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Clin Infect Dis. 2019 Jul 12. pii: ciz639. doi: 10.1093/cid/ciz639. [Epub ahead of print]
Pre-existing anti-neuraminidase antibodies are associated with shortened duration of influenza A (H1N1)pdm virus shedding and illness in naturally infected adults.
Maier HE1, Nachbagauer R2, Kuan G3,4, Ng S1, Lopez R5,3, Sanchez N3, Stadlbauer D2, Gresh L3, Schiller A1, Rajabhathor A2, Ojeda S3, Guglia AF2, Amanat F2,6, Balmaseda A5,3, Krammer F2, Gordon A1.
Author information
Abstract
BACKGROUND:
Influenza causes a substantial burden worldwide, and current seasonal influenza vaccine has suboptimal effectiveness. To develop better, more broadly protective vaccines, a more thorough understanding is needed of how antibodies that target the influenza virus surface antigens, hemagglutinin (HA; including head and stalk regions), and neuraminidase (NA), impact influenza illness and virus transmission.
METHODS:
We used a case-ascertained, community-based study of household influenza virus transmission set in Managua, Nicaragua. Using data from 170 RT-PCR-confirmed influenza virus A(H1N1)pdm infections and 45 household members with serologically-confirmed infection, we examined the association of pre-existing NA, hemagglutination inhibiting (HAI), and HA stalk antibody levels and influenza viral shedding and disease duration using accelerated failure time (AFT) models.
RESULTS:
Among RT-PCR-confirmed infections in adults, pre-existing anti-NA antibody levels of ≥40 were associated with a 69% (95%CI: 34%, 85%) shortened shedding duration (mean: 1.0 vs 3.2 days). NA antibody levels of ≥80 were associated with further shortened shedding and significantly shortened symptom duration (ILI: 82%, 95%CI: 39%, 95%). Among RT-PCR-confirmed infections in children, HAI titers of ≥1:20 were associated with a 32% (95%CI: 13%, 47%) shortened shedding duration (mean: 3.9 vs 6.0 days).
CONCLUSIONS:
Our results suggest that anti-NA antibodies play a large role in reducing influenza illness duration in adults and may impact transmission, most clearly among adults. Neuraminidase should be considered as an additional target in next-generation influenza virus vaccine development.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
KEYWORDS:
hemagglutination inhibition (HAI); household; influenza; neuraminidase; shedding
PMID: 31300819 DOI: 10.1093/cid/ciz639
Pre-existing anti-neuraminidase antibodies are associated with shortened duration of influenza A (H1N1)pdm virus shedding and illness in naturally infected adults.
Maier HE1, Nachbagauer R2, Kuan G3,4, Ng S1, Lopez R5,3, Sanchez N3, Stadlbauer D2, Gresh L3, Schiller A1, Rajabhathor A2, Ojeda S3, Guglia AF2, Amanat F2,6, Balmaseda A5,3, Krammer F2, Gordon A1.
Author information
Abstract
BACKGROUND:
Influenza causes a substantial burden worldwide, and current seasonal influenza vaccine has suboptimal effectiveness. To develop better, more broadly protective vaccines, a more thorough understanding is needed of how antibodies that target the influenza virus surface antigens, hemagglutinin (HA; including head and stalk regions), and neuraminidase (NA), impact influenza illness and virus transmission.
METHODS:
We used a case-ascertained, community-based study of household influenza virus transmission set in Managua, Nicaragua. Using data from 170 RT-PCR-confirmed influenza virus A(H1N1)pdm infections and 45 household members with serologically-confirmed infection, we examined the association of pre-existing NA, hemagglutination inhibiting (HAI), and HA stalk antibody levels and influenza viral shedding and disease duration using accelerated failure time (AFT) models.
RESULTS:
Among RT-PCR-confirmed infections in adults, pre-existing anti-NA antibody levels of ≥40 were associated with a 69% (95%CI: 34%, 85%) shortened shedding duration (mean: 1.0 vs 3.2 days). NA antibody levels of ≥80 were associated with further shortened shedding and significantly shortened symptom duration (ILI: 82%, 95%CI: 39%, 95%). Among RT-PCR-confirmed infections in children, HAI titers of ≥1:20 were associated with a 32% (95%CI: 13%, 47%) shortened shedding duration (mean: 3.9 vs 6.0 days).
CONCLUSIONS:
Our results suggest that anti-NA antibodies play a large role in reducing influenza illness duration in adults and may impact transmission, most clearly among adults. Neuraminidase should be considered as an additional target in next-generation influenza virus vaccine development.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
KEYWORDS:
hemagglutination inhibition (HAI); household; influenza; neuraminidase; shedding
PMID: 31300819 DOI: 10.1093/cid/ciz639