What question did this study set out to answer?

To assess whether non-traditional serologic assays can detect immune responses in influenza A(H3N2) infections that fail to elicit standard hemagglutination inhibition titer increases.

July 1, 2026Influenza and Other Respiratory VirusesOpen Access

Hemagglutination Inhibition and Alternate Serologic Responses Following Influenza A(H3N2) Virus Infection

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Authors

CBChen BoshuUniversity of Michigan JZJosé Víctor ZambranaUniversity of Michigan ASAbigail ShotwellUniversity of Michigan

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Implication

Cohort study reveals alternative antibody rises in most hemagglutination inhibition non-responders with influenza A(H3N2), indicating standard serology underestimates infection-induced immunity.

Key Points

To assess whether non-traditional serologic assays can detect immune responses in influenza A(H3N2) infections that fail to elicit standard hemagglutination inhibition titer increases.
Analyzed paired pre-infection and convalescent sera from 306 RT-PCR-confirmed influenza A(H3N2) infections across two household cohort studies (2014–2018) in Managua, Nicaragua.
Quantified antibody responses using hemagglutination inhibition (HAI) and ELISAs directed against full-length hemagglutinin (HA), the HA stalk, and neuraminidase (NA).
Categorized participants into HAI responders (≥4-fold HAI rise), alternate responders (no HAI rise but ≥4-fold rise in ≥1 ELISA), and no-response individuals.
Overall, 77% of participants had a ≥4-fold HAI titer rise, and among the 23% HAI non-responders, 62% exhibited alternate antibody responses.
Individuals without any antibody response exhibited the highest pre-infection HAI and full-length HA titers (p < 0.01), lowest viral loads, and lowest frequency of fever or influenza-like illness symptoms (p < 0.01).
Neuraminidase antibody responses occurred more frequently in symptomatic individuals with moderate baseline titers, whereas extreme baseline titers reduced NA response odds.

Cite This Study

Boshu et al. (2026) studied this question.

synapsesocial.com/papers/6a814f1edd9b32ddc29cd224 https://doi.org/10.1111/irv.70292

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Implication

Cohort study reveals alternative antibody rises in most hemagglutination inhibition non-responders with influenza A(H3N2), indicating standard serology underestimates infection-induced immunity.

Hemagglutination Inhibition and Alternate Serologic Responses Following Influenza A(H3N2) Virus Infection

Discussion

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Implication

Key Points

Cite This Study

Hemagglutination Inhibition and Alternate Serologic Responses Following Influenza A(H3N2) Virus Infection

Discussion

Member takes

Implication

Key Points

Cite This Study

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