1199. Clinical Outcomes Following Influenza Including 2014/H3N2 Infection in Hematopoietic Cell Transplant (HCT) Recipients
Session: Poster Abstract Session: Transplant: Epidemiology of Infections in Transplant Patients and Other Patients with Impaired Immunity
Friday, October 9, 2015
Room: Poster Hall
Background: Compared to the general population, HCT recipients have lower immune response to influenza vaccination and are susceptible to serious outcomes such as lower respiratory tract infection (LRI) and death. Circulating influenza viral strains and the host immune status determine disease severity after HCT.

Methods: We determined the clinical characteristics, management, and outcomes of laboratory-confirmed influenza, including 2014/H3N2 infection, in HCT recipients.

Results: Of the 146 HCT recipients with influenza, 33 developed LRI (23%), and 7 died within 30 days of diagnosis (5%). Most patients received antiviral therapy (83%); however, only 18% received it within 48 hours of symptom onset. Compared to those who never progressed to LRI, patients presenting with LRI were more likely to be black, have delays in seeking medical care from symptom onset, and have lymphocytopenia, elevated creatinine levels, and hypoxia. Significant differences in gender, race, smoking status and BMI were identified between 2014/H3N2 vs. previous influenza season cases. Similar rates of LRI and mortality were observed during the 2014/H3N2 season; however, antiviral therapy was more promptly initiated when compared to previous seasons. Receiving early antiviral therapy (within 48h of symptom onset) was associated with a significant reduction in LRI.

Conclusion: HCT recipients with 2014/H3N2 influenza infection in our cohort did not experience increased rate of LRI and mortality compared to previous season, probably owing to prompt initiation of antiviral therapy by treating physicians. Early antiviral therapy, even empirically, may reduce influenza-associated LRI and mortality in HCT recipients.

Joumana Kmeid, MD1, Jakapat Vanichanan, MD2, Dimpy Shah, MD, MSPH, PhD3, Firas El Chaer, MD4, Jacques Azzi, MD5, Ella Ariza-Heredia, MD3, Victor Mulanovich, MD6 and Roy F. Chemaly, MD, MPH, FIDSA, FACP3, (1)Infectious Diseases, MD Anderson Cancer Center, Houston, TX, (2)Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (3)Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, (4)Infectious Diseases, Baylor College of Medicine, Houston, TX, (5)Internal Medicine, Staten Island University Hospital, Staten Island, NY, (6)Infectious Diseases, Infection Control & Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX

Disclosures:

J. Kmeid, None

J. Vanichanan, None

D. Shah, None

F. El Chaer, None

J. Azzi, None

E. Ariza-Heredia, None

V. Mulanovich, None

R. F. Chemaly, GSK: Grant Investigator , Grant recipient

Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.