Journal
EPIDEMIOLOGY AND INFECTION
Volume 138, Issue 11, Pages 1550-1558Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268810000518
Keywords
Influenza A virus; genetic susceptibility; H5N1 subtype
Funding
- Wellcome Trust UK
- Genome Institute of Singapore, Agency for Science Technology and Research (A*STAR)
- National Institutes of Health, South East Asia Infectious Diseases Clinical Research Network
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The apparent family clustering of avian influenza A/H5N1 has led several groups to postulate the existence of a host genetic influence on susceptibility to A/H5N1, yet the role of host factors on the risk of A/H5N1 disease has received remarkably little attention compared to the efforts focused on viral factors. We examined the epidemiological patterns of human A/H5N1 cases, their possible explanations, and the plausibility of a host genetic effect on susceptibility to A/H5N1 infection. The preponderance of familial clustering of cases and the relative lack of non-familial clusters, the occurrence of related cases separated by time and place, and the paucity of cases in some highly exposed groups such as poultry cullers, are consistent with a host genetic effect. Animal models support the biological plausibility of genetic susceptibility to A/H5N1. Although the evidence is circumstantial, host genetic factors are a parsimonious explanation for the unusual epidemiology of human A/H5N1 cases and warrant further investigation.
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