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165. Kinetics of Serological Responses in Critically Ill Patients Hospitalized With 2009 Pandemic Influenza A(H1N1) Virus Infection in Canada, 2009-2011.

Author

Rolfes, Melissa A., Gross, F. Liaini, Flannery, Brendan, Meyers, Adrienne F. A., Ma Luo, Bastien, Nathalie, Fowler, Robert A., Katz, Jacqueline M., Levine, Min Z., Kumar, Anand, Uyeki, Timothy M., Luo, Ma, and CSIS and ROSII Study Groups

Subjects
*ANTIBODY formation, *H1N1 influenza, *VIRAL antibodies, *IMMUNOGLOBULIN analysis, *MEDICAL microbiology
Abstract

Background: The kinetics of the antibody response during severe influenza are not well documented.Methods: Critically ill patients infected with 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09), confirmed by reverse-transcription polymerase chain reaction analysis or seroconversion (defined as a ≥4-fold rise in titers), during 2009-2011 in Canada were prospectively studied. Antibody titers in serially collected sera were determined using hemagglutinin inhibition (HAI) and microneutralization assays. Average antibody curves were estimated using linear mixed-effects models and compared by patient outcome, age, and corticosteroid treatment.Results: Of 47 patients with A(H1N1)pdm09 virus infection (median age, 47 years), 59% had baseline HAI titers of <40, and 68% had baseline neutralizing titers of <40. Antibody titers rose quickly after symptom onset, and, by day 14, 83% of patients had HAI titers of ≥40, and 80% had neutralizing titers ≥40. Baseline HAI titers were significantly higher in patients who died compared with patients who survived; however, the antibody kinetics were similar by patient outcome and corticosteroid treatment. Geometric mean titers over time in older patients were lower than those in younger patients.Conclusions: Critically ill patients with influenza A(H1N1)pdm09 virus infection had strong HAI and neutralizing antibody responses during their illness. Antibody kinetics differed by age but were not associated with patient outcome. [ABSTRACT FROM AUTHOR]

Published
2018
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