Evaluation of correlates of protection against influenza A(H3N2) and A(H1N1)pdm09 infection: Applications to the hospitalized patient population.
Evaluation of correlates of protection against influenza A(H3N2) and A(H1N1)pdm09 infection: Applications to the hospitalized patient population.
复制标题
评估甲型 (H3N2) 和甲型 (H1N1)pdm09 流感感染防护的相关性：在住院患者群体中的应用。
DOI：
10.1016/j.vaccine.2019.01.055
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发表时间：
2019
期刊：
影响因子：
5.5
通讯作者：
Monto,ArnoldS
中科院分区：
文献类型：
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作者：
Petrie,JoshuaG;Martin,EmilyT;Truscon,Rachel;Johnson,Emileigh;Cheng,CarolineK;McSpadden,EJ;Malosh,RyanE;Lauring,AdamS;Lamerato,LoisE;Eichelberger,MarynaC;Ferdinands,JillM;Monto,ArnoldS
研究背景流感疫苗对预防流感相关住院具有重要意义。然而，流感疫苗的有效性可能因年而异，流感类型和亚型以及这种变化的机制尚未完全了解。保护的血清学相关性的评估可以支持解释流感疫苗在住院population.MethodsWe招募成人住院治疗急性呼吸道疾病在2014-2015年和2015-2016年流感季节的症状开始<10天前登记。采用RT-PCR方法检测流感病毒感染状况。流感疫苗接种状态通过自我报告和病历/登记文件定义。在入院时采集的血清标本进行血凝抑制（HAI）和神经氨酸酶抑制（NAI）试验。我们评估了如何以及抗体测量这些标本代表感染前的免疫状态，并测量抗体和流感疫苗接种和infection.ResultsSerum标本之间的关联检索315名参与者在2014-2015赛季和339名参与者在2015-2016赛季。在发病后3天内从65%的参与者中收集标本。在流感阳性受试者中，几何平均滴度（GMT）不随从发病至标本采集的天数而变化，表明测得的抗体代表感染前免疫状态，而不是对感染的新发应答。在两个季节中，接种疫苗的参与者的HAI和NAI GMT高于未接种疫苗的参与者。针对2014-2015年A（H3 N2）疫苗株的HAI滴度与该季节流行的抗原漂移A（H3 N2）病毒感染的保护无关。与此相反，2015- 2016年甲型H1N1流感pdm 09疫苗株HAI滴度较高与甲型H1N1流感pdm 09感染几率降低相关。类似研究的更广泛实施将为了解当前流感疫苗的成功和缺点提供机会。
BackgroundInfluenza vaccines are important for prevention of influenza-associated hospitalization. However, the effectiveness of influenza vaccines can vary by year and influenza type and subtype and mechanisms underlying this variation are incompletely understood. Assessments of serologic correlates of protection can support interpretation of influenza vaccine effectiveness in hospitalized populations.MethodsWe enrolled adults hospitalized for treatment of acute respiratory illnesses during the 2014–2015 and 2015–2016 influenza seasons whose symptoms began <10 days prior to enrollment. Influenza infection status was determined by RT-PCR. Influenza vaccination status was defined by self-report and medical record/registry documentation. Serum specimens collected at hospital admission were tested in hemagglutination-inhibition (HAI) and neuraminidase-inhibition (NAI) assays. We evaluated how well antibody measured in these specimens represented pre-infection immune status, and measured associations between antibody and influenza vaccination and infection.ResultsSerum specimens were retrieved for 315 participants enrolled during the 2014–2015 season and 339 participants during the 2015–2016 season. Specimens were collected within 3 days of illness onset from 65% of participants. Geometric mean titers (GMTs) did not vary by the number of days from illness onset to specimen collection among influenza positive participants suggesting that measured antibody was representative of pre-infection immune status rather than a de novo response to infection. In both seasons, vaccinated participants had higher HAI and NAI GMTs than unvaccinated. HAI titers against the 2014–2015 A(H3N2) vaccine strain did not correlate with protection from infection with antigenically-drifted A(H3N2) viruses that circulated that season. In contrast, higher HAI titers against the A(H1N1)pdm09 vaccine strain were associated with reduced odds of A(H1N1)pdm09 infection in 2015–2016.ConclusionsSerum collected shortly after illness onset at hospital admission can be used to assess correlates of protection against influenza infection. Broader implementation of similar studies would provide an opportunity to understand the successes and shortcomings of current influenza vaccines.