tetano
Editor, Senior Moderator
Blood. 2011 Mar 3. [Epub ahead of print]
Differences in clinical outcomes following 2009 influenza A/H1N1 and seasonal influenza among hematopoietic cell transplant recipients.
Choi SM, Boudreault AA, Xie H, Englund JA, Corey L, Boeckh M.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;
Abstract
It is not known whether pandemic 2009 influenza A/H1N1 (2009 H1N1) leads to more serious disease than seasonal influenza in hematopoietic cell transplant (HCT) recipients. In a retrospective study in HCT recipients with virologically proven influenza virus infection, a total of 161 HCT recipients (18 2009 H1N1, 103 seasonal influenza A, and 40 seasonal influenza B) were analyzed. In multivariable analyses, more patients with 2009 H1N1 had lower respiratory tract disease (LRD), hypoxemia and prolonged viral shedding compared with seasonal influenza A . Seasonal influenza A and B outcomes were similar. There was no difference in overall and influenza-associated mortality among influenza virus types. Both early and delayed administration of antiviral therapy was shown to be beneficial in terms of decreased rates of development of lower respiratory tract disease, although earlier intervention appeared to be more effective. Profound lymphopenia and lack of early antiviral therapy was associated significantly with LRD, hypoxemia and death. High-dose corticosteroid treatment (≥ 1 mg/kg) given at the time of influenza diagnosis was associated with a reduced risk for mechanical ventilation. Thus, our data suggest that infection with 2009 influenza A/H1N1 resulted in more severe respiratory disease in HCT recipients when compared to seasonal influenza.
PMID: 21372154 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21372154
Differences in clinical outcomes following 2009 influenza A/H1N1 and seasonal influenza among hematopoietic cell transplant recipients.
Choi SM, Boudreault AA, Xie H, Englund JA, Corey L, Boeckh M.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States;
Abstract
It is not known whether pandemic 2009 influenza A/H1N1 (2009 H1N1) leads to more serious disease than seasonal influenza in hematopoietic cell transplant (HCT) recipients. In a retrospective study in HCT recipients with virologically proven influenza virus infection, a total of 161 HCT recipients (18 2009 H1N1, 103 seasonal influenza A, and 40 seasonal influenza B) were analyzed. In multivariable analyses, more patients with 2009 H1N1 had lower respiratory tract disease (LRD), hypoxemia and prolonged viral shedding compared with seasonal influenza A . Seasonal influenza A and B outcomes were similar. There was no difference in overall and influenza-associated mortality among influenza virus types. Both early and delayed administration of antiviral therapy was shown to be beneficial in terms of decreased rates of development of lower respiratory tract disease, although earlier intervention appeared to be more effective. Profound lymphopenia and lack of early antiviral therapy was associated significantly with LRD, hypoxemia and death. High-dose corticosteroid treatment (≥ 1 mg/kg) given at the time of influenza diagnosis was associated with a reduced risk for mechanical ventilation. Thus, our data suggest that infection with 2009 influenza A/H1N1 resulted in more severe respiratory disease in HCT recipients when compared to seasonal influenza.
PMID: 21372154 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21372154