Interpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera.
Interpreting Seroepidemiologic Studies of Influenza in a Context of Nonbracketing Sera.
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DOI：
10.1097/ede.0000000000000408
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
Cowling BJ
中科院分区：
文献类型：
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作者：
Tsang TK;Fang VJ;Perera RA;Ip DK;Leung GM;Peiris JS;Cauchemez S;Cowling BJ
在流感流行病学中，几十年来，对流感季节前后从人群中收集的配对血清进行分析，以研究人群中流感病毒感染的累积发病率。然而，当血清是在流行病开始之后或结束之前收集的，并且没有整齐地将流行病分类时，解释变得具有挑战性。在一项基于社区的研究中纵向收集了血清样本。大多数参与者在2009年甲型H1N1流感pdm09病毒开始传播后提供了第一份血清。我们开发了一个贝叶斯分层模型来纠正非交叉血清，并根据香港的血清学数据和监测数据估计累积感染发生率。我们分析了从2009年4月至2010年12月收集的2097名未接种疫苗的参与者的4843份血清。考虑非括号法后，我们估计H1N1pdm09病毒感染的累积发病率为45.1%。（95%可信区间，CI：40.2%，49.2%），16.5% 0 - 18岁儿童、19 - 50岁成人和> 50岁的老年人分别为（95% CI：13.0%，19.7%）和11.3%（95% CI：5.9%，17.5%）。包括所有可用的数据大大提高了精度相比，一个简单的分析，仅基于血清收集在6个月的时间间隔在一个子集的参与者。我们开发了一个抗体滴度的分析框架，该框架考虑了血清收集与流感活动有关的时间，并允许对流行病期间感染的累积发生率进行稳健估计。
In influenza epidemiology, analysis of paired sera collected from people before and after influenza seasons has been used for decades to study the cumulative incidence of influenza virus infections in populations. However, interpretation becomes challenging when sera are collected after the start or before the end of an epidemic, and do not neatly bracket the epidemic. Serum samples were collected longitudinally in a community-based study. Most participants provided their first serum after the start of circulation of influenza A(H1N1)pdm09 virus in 2009. We developed a Bayesian hierarchical model to correct for non-bracketing sera and estimate the cumulative incidence of infection from the serological data and surveillance data in Hong Kong. We analysed 4843 sera from 2097 unvaccinated participants in the study, collected from April 2009 through December 2010. After accounting for non-bracketing, we estimated that the cumulative incidence of H1N1pdm09 virus infection was 45.1% (95% credible interval, CI: 40.2%, 49.2%), 16.5% (95% CI: 13.0%, 19.7%) and 11.3% (95% CI: 5.9%, 17.5%) for children 0–18y, adults 19–50y and older adults >50y respectively. Including all available data substantially increased precision compared to a simpler analysis based only on sera collected at 6-month intervals in a subset of participants. We developed a framework for the analysis of antibody titers that accounted for the timing of sera collection with respect to influenza activity and permitted robust estimation of the cumulative incidence of infection during an epidemic.