Immunogenicity and safety of inactivated quadrivalent influenza vaccine in adults: A systematic review and meta-analysis of randomised controlled trials

Moa, Aye; Chughtai, Abrar Ahmad; Muscatello, David; Turner, Robin; MacIntyre, C. Raina

doi:10.1016/j.vaccine.2016.06.064

Cited by 74 publications

(65 citation statements)

References 35 publications

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“…The answer probably lies in two important issues. The first one is the small group of patients and the second one arises from the existence of resistant forms of the virus [21,22].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

Cvetanovska¹,

Milenkovik²,

Uroshevik³

et al. 2016

Prilozi

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Introduction: Clinical manifestations of influenza range from relatively mild and self-limiting respiratory infections to severe clinical manifestations with significant morbidity and mortality. The awareness of predictive indicators for the lethal outcome of influenza is of particular significance in making timely and exact decision for adequate treatment. The aim of this study was to identify the factors in patients with a severe form of influenza, resulting in lethal outcome. Materials and methods:The investigation was a prospective group comparison conducted at the University Clinic for Infectious Diseases in Skopje, R. Macedonia in the period from January 01, 2012 to January 01, 2015. The study included adult patients with a severe form of influenza who were further categorized into a group of either survived patients or a group of deceased patients. Demographic, clinical and biochemical data were noted in all patients included in the study on admission. The variables of the univariate analysis that showed a significant difference in terms of the outcome were used for creating multivariate logistic and regression analysis of the outcome as dependent factors. The independent predictors for lethal outcome in severe cases of influenza were identified by using logistic regression. Results: The study included 87 patients with a severe form of clinical and laboratory confirmed influenza. The patients were divided in two groups: survived (n = 75) and deceased (n = 75). The overall mortality was 13.79%. Multivariate analysis conducted on admission to hospital identified cardiovascular comorbid diseases (p = 0.014), urea values higher than 8.3 U/L (p = 0.045) and SAPS score (p = 0.048) as independent predictors of the outcome in patients with severe form of influenza. Influenza patients with cardiovascular diseases had 2.024 times greater risk of death from influenza in comparison to the patients having influenza without history of such a disease (OR = 2.024 95% CI 1.842-17.337). Patients with serum urea values higher than 8.3 U/L had 1.89 times higher chance of death compared to patients with normal values (OR = 1.89 95% CI 1.091-11.432). The increase of the SAPS score in one point increased the chance of death in patients with influenza by 1.2% (OR = 1.12 95% CI 1.01-2.976). The ROC analysis indicated that cardiovascular diseases, increased urea values and SAPS score in combination act as a good prognostic model for the fatal outcome. The global authenticity of this predictive model to foresee lethal outcome amounts to 80%, sensitivity being 82%, and specificity 70%. Conclusion: Cardiovascular diseases, increased values of urea over 8.3 mmol/l and SAPS score are independent predictive indicators for lethal outcome in severe influenza. Early identification of the outcome predictors in patients with severe influenza will allow implementation of adequate medical treatment and will contribute to decreasing of mortality in patients with severe form of influenza.

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“…The answer probably lies in two important issues. The first one is the small group of patients and the second one arises from the existence of resistant forms of the virus [21,22].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

Cvetanovska¹,

Milenkovik²,

Uroshevik³

et al. 2016

Prilozi

View full text Add to dashboard Cite

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“…Therefore, influenza A viruses have often received more attention and concern as a global threat compared to influenza B viruses [16]. Of note, the quadrivalent influenza vaccine that is recently licensed in many countries [17] now offers protection against both lineages of influenza B virus as well as the two influenza A subtypes [18]. …”

Section: Introductionmentioning

confidence: 99%

A Perspective on the Structural and Functional Constraints for Immune Evasion: Insights from Influenza Virus

Wilson

2017

Journal of Molecular Biology

148

174

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Influenza virus evolves rapidly to constantly escape from natural immunity. Most humoral immune responses to influenza virus target the hemagglutinin glycoprotein (HA), which is the major antigen on the surface of the virus. The HA is comprised of a globular head domain for receptor binding and a stem domain for membrane fusion. The major antigenic sites of HA are located in the globular head subdomain, which is highly tolerant of amino-acid substitutions and continual addition of glycosylation sites. Nonetheless, the evolution of the receptor-binding site (RBS) and the stem region on HA is severely constrained by their functional roles in engaging the host receptor and in mediating membrane fusion, respectively. Here, we review how broadly neutralizing antibodies (bnAbs) exploit these evolutionary constraints to protect against diverse influenza strains. We also discuss the emerging role of other epitopes that are conserved only in subsets of viruses. This rapidly increasing knowledge of the evolutionary biology, immunology, structural biology, and virology of influenza virus is invaluable for development and design of more universal influenza vaccines as well as novel therapeutics.

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“…Due to the small number of patients this difference between the two groups was insignificant. These results shoud be taken with precaution since many studies show that vaccination significantly reduces mortality rate of influenza (De Florentiis et al, 2010;Moa et al, 2016;Sridhar et al, 2015).…”

Section: Discussionmentioning

confidence: 95%

The influence of comorbid factors in surviving of patients with severe form of seasonal influenza

Cvetanovska¹,

Milenkovik²,

Grozdanovski³

et al. 2016

Maced. Pharm. Bull.

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Elderly patients and patients with different comorbid conditions are at a higher risk of developing severe clinical course and lethal influenza outcome. The aim of this study was to define comorbid conditions in patients with a severe form of seasonal influenza, and to define their influence on lethal outcome. The study was a prospective, group comparison and was conducted at the University Clinic for Infectious Diseases in Skopje, Macedonia, during the period of January 01, 2012 to January 01, 2015. The study included 87 adult patients with a severe form of seasonal influenza, who were further categorized in to a group of either survived patients (n=75) and a group of deceased patients (n=12). Demographic parameters of the patients, as well as any comorbid medical conditions, such as cardiovascular disease, chronic lung disease, neurological diseases, weakened immune system, endocrine disorders, kidney disorders, liver disorders, pregnancy, overweight were noted upon admission in the hospital. The variables of the univariate analysis that showed a significant difference in terms of the outcome were used for creating multivariate logistic and regression analysis to identify independent predictors for lethal outcome in severe cases of influenza. Multivariate analysis identified cardiovascular comorbid diseases (p=0.014), as an independent predictor of the outcome in patients with severe form of seasonal influenza. Influenza patients with cardiovascular diseases had 2.024 times greater risk of death from influenza in comparison to patients having influenza without a history of such a disease (OR=2.024 95% CI 1.842-17.337).

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Immunogenicity and safety of inactivated quadrivalent influenza vaccine in adults: A systematic review and meta-analysis of randomised controlled trials

Abstract: In adults, inactivated QIV was as immunogenic as seasonal TIV, with equivalent efficacy against the shared three strains included in TIV, and a superior immunogenicity against the non-TIV B lineage.

Cited by 74 publications

References 35 publications

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

A Perspective on the Structural and Functional Constraints for Immune Evasion: Insights from Influenza Virus

The influence of comorbid factors in surviving of patients with severe form of seasonal influenza

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