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Clin Infect Dis . Obesity Is Associated With Increased Susceptibility to Influenza A (H1N1pdm) but Not H3N2 Infection

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  • Clin Infect Dis . Obesity Is Associated With Increased Susceptibility to Influenza A (H1N1pdm) but Not H3N2 Infection


    Clin Infect Dis


    . 2020 Jul 9;ciaa928.
    doi: 10.1093/cid/ciaa928. Online ahead of print.
    Obesity Is Associated With Increased Susceptibility to Influenza A (H1N1pdm) but Not H3N2 Infection


    Hannah E Maier 1 , Guillermina Kuan 2 3 , Lionel Gresh 2 , Roger Lopez 2 4 , Nery Sanchez 2 , Amy Schiller 1 , Sergio Ojeda 2 , Eva Harris 5 , Angel Balmaseda 3 4 , Aubree Gordon 1



    Affiliations

    Abstract

    Background: Obesity has been shown to increase the risk of severe outcomes and death for influenza virus infections. However, we don't understand the influence of obesity on susceptibility to infection or on non-severe influenza outcomes.
    Methods: We performed a case-ascertained, community-based study of influenza transmission within households in Nicaragua. To investigate whether obesity increases the likelihood of influenza infection and symptomatic infection we use logistic regression models.
    Results: Between 2015 and 2018, a total of 335 index cases with influenza A and 1,506 of their household contacts were enrolled. Obesity was associated with increased susceptibility to symptomatic H1N1pdm infection among adults (OR: 2.10, 95%CI: 1.08-4.06), but not children, and this association increased with age. Among adults with H1N1pdm infection, obesity was associated with increased likelihood of symptoms (OR: 3.91, 95%CI: 1.55-9.87). For middle aged and older adults with obesity there was also a slight increase in susceptibility to any H1N1pdm infection (OR: 1.20, 95%CI: 0.62-2.34). Body Mass Index (BMI) was also linearly associated with increased susceptibility to symptomatic H1N1pdm infection, primarily among middle aged and older adult women (5-unit BMI increase OR: 1.40, 95%CI: 1.00-1.97). Obesity was not associated with increased H3N2 susceptibility or associated symptoms.
    Conclusions: We found that among adults obesity is associated with susceptibility to H1N1pdm infection and with symptoms associated with H1N1pdm infection, but not with susceptibility to H3N2 infection or associated symptoms. These findings will help target prevention efforts and therapeutics to this high-risk population.


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