P. HorbyH. SudoyoV. ViprakasitA. FoxP. Q. ThaiH. YuS. DavilaM. HibberdS. J. DunstanY. MonteeraratJ. J. FarrarS. MarzukiN. T. HienUniversity of OxfordNuffield Department of Clinical MedicineEijkman Institute for Molecular BiologyMahidol UniversityNational Institute of Hygiene and Epidemiology HanoiChinese Center for Disease Control and PreventionGenome Institute of Singapore2018-09-242018-09-242010-11-01Epidemiology and Infection. Vol.138, No.11 (2010), 1550-155814694409095026882-s2.0-77957324904https://repository.li.mahidol.ac.th/handle/20.500.14594/29494The 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. Copyright © 2010 Cambridge University Press.Mahidol UniversityMedicineReviewSCOPUS10.1017/S0950268810000518