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Background  Some patients have a greater response to viral infection than do others having a similar level of viral replication. Hypercytokinemia is the principal immunopathological mechanism that contributes to a severer clinical course in cases of influenza A/H1N1. The benefit produced, or damage caused, by these cytokines in severe disease is not known. The genes that code for these molecules are polymorphic and certain alleles have been associated with susceptibility to various diseases. The objective of the present study was to determine whether there was an association between polymorphisms of  TNF ,  LTA ,  IL1B ,  IL6 ,  IL8 , and  CCL1  and the infection and severity of the illness caused by the pandemic A/H1N1 in Mexico in 2009.    Methods  Case–control study. The cases were patients confirmed with real time PCR with infection by the A/H1N1 pandemic virus. The controls were patients with infection like to influenza and non-familial healthy contacts of the patients with influenza. Medical history and outcome of the disease was registered. The DNA samples were genotyped for polymorphisms  TNF  rs361525, rs1800629, and rs1800750;  LTA  rs909253;  IL1B  rs16944;  IL6  rs1818879;  IL8  rs4073; and  CCL1  rs2282691. Odds ratio (OR) and the 95% confidence interval (95% CI) were calculated. The logistic regression model was adjusted by age and severity of the illness in cases.    Results  Infection with the pandemic A/H1N1 virus was associated with the following genotypes:  TNF  rs361525 AA, OR = 27.00; 95% CI = 3.07–1248.77);  LTA  rs909253 AG (OR = 4.33, 95% CI = 1.82–10.32);  TNF  rs1800750 AA (OR = 4.33, 95% CI = 1.48–12.64); additionally,  LTA  rs909253 AG showed a limited statistically significant association with mortality (p = 0.06, OR = 3.13). Carriers of the  TNF  rs1800629 GA genotype were associated with high levels of blood urea nitrogen (p = 0.05); those of the  TNF  rs1800750 AA genotype, with high levels of creatine phosphokinase (p=0.05). The  IL1B  rs16944 AA genotype was associated with an elevated number of leukocytes (p <0.001) and the  IL8  rs4073 AA genotype, with a higher value for P a O 2  mm Hg.    Conclusion  The polymorphisms of genes involved in the inflammatory process contributed to the severity of the clinical behavior of infection by the pandemic influenza A/H1N1 virus.

Pandemic influenza A/H1N1 virus infection and TNF, LTA, IL1B, IL6, IL8, and CCLpolymorphisms in Mexican population: a case–control study