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. 2011;6(12):e28627.
doi: 10.1371/journal.pone.0028627. Epub 2011 Dec 14.

Long term immune responses to pandemic influenza A/H1N1 infection in solid organ transplant recipients

Aliyah Baluch  1 , Atul Humar, Adrian Egli, Jonathan Gubbay, Luiz Lisboa, Leticia Wilson, Deepali Kumar
Affiliations

Long term immune responses to pandemic influenza A/H1N1 infection in solid organ transplant recipients

Aliyah Baluch et al. PLoS One. 2011.

Abstract

In solid organ transplant (SOT) recipients it is unknown if natural infection with influenza confers protection from re-infection with the same strain during the next influenza season. The purpose of this study was to determine if infection with pandemic influenza A/H1N1 (pH1N1) resulted in a long-term immunologic response. Transplant recipients with microbiologically proven pH1N1 infection in 2009/2010 underwent humoral and cell-mediated immunity (CMI) testing for pH1N1 just prior to the next influenza season. Concurrent testing for A/Brisbane/59/2007 was done to rule-out cross-reacting antibody. We enrolled 22 adult transplant patients after pH1N1 infection. Follow up testing was done at a median of 7.4 months (range 5.8-15.4) after infection. After excluding those with cross-reactive antibody, 7/19 (36.8%) patients were seroprotected. Detectable pH1N1-specific CD4+ and CD8+ interferon-γ producing T-cells were found in 11/22 (50%) and 8/22 (36.4%) patients respectively. Humoral immunity had a significant correlation with a CD4 response. This is the first study in transplant patients to evaluate long-term humoral and cellular response after natural influenza infection. We show that a substantial proportion of SOT recipients with previous pH1N1 infection lack long-term humoral and cellular immune responses to pH1N1. These patients most likely are at risk for re-infection.

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Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts: D.K. has received research support paid to the institution from Hoffmann-LaRoche and Sanofi-Pasteur. A.H. has received research support paid to the institution from Hoffmann-LaRoche and speaker honoraria from Hoffman-LaRoche. A.E. is supported by the Swiss National Fund Grant PBBSP3-130963. This does not alter the author's adherence to all the PLoS ONE policies on sharing data and materials. The remaining authors have no conflict of interest.

Figures

Figure 1
Figure 1. Range of pH1N1-specific CD4+IFNγ+ and CD8+IFNγ+ T cell frequencies (%) in peripheral blood mononuclear cells of individual patients (n = 22).
Samples taken after natural pH1N1 infection but prior to the onset of the next influenza season. Horizontal line represents median response.
Figure 2
Figure 2. Representative flow cytometry plots for 3 individual patients.
A) Patient 1: pH1N1 antibody titer of 1∶640, CD4+/IFNγ frequency of 1.78% (positive), and CD8+/IFNγ frequency of 0.57% (positive); B) Patient 2: pH1N1 antibody titer of 1∶80, CD4+/IFNγ frequency of 0.25% (negative), and CD8+/IFNγ frequency of 0.13% (negative); C) Patient 3: Negative serology, CD4+/IFNγ frequency of 0.07% (negative) and CD8+/IFNγ frequency of 0.07% (negative).
Figure 3
Figure 3. Relationship between CD4+IFNγ T-cell frequency (%) and the humoral response (n = 19).
(R2 = 0.428, P = 0.002).
See this image and copyright information in PMC

References

    1. Kumar D, Michaels MG, Morris MI, Green M, Avery RK, et al. Outcomes from pandemic influenza A H1N1 infection in recipients of solid-organ transplants: a multicentre cohort study. Lancet Infect Dis. 2010;10(8):521–526. - PMC - PubMed
    1. Low CY, Kee T, Chan KP, Oon LL, Tan CK, et al. Pandemic (H1N1) 2009 infection in adult solid organ transplant recipients in Singapore. Transplantation. 2010;90(9):1016–1021. - PubMed
    1. Smud A, Nagel CB, Madsen E, Rial Mdel C, Barcan LA, et al. Pandemic influenza A/H1N1 virus infection in solid organ transplant recipients: a multicenter study. Transplantation. 2010;90(12):1458–1462. - PubMed
    1. Wang M, Yuan J, Li T, Liu Y, Wu J, et al. Antibody Dynamics of 2009 Influenza A (H1N1) Virus in Infected Patients and Vaccinated People in China. PLoS One. 2011;6(2):e16809. - PMC - PubMed
    1. McMichael AJ, Gotch FM, Noble GR, Beare PA. Cytotoxic T-cell immunity to influenza. N Engl J Med. 1983;309(1):13–17. - PubMed

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