Host immunological response and factors associated with clinical outcome in patients with the novel influenza A H7N9 infection.

摘要: In March 2013, an influenza outbreak caused by the novel avian-origin H7N9 A virus emerged in eastern China and had 43 fatalities 31 July although basis for disease pathogenesis still remains unclear. To assess immunological viral factors associated with severity, RNA inflammatory cytokines were quantified 18 patients Shanghai, China. Detailed clinical information was collected laboratory investigations performed all patients. infection is characterized high pharyngeal load frequent detection of blood. High persisted through first 10 days antiviral therapy fatal cases. Genetic characterization revealed Arg292Lys mutation neuraminidase gene oseltamivir-resistance. Pronounced lymphopenia chemokine cytokine levels observed H7N9-infected patients, particularly those where fatal. Serum interleukin-6 (IL-6), IL-8 macrophage protein-1β our subjects also correlated positively load. Lymphocyte counts 97 pg/mL, >40 pg/mL C-reactive protein >90 mg/L identified as being connected adverse outcome univariate logistic analysis. Significant survival differences between serum <90 mg/L or creatinine <90 μmol/L higher levels. Our data demonstrated that load, resulting intense responses, played important role pathogenesis. Though immunomodulatory treatment has potential benefits, focus management should be on preventing response early diagnosis effective treatment.