Activated CD4+ T cells and CD14hiCD16+ monocytes correlate with antibody response following influenza virus infection in humans

Cell Rep Med. 2021 Apr 7;2(4):100237. doi: 10.1016/j.xcrm.2021.100237. eCollection 2021 Apr 20.


The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts.

Keywords: antibody; cellular immunity; humoral immunity; immune correlate; infection; influenza; monocytes; mucosal immunity; respiratory virus; seroconversion.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Viral / immunology
  • Antibody Formation / immunology*
  • CD4-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / immunology*
  • Humans
  • Immunity, Mucosal / immunology
  • Influenza A virus / immunology
  • Influenza Vaccines / immunology
  • Influenza, Human / immunology*
  • Lipopolysaccharide Receptors / immunology*
  • Monocytes / immunology*
  • Orthomyxoviridae Infections / immunology


  • Antibodies, Viral
  • CD14 protein, human
  • Influenza Vaccines
  • Lipopolysaccharide Receptors