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Convalescent plasma treatment reduced mortality in patients with severe H1N1

Hung I. Clin Infect Dis. 2011;52:510-519.

Issue: February 2011

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A new convalescent plasma therapy led to reductions in respiratory tract viral load, serum cytokine response and mortality among patients hospitalized with severe 2009 H1N1 infection, according to new findings published in Clinical Infectious Diseases.

Previous research has indicated that convalescent plasma therapy is beneficial for the treatment of Spanish influenza and influenza A (H5N1). Kwok-Yung Yuen, MD of the University of Hong Kong, and colleagues sought to determine the efficacy of the new therapy in patients with severe influenza A (H1N1).

The study cohort included 93 patients aged 18 and older with severe 2009 H1N1 infection from seven hospital clusters included in the Hospital Authority of Hong Kong. All patients required intensive care.

Twenty patients received IV 500 mL convalescent plasma therapy for 4 hours. The researchers compared clinical outcomes between the treatment group and the nontreatment group (n=73). Both groups were matched for age, gender, and disease severity scores.

Compared with a 54.8% mortality in the control group, mortality was significantly lower in the treatment group (20%; P=.01). Although plasma therapy decreased mortality (OR=0.20; 95% CI, 0.06-0.69), an independent association was found between acute renal failure and death (OR= 3.79; 95% CI, 1.15-12.4).

Compared with controls, convalescent plasma therapy was associated with significantly lower viral loads in a subgroup analysis of 44 patients with serial respiratory tract viral load and cytokine level (P<.05).

“One of the benefits of convalescent plasma treatment in patients with severe [H1N1] infection is that it does not suffer from the problem of drug resistance,” Yuen said in a press release. “Additionally, it would remain effective until the virus has changed significantly enough to affect immunity. This form of treatment may be useful in future novel viral infections.”

Disclosure: Dr. Yuen reports no relevant financial disclosures.

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