title: Kinetics of serological responses in influenza A(H7N9)-infected patients correlate with clinical outcome in China, 2013.
abstract: The novel avian influenza A(H7N9) infection has recently emerged to cause severe respiratory illness in China. The objectives of this study were to define the kinetics of the antibody responses in patients with influenza A(H7N9) disease and to correlate these kinetics with clinical outcome. Serial serum samples were obtained at intervals of three to four days from 18 patients with virologically confirmed A(H7N9) disease in Shanghai. We determined the kinetics of the haemagglutination inhibition (HI) and A(H7H9) pseudotype neutralisation antibody (Nab) responses and correlated these with clinical outcomes. Most patients had robust serological responses by both HI and Nab tests. Taking into account censoring due to time of testing and death, the median time from onset of illness to Nab titre ≥1:40 was 14 days (95% confidence interval (CI): 11–18 days) in the fatal cases and 10.5 days (95% CI: 7–12) in the survivors (p=0.003). The two groups did not differ in initial Nab titres, but the rate of increase in Nab titres was significantly faster for survivors by approximately 10-fold per 15 days (p=0.007). Early and rapid induction of Nab was correlated significantly with better clinical outcome.
authors.affiliation: Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: A
authors.initials: A
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.forename: D
authors.initials: D
authors.lastname: Tian
authors.forename: E H
authors.initials: EH
authors.lastname: Lau
authors.forename: Y
authors.initials: Y
authors.lastname: Wan
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Dong
authors.forename: Z
authors.initials: Z
authors.lastname: Song
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: M
authors.initials: M
authors.lastname: Bao
authors.forename: M
authors.initials: M
authors.lastname: Zhou
authors.forename: S
authors.initials: S
authors.lastname: Yuan
authors.forename: J
authors.initials: J
authors.lastname: Sun
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: Y
authors.initials: Y
authors.lastname: Hu
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.forename: C Y
authors.initials: CY
authors.lastname: Leung
authors.forename: J T
authors.initials: JT
authors.lastname: Wu
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: J S
authors.initials: JS
authors.lastname: Peiris
authors.forename: J
authors.initials: J
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood* / Q000235:genetics; D000998:Antiviral Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D064766:Influenza A Virus, H7N9 Subtype / Q000276:immunology* / Q000302:isolation & purification; D007251:Influenza, Human / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D053139:Oseltamivir / Q000627:therapeutic use; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D053139:Oseltamivir