Oxford University Clinical Research Unit, Vietnam.
Epidemiol Infect. 2010 Nov;138(11):1550-8. doi: 10.1017/S0950268810000518. Epub 2010 Mar 18.
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.
禽流感病毒 A/H5N1 的明显家族聚集性使得一些研究小组推测宿主遗传因素对 A/H5N1 的易感性存在影响，但与集中研究病毒因素相比，宿主因素在 A/H5N1 疾病风险中的作用却很少受到关注。我们研究了人类 A/H5N1 病例的流行病学模式、可能的解释以及宿主遗传因素对 A/H5N1 感染易感性的影响。大量病例的家族聚集性和相对较少的非家族聚集性、时间和地点上相关病例的发生以及在一些高暴露人群（如扑杀家禽的人员）中病例的缺乏，都与宿主遗传因素有关。动物模型支持宿主对 A/H5N1 易感性存在遗传基础的生物学合理性。尽管证据只是间接的，但宿主遗传因素是解释人类 A/H5N1 病例异常流行病学的一种简单解释，值得进一步研究。
