Identification of complement-related host genetic risk factors associated with influenza A(H1N1)pdm09 outcome: challenges ahead

  • Fani ChatzopoulouEmail author
  • Georgia Gioula
  • Ioannis Kioumis
  • Dimitris Chatzidimitriou
  • Maria Exindari
Original Investigation


Influenza remains an important threat for human health, despite the extensive study of influenza viruses and the production of effective vaccines. In contrast to virus genetics determinants, host genetic factors with clinical impact remained unexplored until recently. The association between three single nucleotide polymorphisms (SNPs) and influenza outcome in a European population was investigated in the present study. All samples were collected during the influenza A(H1N1)pdm09 post-pandemic period 2010–11 and a sufficient number of severe and fatal cases was included. Host genomic DNA was isolated from pharyngeal samples of 110 patients from northern Greece with severe (n = 59) or mild (n = 51) influenza A(H1N1)pdm09 disease, at baseline, and the genotype of CD55 rs2564978, C1QBP rs3786054 and FCGR2A rs1801274 SNPs was investigated. Our findings suggest a relationship between the two complement-related SNPs, namely, the rare TT genotype of CD55 and the rare AA genotype of C1QBP with increased death risk. No significant differences were observed for FCGR2A genotypes neither with fatality nor disease severity. Additional large-scale genetic association studies are necessary for the identification of reliable host genetic risk factors associated with influenza A(H1N1)pdm09 outcome. Prophylactic intervention of additional high-risk populations, according to their genetic profile, will be a key achievement for the fight against influenza viruses.


Influenza A(H1N1)pdm09 Complement Host genetics CD55 C1QBP FCGR2A 



This work received no specific grant from any funding agency.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures included in this work were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. To this end, the ethical approval of this study has been provided by the “Bioethics Committee of the Medical School of the Aristotle University of Thessaloniki” (protocol approval number 432).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Authors and Affiliations

  1. 1.Laboratory of Microbiology, School of MedicineAristotle University of ThessalonikiThessalonikiGreece
  2. 2.Respiratory Infections Unit, Pulmonary DepartmentAristotle University of Thessaloniki, G. Papanikolaou HospitalThessalonikiGreece

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