The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts

Matthew J. Memoli, Rani Athota, Susan Reed, Lindsay Czajkowski, Tyler Bristol, Kathleen Proudfoot, Rachel Hagey, Jocelyn Voell, Charles Fiorentino, Angela Ademposi, Shmuel Shoham, Jeffery K. Taubenberger

Research output: Contribution to journalArticle

Abstract

Introduction. Medical advances have led to an increase in the world's population of immunosuppressed individuals. The most severely immunocompromised patients are those who have been diagnosed with a hematologic malignancy, solid organ tumor, or who have other conditions that require immunosuppressive therapies and/or solid organ or stem cell transplants.Materials and methods. Medically attended patients with a positive clinical diagnosis of influenza were recruited prospectively and clinically evaluated. Nasal washes and serum were collected. Evaluation of viral shedding, nasal and serum cytokines, clinical illness, and clinical outcomes were performed to compare severely immunocompromised individuals to nonimmunocompromised individuals with influenza infection.Results. Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment.Conclusions. Immunocompromised patients are at risk for more severe or complicated influenza induced disease, which may be difficult to prevent with existing vaccines and antiviral treatments. Specific issues to consider when managing a severely immunocompromised host include the development of asymptomatic shedding, multi-drug resistance during prolonged antiviral therapy, and the potential high risk of pulmonary involvement.Clinical trials registration, ClinicalTrials.gov identifier NCT00533182.

Original languageEnglish (US)
Pages (from-to)214-224
Number of pages11
JournalClinical Infectious Diseases
Volume58
Issue number2
DOIs
StatePublished - Jan 15 2014

Fingerprint

Immunocompromised Host
Human Influenza
Antiviral Agents
Virus Shedding
Infection
Nose
Multiple Drug Resistance
Hematologic Neoplasms
Immunosuppressive Agents
Serum
Signs and Symptoms
Stem Cells
Therapeutics
Vaccines
Clinical Trials
Cytokines
Transplants
Lung
Population
Neoplasms

Keywords

  • Immunocompromised host
  • Influenza
  • Influenza A
  • Stem cell transplant

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Memoli, M. J., Athota, R., Reed, S., Czajkowski, L., Bristol, T., Proudfoot, K., ... Taubenberger, J. K. (2014). The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts. Clinical Infectious Diseases, 58(2), 214-224. https://doi.org/10.1093/cid/cit725

The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts. / Memoli, Matthew J.; Athota, Rani; Reed, Susan; Czajkowski, Lindsay; Bristol, Tyler; Proudfoot, Kathleen; Hagey, Rachel; Voell, Jocelyn; Fiorentino, Charles; Ademposi, Angela; Shoham, Shmuel; Taubenberger, Jeffery K.

In: Clinical Infectious Diseases, Vol. 58, No. 2, 15.01.2014, p. 214-224.

Research output: Contribution to journalArticle

Memoli, MJ, Athota, R, Reed, S, Czajkowski, L, Bristol, T, Proudfoot, K, Hagey, R, Voell, J, Fiorentino, C, Ademposi, A, Shoham, S & Taubenberger, JK 2014, 'The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts', Clinical Infectious Diseases, vol. 58, no. 2, pp. 214-224. https://doi.org/10.1093/cid/cit725
Memoli, Matthew J. ; Athota, Rani ; Reed, Susan ; Czajkowski, Lindsay ; Bristol, Tyler ; Proudfoot, Kathleen ; Hagey, Rachel ; Voell, Jocelyn ; Fiorentino, Charles ; Ademposi, Angela ; Shoham, Shmuel ; Taubenberger, Jeffery K. / The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts. In: Clinical Infectious Diseases. 2014 ; Vol. 58, No. 2. pp. 214-224.
@article{81f139b566a44d3e8adefa0018361b04,
title = "The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts",
abstract = "Introduction. Medical advances have led to an increase in the world's population of immunosuppressed individuals. The most severely immunocompromised patients are those who have been diagnosed with a hematologic malignancy, solid organ tumor, or who have other conditions that require immunosuppressive therapies and/or solid organ or stem cell transplants.Materials and methods. Medically attended patients with a positive clinical diagnosis of influenza were recruited prospectively and clinically evaluated. Nasal washes and serum were collected. Evaluation of viral shedding, nasal and serum cytokines, clinical illness, and clinical outcomes were performed to compare severely immunocompromised individuals to nonimmunocompromised individuals with influenza infection.Results. Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment.Conclusions. Immunocompromised patients are at risk for more severe or complicated influenza induced disease, which may be difficult to prevent with existing vaccines and antiviral treatments. Specific issues to consider when managing a severely immunocompromised host include the development of asymptomatic shedding, multi-drug resistance during prolonged antiviral therapy, and the potential high risk of pulmonary involvement.Clinical trials registration, ClinicalTrials.gov identifier NCT00533182.",
keywords = "Immunocompromised host, Influenza, Influenza A, Stem cell transplant",
author = "Memoli, {Matthew J.} and Rani Athota and Susan Reed and Lindsay Czajkowski and Tyler Bristol and Kathleen Proudfoot and Rachel Hagey and Jocelyn Voell and Charles Fiorentino and Angela Ademposi and Shmuel Shoham and Taubenberger, {Jeffery K.}",
year = "2014",
month = "1",
day = "15",
doi = "10.1093/cid/cit725",
language = "English (US)",
volume = "58",
pages = "214--224",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts

AU - Memoli, Matthew J.

AU - Athota, Rani

AU - Reed, Susan

AU - Czajkowski, Lindsay

AU - Bristol, Tyler

AU - Proudfoot, Kathleen

AU - Hagey, Rachel

AU - Voell, Jocelyn

AU - Fiorentino, Charles

AU - Ademposi, Angela

AU - Shoham, Shmuel

AU - Taubenberger, Jeffery K.

PY - 2014/1/15

Y1 - 2014/1/15

N2 - Introduction. Medical advances have led to an increase in the world's population of immunosuppressed individuals. The most severely immunocompromised patients are those who have been diagnosed with a hematologic malignancy, solid organ tumor, or who have other conditions that require immunosuppressive therapies and/or solid organ or stem cell transplants.Materials and methods. Medically attended patients with a positive clinical diagnosis of influenza were recruited prospectively and clinically evaluated. Nasal washes and serum were collected. Evaluation of viral shedding, nasal and serum cytokines, clinical illness, and clinical outcomes were performed to compare severely immunocompromised individuals to nonimmunocompromised individuals with influenza infection.Results. Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment.Conclusions. Immunocompromised patients are at risk for more severe or complicated influenza induced disease, which may be difficult to prevent with existing vaccines and antiviral treatments. Specific issues to consider when managing a severely immunocompromised host include the development of asymptomatic shedding, multi-drug resistance during prolonged antiviral therapy, and the potential high risk of pulmonary involvement.Clinical trials registration, ClinicalTrials.gov identifier NCT00533182.

AB - Introduction. Medical advances have led to an increase in the world's population of immunosuppressed individuals. The most severely immunocompromised patients are those who have been diagnosed with a hematologic malignancy, solid organ tumor, or who have other conditions that require immunosuppressive therapies and/or solid organ or stem cell transplants.Materials and methods. Medically attended patients with a positive clinical diagnosis of influenza were recruited prospectively and clinically evaluated. Nasal washes and serum were collected. Evaluation of viral shedding, nasal and serum cytokines, clinical illness, and clinical outcomes were performed to compare severely immunocompromised individuals to nonimmunocompromised individuals with influenza infection.Results. Immunocompromised patients with influenza had more severe disease/complications, longer viral shedding, and more antiviral resistance while demonstrating less clinical symptoms and signs on clinical assessment.Conclusions. Immunocompromised patients are at risk for more severe or complicated influenza induced disease, which may be difficult to prevent with existing vaccines and antiviral treatments. Specific issues to consider when managing a severely immunocompromised host include the development of asymptomatic shedding, multi-drug resistance during prolonged antiviral therapy, and the potential high risk of pulmonary involvement.Clinical trials registration, ClinicalTrials.gov identifier NCT00533182.

KW - Immunocompromised host

KW - Influenza

KW - Influenza A

KW - Stem cell transplant

UR - http://www.scopus.com/inward/record.url?scp=84891808523&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891808523&partnerID=8YFLogxK

U2 - 10.1093/cid/cit725

DO - 10.1093/cid/cit725

M3 - Article

C2 - 24186906

AN - SCOPUS:84891808523

VL - 58

SP - 214

EP - 224

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 2

ER -