau; and the Hospital Authority of the Hong Kong Special Administrative Region.

 
dc.identifier.issn1058-4838
2013 Impact Factor: 9.416
 
dc.identifier.issue4
 
dc.identifier.openurl
 
dc.identifier.pmid21248066
 
dc.identifier.scopuseid_2-s2.0-79951821842
 
dc.identifier.spage447
 
dc.identifier.urihttp://hdl.handle.net/10722/133634
 
dc.identifier.volume52
 
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.subject.meshAntibodies, Neutralizing - blood
 
dc.subject.meshImmunotherapy - methods
 
dc.subject.meshInfluenza A Virus, H1N1 Subtype - immunology - isolation and purification - pathogenicity
 
dc.subject.meshInfluenza, Human - mortality - therapy - virology
 
dc.subject.meshPlasma - immunology
 
dc.titleConvalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection
 
dc.typeArticle
 
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Author Affiliations
  1. Kwong Wah Hospital
  2. Hong Kong Hospital Authority
  3. Tseung Kwan O Hospital
  4. The University of Hong Kong
  5. Princess Margaret Hospital Hong Kong
  6. Tuen Mun Hospital
  7. Queen Elizabeth Hospital Hong Kong
  8. Hong Kong Red Cross Blood Transfusion Service
  9. Pamela Youde Nethersole Eastern Hospital
  10. United Christian Hospital Hong Kong
  11. North District Hospital Hong Kong
  12. Ruttonjee Hospital Hong Kong
  13. Queen Mary Hospital Hong Kong
  14. Alice Ho Miu Ling Nethersole Hospital
  15. Caritas Medical Centre Hong Kong
  16. Hong Kong Sanatorium and Hospital