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

Med Microbiol Immunol. 2019 Oct;208(5):631-640. doi: 10.1007/s00430-018-0567-9. Epub 2018 Oct 10.


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.

Keywords: C1QBP; CD55; Complement; FCGR2A; Host genetics; Influenza A(H1N1)pdm09.

MeSH terms

  • Adolescent
  • Adult
  • Complement System Proteins / genetics*
  • Female
  • Genetic Predisposition to Disease*
  • Genotype
  • Greece
  • Humans
  • Immunologic Factors / genetics*
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / genetics*
  • Influenza, Human / virology*
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Young Adult


  • Immunologic Factors
  • Complement System Proteins