title: Detection of the influenza A(H1N1)pdm09 virus carrying the K-15E, P83S and Q293H mutations in patients who have undergone bone marrow transplant.
abstract: The 2009 pandemic influenza A(H1N1)pdm09 virus emerged and caused considerable morbidity and mortality in the third world, especially in Brazil. Although circulating strains of A(H1N1)pdm09 are A/California/04/2009-like (CA-04-like) viruses, various studies have suggested that some mutations in the viral hemagglutinin (HA) may be associated with enhanced severity and fatality. This phenomenon is particularly challenging for immunocompromised individuals, such as those who have undergone bone marrow transplant (BMT), because they are more likely to display worse clinical outcomes to influenza infection than non-immunocompromised individuals. We studied the clinical and viral aspects of post-BMT patients with confirmed A(H1N1)pdm09 diagnosis in the largest cancer hospital in Brazil. We found a viral strain with K-15E, P83S and Q293H polymorphisms in the HA, which is presumably more virulent, in these individuals. Despite that, these patients showed only mild symptoms of infection. Our findings complement the discovery of mild cases of infection with the A(H1N1)pdm09 virus with the K-15E, P83S and Q293H mutations in Brazil and oppose other studies that have linked these changes with increased disease severity. These results could be important for a better comprehension of the impact of the pandemic influenza in the context of BMT.
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Milene
authors.initials: M
authors.lastname: Mesquita
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Paola
authors.initials: P
authors.lastname: Resende
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Andressa
authors.initials: A
authors.lastname: Marttorelli
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Viviane
authors.initials: V
authors.lastname: Machado
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Carolina Q
authors.initials: CQ
authors.lastname: Sacramento
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Natalia
authors.initials: N
authors.lastname: Fintelman-Rodrigues
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Juliana L
authors.initials: JL
authors.lastname: Abrantes
authors.affiliation: Center for Bone Marrow Transplantation (CEMO), National Cancer Institute (INCa), Rio de Janeiro, RJ, Brazil.
authors.forename: Rita
authors.initials: R
authors.lastname: Tavares
authors.affiliation: Center for Bone Marrow Transplantation (CEMO), National Cancer Institute (INCa), Rio de Janeiro, RJ, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schirmer
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Marilda M
authors.initials: MM
authors.lastname: Siqueira
authors.affiliation: Measles and Respiratory viruses Laboratory, WHO/NIC, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Thiago Moreno L
authors.initials: TM
authors.lastname: Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D016026:Bone Marrow Transplantation; D016022:Case-Control Studies; D002648:Child; D004252:DNA Mutational Analysis; D004285:Dogs; D005260:Female; D006389:Hemagglutinins, Viral / Q000235:genetics; D054884:Host-Pathogen Interactions; D006801:Humans; D016867:Immunocompromised Host; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics* / Q000502:physiology; D007251:Influenza, Human / Q000473:pathology* / Q000821:virology; D061985:Madin Darby Canine Kidney Cells; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation; D010802:Phylogeny; D011110:Polymorphism, Genetic; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D006389:Hemagglutinins, Viral
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