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Sharp CP, Lail A, Donfield S, Simmons R, Leen C, Klenerman P, Delwart E, Gomperts ED, Simmonds P. High frequencies of exposure to the novel human parvovirus PARV4 in hemophiliacs and injection drug users, as detected by a serological assay for PARV4 antibodies. J Infect Dis 2009; 200:1119-25. [PMID: 19691429 DOI: 10.1086/605646] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND PARV4 is a human parvovirus that was first detected in and cloned from an individual with a human immunodeficiency virus (HIV) seroconversion-like illness and that subsequently persisted in the lymphoid tissue and bone marrow. In contrast to human parvovirus B19 infections, PARV4 infections are most frequently detected in injection drug users (IDUs), particularly those who are coinfected with HIV type 1 (HIV-1). To investigate the routes of transmission of PARV4 and to ascertain whether infections are acquired through plasma-derived blood products, we developed a novel anti-PARV4 enzyme-linked immunosorbent assay (ELISA) to determine its seroprevalence in subjects with parenteral exposure. METHODS PARV4 viral protein 2 (VP2) was expressed and used as antigen in an indirect ELISA, to detect anti-PARV4 immunoglobulin G. RESULTS All 50 adult control subjects who were nonparenterally exposed to PARV4 were anti-PARV4 negative, in contrast to HIV-infected and HIV-uninfected IDUs, who had antibody frequencies of 67% and 33%, respectively. Predominantly parenteral transmission was confirmed by the finding of similar frequencies of infection among HIV-coinfected and HIV-uninfected hemophiliacs (11 of 20 individuals and 4 of 15 individuals, respectively) who were treated with nonvirally inactivated factor VIII/factor IX, whereas all but 1 of the 35 nonhemophiliac siblings of these siblings were found to be seronegative (despite having close household contact). CONCLUSIONS The present study provides convincing evidence that PARV4 is primarily transmitted parenterally. Evidence for widespread infection of hemophiliacs treated with nonvirally inactivated clotting factor creates fresh safety concerns for plasma-derived blood products, particularly because parvoviruses are relatively resistant to virus inactivation.
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Affiliation(s)
- Colin P Sharp
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
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152
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Tuke PW, Parry RP, Appleton H. Parvovirus PARV4 visualization and detection. J Gen Virol 2009; 91:541-4. [DOI: 10.1099/vir.0.014852-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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153
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Chen Z, Guan W, Cheng F, Chen AY, Qiu J. Molecular characterization of human parvovirus B19 genotypes 2 and 3. Virology 2009; 394:276-85. [PMID: 19758675 DOI: 10.1016/j.virol.2009.08.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 07/28/2009] [Accepted: 08/26/2009] [Indexed: 10/20/2022]
Abstract
We have characterized the transcription profiles of parvovirus B19 (B19V) genotype-2 A6 and genotype-3 V9 variants. The A6 RNA profile differs from that of the prototype B19V in both B19V non-permissive and permissive cells, whereas the overall profile of the V9 RNA in these cells is similar to that of the prototype. A unique feature we have identified is that the genotype-2 A6 variant used only one splice acceptor to remove the first intron. We also demonstrated that the inverted terminal repeats (ITRs) of the prototype B19V support replication of the V9 genome, which produces infectious virus, but not that of the A6 genome, in B19V-permissive cells. Similar to the proapoptotic nature of the prototype B19V large non-structural protein (NS1), the A6 and V9 NS1 proteins also are potent inducers of apoptosis in B19V-permissive cells.
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Affiliation(s)
- Zhaojun Chen
- Department of Clinical Laboratory, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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154
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Phylogenetic analysis of human parvovirus b19 sequences from eleven different countries confirms the predominance of genotype 1 and suggests the spread of genotype 3b. J Clin Microbiol 2009; 47:3735-8. [PMID: 19741071 DOI: 10.1128/jcm.01201-09] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Phylogenetic analysis of 166 human parvovirus B19 sequences from 11 different countries attributed 91.57% to genotype 1, 5.42% to genotype 3b, and 3.01% to genotype 3a. Very similar viruses of genotype 1 circulated widely in Europe and Israel. Genotype 3b seems to show an increasing spread outside of Africa.
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155
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Facial rash in a pregnant woman. J Clin Virol 2009; 46:105-6. [PMID: 19716763 DOI: 10.1016/j.jcv.2009.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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156
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Analysis of nucleotide sequences of human parvovirus B19 genome reveals two different modes of evolution, a gradual alteration and a sudden replacement: a retrospective study in Sapporo, Japan, from 1980 to 2008. J Virol 2009; 83:10975-80. [PMID: 19710152 DOI: 10.1128/jvi.00273-09] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
There have been no long-term systematic analyses of the molecular epidemiology of human parvovirus B19 (B19V). We investigated the variations of nucleotide sequences of B19V strains collected in Sapporo, Japan, from 1980 to 2008. In that period, six outbreaks of erythema infectiosum occurred regularly at 5-year intervals. The B19V strains collected successively, regardless of the outbreak, were analyzed for nucleotide variation in the subgenomic NS1-VP1u junction. The isolated strains can be classified into 10 subgroups. Two patterns of change of endemic strains were observed. One was a dynamic replacement of strains that occurred almost every 10 years, and the other was a gradual change consisting of an accumulation of point mutations.
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157
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Abstract
B19 infection-associated joint symptoms occur most frequently in adults, usually presenting as a self-limited, acute symmetric polyarthritis affecting the small joints of the hands, wrists, and knees. A small percentage of patients persist with chronic polyarthritis that mimics rheumatoid arthritis raising the question of whether B19 virus may have a role as a concomitant or precipitating factor in the pathogenesis of autoimmune conditions. Comprehensive and updated reviews address different aspects of human parvovirus infection. This article focuses on the evidence supporting the arthritogenic potential of the B19 virus and the proposed mechanisms that underlie it.
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Affiliation(s)
- Ines Colmegna
- Lowance Center for Human Immunology and Rheumatology, Emory University School of Medicine, 101 Woodruff Circle, Room 1014, Atlanta, GA 30322, USA.
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158
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Detection of parvovirus B19 in the lower respiratory tract. J Clin Virol 2009; 46:150-3. [PMID: 19632147 PMCID: PMC7172881 DOI: 10.1016/j.jcv.2009.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/25/2009] [Accepted: 06/29/2009] [Indexed: 12/31/2022]
Abstract
BACKGROUND Human parvovirus B19 infection generally displays a self-limiting course followed by viral clearance; although, in some cases, persistent infection may occur. Few cases of severe pulmonary disease following primary infection in both immunocompetent and immunocompromised patients were reported. OBJECTIVES To investigate the prevalence and clinical impact of parvovirus B19 in the lower respiratory tract. STUDY DESIGN The prevalence of parvovirus B19-DNA was evaluated by Real-Time PCR in 264 bronchoalveolar lavages (BAL) from 189 adult patients over a full-year period and related to demographic characteristics, underlying pathologies, immune status, admission to intensive care unit, mortality within 28 days, and discharge diagnosis. RESULTS Parvovirus B19-DNA was detected in 7/189 (3.7%) patients, without significant association to demographic characteristics, immune status, transplant versus non-transplant status, admission to intensive care unit, presence of haematological conditions. In two lung transplant recipients surveillance specimens were positive to B19. Four of the remaining five patients presented respiratory insufficiency. A significant association to mortality was found, as 3/7 (42.9%) positive patients died within 28 days. No patient presented serological evidence of recent or acute infection and viremia. CONCLUSIONS Parvovirus B19 may be detected at low frequency in BAL specimens from patients with different pathological backgrounds. This finding could be due to chronic infection with virus persistence in the lower respiratory tract, also in the absence of symptoms unequivocally attributable to B19. The high rate of mortality warrants the need for further studies to evaluate the opportunity to consider parvovirus B19 in the diagnostic work-up of lower respiratory tract infections.
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159
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Grant JK, Yin NC, Zaytoun AM, Waseem H, Hobbs JA. Persistent adeno-associated virus 2 and parvovirus B19 sequences in post-mortem human cerebellum. THE CEREBELLUM 2009; 8:490-8. [PMID: 19585179 DOI: 10.1007/s12311-009-0126-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 06/24/2009] [Indexed: 12/18/2022]
Abstract
We previously reported in a large cohort (N = 104) of post-mortem tissues the detection of both the non-pathogenic adeno-associated virus (AAV2) in approximately 13% and the pathogenic human parvovirus B19 (B19) in approximately 42% of human brains, particularly the dorsolateral prefrontal cortex. Multiple animal parvoviruses target the developing cerebellum (CBLM) resulting in hypoplasia and ataxia, but very little is known about the human parvoviruses and their ability to infect or cause disease in the CBLM. We have now confirmed in the above cohort the presence of AAV2 and B19 sequences in the CBLM. Our results show that approximately 27% and approximately 70% of human CBLM are positive by nested polymerase chain reaction for AAV2 and B19 sequences, respectively. We also document in a second cohort (N = 10) the presence of AAV2 (50%) and B19 (100%) sequences in the CBLM and correlate our results for B19 with studies from matched sera. Eighty percent (80%) of this cohort was positive for anti-B19 IgG, while none were IgM+, suggesting that most individuals had been previously infected with B19 but none acutely. To our knowledge, this study is the first to demonstrate that both AAV2 and B19 sequences are present at relatively high frequencies in the CBLM and are likely due to persistent rather than acute infection. Further studies will lead to insights into AAV2- and/or B19-CBLM interactions including mechanisms of infection, persistence, and possibly neuropathology, including cerebellar hypoplasia and ataxia.
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Affiliation(s)
- James K Grant
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32610, USA
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160
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Kantola K, Sadeghi M, Lahtinen A, Koskenvuo M, Aaltonen LM, Möttönen M, Rahiala J, Saarinen-Pihkala U, Riikonen P, Jartti T, Ruuskanen O, Söderlund-Venermo M, Hedman K. Merkel cell polyomavirus DNA in tumor-free tonsillar tissues and upper respiratory tract samples: implications for respiratory transmission and latency. J Clin Virol 2009; 45:292-5. [PMID: 19464943 PMCID: PMC7172143 DOI: 10.1016/j.jcv.2009.04.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 04/20/2009] [Indexed: 11/23/2022]
Abstract
Background Merkel cell polyomavirus (MCPyV) was discovered recently. It is considered a potential causative agent of Merkel cell carcinoma, a life-threatening skin cancer. Objectives To study the prevalence of MCPyV in a large number of clinical samples of various types. Most of the samples were examined also for the other newly found polyomaviruses KI (KIPyV) and WU (WUPyV). Study design Altogether 1390 samples from immunocompetent or immunocompromised patients, including (i) tonsillar tissues and sera from tonsillectomy patients; (ii) nasopharyngeal aspirates (NPAs) and sera from wheezing children and (iii) nasal swabs, sera and stools from febrile leukemic children were studied for MCPyV. The tonsils, nasal swabs and stools were also studied for KIPyV and WUPyV. Results MCPyV DNA was detected in 14 samples altogether; 8 of 229 (3.5%) tonsillar tissues, 3 of 140 (2.1%) NPAs, 2 of 106 (1.9%) nasal swabs and 1 of 840 (0.1%) sera. WUPyV and KIPyV were detected in 5 (2.2%) and 0 tonsils, 1 (0.9%) and 4 (3.8%) nasal swabs and 0 and 2 (2.7%) fecal samples, respectively. The patients carrying in tonsils MCPyV were of significantly higher age (median 42 years) than those carrying WUPyV (4 years, p < 0.001). Conclusions MCPyV DNA occurs in tonsils more frequently in adults than in children. By contrast, WUPyV DNA is found preferentially in children. MCPyV occurs also in nasal swabs and NPAs, in a frequency similar to that of KIPyV and WUPyV. The tonsil may be an initial site of WUPyV infection and a site of MCPyV persistence.
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Affiliation(s)
- Kalle Kantola
- Department of Virology, Haartman Institute, University of Helsinki, P.O. Box 21, FIN-00014, Helsinki, Finland.
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161
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Baylis SA, Buchheit KH. A proficiency testing study to evaluate laboratory performance for the detection of different genotypes of parvovirus B19. Vox Sang 2009; 97:13-20. [PMID: 19416495 DOI: 10.1111/j.1423-0410.2009.01170.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES In Europe, it is a regulatory requirement that parvovirus B19 (B19V) DNA nucleic acid amplification technique-based testing is performed on plasma pools for certain classes of plasma-derived medicinal products. This proficiency testing study set out to examine the ability of public quality control laboratories and plasma fractionation organizations to detect different genotypes of B19V using nucleic acid amplification technique-based assays. MATERIALS AND METHODS Laboratories were supplied with cloned DNAs representing the main genotypes of B19V. All samples were adjusted to equivalent copy number and were distributed as part of a routine external quality assessment programme investigating the evaluation of B19V containing plasma samples by these laboratories. The plasmid clones were distributed to 25 laboratories, representing 13 quality control laboratories and 12 manufacturers of plasma derivatives. The criteria for acceptable detection of the different genotypes of B19V DNA was based upon the maximum theoretical efficiency for polymerase chain reaction amplification. Proficient laboratories were deemed to be those reporting results within 1 log(10) dilution for each of the different virus genotypes. RESULTS Data were returned by 23 of the participating laboratories. Some laboratories returned data for more than one type of assay and in total 27 data sets were analysed. Nine of the participating laboratories were able to successfully detect all the virus genotypes according to the applied criteria, all except one used in-house assays. CONCLUSIONS The results of the study highlight that there are still discrepancies in the detection of a broad spectrum of B19V genotypes, with implications for batch release testing.
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Affiliation(s)
- S A Baylis
- National Institute for Biological Standards and Control, Potters Bar, Hertfordshire, UK.
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162
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Sidoti F, Fierro MT, Costa C, Ponti R, Bergallo M, Comessatti A, Fumagalli M, Novelli M, Merlino C, Cavallo R, Bernengo MG. Prevalence and significance of human parvovirus variants in skin from primary cutaneous T cell lymphomas, inflammatory dermatoses and healthy subjects. Arch Dermatol Res 2009; 301:647-52. [DOI: 10.1007/s00403-009-0954-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 04/01/2009] [Accepted: 04/03/2009] [Indexed: 11/29/2022]
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163
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Fölster-Holst R, Kreth HW. Viral exanthems in childhood â infectious (direct) exanthems. Part 1: Classic exanthems. J Dtsch Dermatol Ges 2009; 7:309-16. [DOI: 10.1111/j.1610-0387.2008.06868.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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164
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Rinckel LA, Buno BR, Gierman TM, Lee DC. Discovery and analysis of a novel parvovirus B19 Genotype 3 isolate in the United States. Transfusion 2009; 49:1488-92. [PMID: 19389024 DOI: 10.1111/j.1537-2995.2009.02160.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parvovirus B19 (B19V) is a pathogen frequently identified in human plasma donations through the detection of nucleic acids. Three B19V genotypes have been defined based on isolates having greater than 10% divergence in overall DNA sequence. B19V Genotype 3 is a rarely occurring genotype that has been detected primarily in Ghana with sporadic reports in Brazil and France but has not been previously reported in North America. STUDY DESIGN AND METHODS A polymerase chain reaction assay was developed with broad specificity for B19V detection. The performance of this assay was assessed by testing approximately 440,000 clinical samples representing more than 81,000 individual donors. Determinations of B19V titer, DNA sequence, and antibody concentrations were performed on samples of interest. RESULTS This assessment identified a series of eight plasma donations spanning 28 days from a single donor in the United States infected with B19V Genotype 3 as confirmed by DNA sequence analysis. The B19V titer of this series of donations showed virus titers that peaked at greater than 10(11) IU/mL. The virus titer decreased significantly over the next several donations coinciding with an increase in immunoglobulin M (IgM) levels. The immunoglobulin G levels also increased but lagged approximately 7 days behind the IgM levels. CONCLUSION This is the first report of a B19V Genotype 3 detected from a plasma donor located in the United States. Although our data are consistent with recent reports suggesting low incidence for this genotype, they indicate its increasing relevance among blood and plasma donors.
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Affiliation(s)
- Lori A Rinckel
- Department of Pathogen Safety, Talecris Biotherapeutics, Raleigh Test Laboratory, 1200 New Hope Road, Raleigh, NC 27610, USA.
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165
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Kapoor A, Slikas E, Simmonds P, Chieochansin T, Naeem A, Shaukat S, Alam MM, Sharif S, Angez M, Zaidi S, Delwart E. A newly identified bocavirus species in human stool. J Infect Dis 2009; 199:196-200. [PMID: 19072716 DOI: 10.1086/595831] [Citation(s) in RCA: 250] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Viral metagenomic analysis was used to identify a previously uncharacterized parvovirus species, "HBoV2," whose closest phylogenetic relative is the human bocavirus (HBoV). HBoV2 has a genomic organization identical to that of HBoV but has only 78%, 67%, and 80% identity, respectively, with the latter's NS1, NP1, and VP1/VP2 proteins. The study used polymerase chain reaction to detect HBoV2 sequences in 5 of 98 stool samples from Pakistani children and in 3 of 699 stool samples from Edinburgh. Nearly-full-length genome sequencing revealed the presence of 3 HBoV2 genotypes and evidence of recombination between genotypes. Further studies are necessary to identify anatomical sites of HBoV2 replication and potential associations with clinical symptoms or disease.
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Affiliation(s)
- Amit Kapoor
- Blood Systems Research Institute and Department of Laboratory Medicine, University of California, San Francisco, CA 94118, USA
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166
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Diversité génétique des Erythrovirus humains. ACTA ACUST UNITED AC 2009; 57:167-74. [DOI: 10.1016/j.patbio.2008.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 02/11/2008] [Indexed: 11/20/2022]
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167
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Abstract
Globally, echovirus 30 (E30) is one of the most frequently identified enteroviruses and a major cause of meningitis. Despite its wide distribution, little is known about its transmission networks or the dynamics of its recombination and geographical spread. To address this, we have conducted an extensive molecular epidemiology and evolutionary study of E30 isolates collected over 8 years from a geographically wide sample base (11 European countries, Asia, and Australia). 3Dpol sequences fell into several distinct phylogenetic groups, interspersed with other species B serotypes, enabling E30 isolates to be classified into 38 recombinant forms (RFs). Substitutions in VP1 and 3Dpol regions occurred predominantly at synonymous sites (ratio of nonsynonymous to synonymous substitutions, 0.05) with VP1 showing a rapid substitution rate of 8.3 x 10(-3) substitutions per site per year. Recombination frequency was tightly correlated with VP1 divergence; viruses differing by evolutionary distances of >0.1 (or 6 years divergent evolution) almost invariably (>97%) had different 3Dpol groups. Frequencies of shared 3Dpol groups additionally correlated with geographical distances, with Europe and South Asia showing turnover of entirely distinct virus populations. Population turnover of E30 was characterized by repeated cycles of emergence, dominance, and disappearance of individual RFs over periods of 3 to 5 years, although the existence and nature of evolutionary selection underlying these population replacements remain unclear. The occurrence of frequent "sporadic" recombinants embedded within VP1 groupings of other RFs and the much greater number of 3Dpol groups than separately identifiable VP1 lineages suggest frequent recombination with an external diverse reservoir of non-E30 viruses.
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168
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High prevalence of human parvovirus B19 DNA in myocardial autopsy samples from subjects without myocarditis or dilative cardiomyopathy. J Clin Microbiol 2008; 47:106-10. [PMID: 19005147 DOI: 10.1128/jcm.01672-08] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human parvovirus B19 has been linked to a variety of cardiac diseases, as well as to erythema infectiosum, acute arthropathy, and fetal hydrops. A causal association between viral infection and cardiac disease was frequently postulated following the detection of B19 DNA by PCR in endomyocardial biopsy specimens. Since the lifelong persistence of B19 DNA in bone marrow, skin, synovia, tonsils, and liver was previously reported, the aim of our study was to investigate the possibility of asymptomatic B19 DNA persistence in heart tissue. Myocardial autopsy and postmortem blood samples were prospectively collected from 69 bodies sent to the Department of Forensic Medicine, Freiburg University Medical Center, for inquests. All study subjects were screened for B19-specific antibodies using a commercial enzyme immunoassay. Tissue samples were analyzed by real-time PCR for the presence of viral DNA. Since the presence of B19 genotype 2, known to have been circulating before 1960, would prove long-lasting persistence, the presence of the B19 genotype was retrospectively determined in seven of the study subjects by melting temperature analysis and sequencing of the PCR product. B19 DNA was found in myocardial samples from 46 of 48 seropositive and in none of 21 seronegative individuals. B19 genotype 1 was found in three patients born between 1950 and 1969. Genotype 2 was found in four patients born between 1927 and 1957. Our findings suggest lifelong persistence of B19 DNA in heart tissue. Thus, the detection of B19 DNA in myocardial biopsy specimens alone is not sufficient to postulate a relationship between B19 infection and cardiac disease.
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169
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Lindner J, Noutsias M, Lassner D, Wenzel J, Schultheiss HP, Kuehl U, Modrow S. Adaptive immune responses against parvovirus B19 in patients with myocardial disease. J Clin Virol 2008; 44:27-32. [PMID: 18980860 DOI: 10.1016/j.jcv.2008.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Revised: 09/02/2008] [Accepted: 09/12/2008] [Indexed: 12/15/2022]
Abstract
BACKGROUND Parvovirus B19 (B19V)-DNA is frequently detected in endomyocardial biopsies (EMBs) from patients with acute myocarditis (AMC) and dilated cardiomyopathy (DCM), but also in various healthy tissues. The clinical relevance of this DNA-persistence is unclear. OBJECTIVES To investigate potential pathogenic influences of B19V-DNA in EMBs, we analyzed B19V-specific adaptive immune responses in AMC/DCM patients and healthy controls. STUDY DESIGN 15 AMC/DCM patients with detectable B19V-DNA in EMBs and 51 controls were analyzed for signs of acute B19V-infections and virus-specific immune responses by PCR, ELISA, Western line, and ELISpot-assays. RESULTS Productive B19V-infection was determined in three patients. Slightly lower levels of B19V-specific T-cells were observed in patients as compared to the controls, no differences were observed in virus-specific serology. Viral DNA-load in EMBs could not be correlated to the number of B19V-specific T-cells. No differences in T-cell response, viremia and/or serological markers indicative for viral pathogenesis were observed in patients with inflammatory cardiomyopathy. CONCLUSIONS Discrepancies in B19V-specific adaptive immunity were not observed in AMC/DCM patients as compared to controls. The data indicate that the exclusive detection of B19V-DNA in EMBs is not sufficient to associate B19V with AMC/DCM but should be complemented with additional virological and immunological parameters in further studies.
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Affiliation(s)
- Juha Lindner
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Germany
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170
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Corcioli F, Zakrzewska K, Rinieri A, Fanci R, Innocenti M, Civinini R, De Giorgi V, Di Lollo S, Azzi A. Tissue persistence of parvovirus B19 genotypes in asymptomatic persons. J Med Virol 2008; 80:2005-11. [DOI: 10.1002/jmv.21289] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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171
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Simmonds P, Douglas J, Bestetti G, Longhi E, Antinori S, Parravicini C, Corbellino M. A third genotype of the human parvovirus PARV4 in sub-Saharan Africa. J Gen Virol 2008; 89:2299-2302. [PMID: 18753240 DOI: 10.1099/vir.0.2008/001180-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PARV4 is a recently discovered human parvovirus widely distributed in injecting drug users in the USA and Europe, particularly in those co-infected with human immunodeficiency virus (HIV). Like parvovirus B19, PARV4 persists in previously exposed individuals. In bone marrow and lymphoid tissue, PARV4 sequences were detected in two sub-Saharan African study subjects with AIDS but without a reported history of parenteral exposure and who were uninfected with hepatitis C virus. PARV4 variants infecting these subjects were phylogenetically distinct from genotypes 1 and 2 (formerly PARV5) that were reported previously. Analysis of near-complete genome sequences demonstrated that they should be classified as a third (equidistant) PARV4 genotype. The availability of a further near-complete genome sequence of this novel genotype facilitated identification of conserved novel open reading frames embedded in the ORF2 coding sequence; one encoded a putative protein with identifiable homology to SAT proteins of members of the genus Parvovirus.
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Affiliation(s)
- Peter Simmonds
- Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK
| | - Jill Douglas
- Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK
| | - Giovanna Bestetti
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Erika Longhi
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Spinello Antinori
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Carlo Parravicini
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
| | - Mario Corbellino
- Infectious Diseases and Tropical Medicine and Pathology Departments, Luigi Sacco Hospital, Milano, Italy
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Höfling K, Simon A, Eis-Hübinger A. Mikrobiologische Diagnostik letaler Infektionen im Säuglings- und Kindesalter. Rechtsmedizin (Berl) 2008. [DOI: 10.1007/s00194-008-0544-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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173
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Kühl U, Lassner D, Pauschinger M, Gross UM, Seeberg B, Noutsias M, Poller W, Schultheiss HP. Prevalence of erythrovirus genotypes in the myocardium of patients with dilated cardiomyopathy. J Med Virol 2008; 80:1243-51. [PMID: 18461615 DOI: 10.1002/jmv.21187] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Parvovirus B19 (PVB19) is a member of the human erythrovirus family detected frequently in endomyocardial biopsies from patients with dilated cardiomyopathy. Human erythroviruses cluster into three genotypes 1-3 which share a high degree of homology between major structural proteins and may cause indistinguishable infections clinically and serologically. In human cardiac tissue erythrovirus genotypes other than PVB19 have not yet been reported. Three hundred seventeen consecutive patients with symptomatic dilated cardiomyopathy (median left ventricular ejection fraction: 28.6%, range 5-45%) who underwent endomyocardial biopsy for the elucidation of the etiology, were analyzed using a new consensus PCR assay designed for the detection of the three erythrovirus genotype sequences. Endomyocardial biopsies of 151 (47.6%) patients were erythrovirus-positive. Genotype 1 specific sequences were detected in 43/151 (28.5%) of positive biopsy samples, whereas genotype 2-specific sequences so far considered rare in human disease and not yet been described in human heart tissue was identified in 108/151 (71.5%) of virus-positive endomyocardial biopsies with a preference in patients above 50 years of age. In spite of younger age, systolic left ventricular dysfunction of genotype 1-positive patients was significantly reduced as compared to genotype 2-positive patients (24.4+/-10.4% vs. 31.0+/-9.5%, P=0.0001) at the initial presentation. The data show that two genetically distinct erythrovirus variants with a different age distribution are detectable in endomyocardial biopsies of patients with dilated cardiomyopathy. The erythrovirus genotype 2, not described previously in human heart tissue, is highly prevalent in the heart but the less prevalent genotype 1 is associated with more severe disturbed cardiac function.
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Affiliation(s)
- U Kühl
- Department of Cardiology and Pneumology, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Germany.
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174
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Matsukura H, Shibata S, Tani Y, Shibata H, Furuta RA. Persistent infection by human parvovirus B19 in qualified blood donors. Transfusion 2008; 48:1036-7. [PMID: 18454740 DOI: 10.1111/j.1537-2995.2008.01704.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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175
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Schneider B, Fryer JF, Oldenburg J, Brackmann HH, Baylis SA, Eis-Hübinger AM. Frequency of contamination of coagulation factor concentrates with novel human parvovirus PARV4. Haemophilia 2008; 14:978-86. [PMID: 18565125 DOI: 10.1111/j.1365-2516.2008.01800.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Human parvovirus, PARV4 was identified in a plasma sample from a patient presenting with symptoms resembling acute HIV infection. Further strains of PARV4 and those of a closely related variant virus, were identified in plasma pools used in the manufacture of blood derivatives. DNA sequence analysis of these strains demonstrated two distinct PARV4 genotypes. It has subsequently been proposed that transmission of PARV4 occurs by parenteral routes. To investigate the risk of contamination of plasma-derived coagulation factor concentrates, we analysed 169 lots for PARV4 DNA by polymerase chain reaction. Positive samples were confirmed by nucleotide sequence analysis and quantification of the viral load. Twenty-one lots, representing eight different products were administered until the beginning of the 1980s and were not virally inactivated. Two lots examined were used in 1997, and 146 lots representing 13 products had been administered between October 2000 and February 2003. PARV4 DNA was detected in 7(33%) of the formerly administered lots, in one lot used in 1997, and in 13(9%) recently used lots. PARV4 genotype 2 DNA was predominantly present in the older concentrates, whilst genotype 1 was found more frequently in recently used lots. In three lots, both PARV4 genotypes were detected. Viral loads ranged between <100 and 10(5.8) copies mL(-1) of product, with higher viral loads in the older concentrates. The results show that PARV4 contamination can be detected in an appreciable proportion of clotting factor concentrates. Further studies are needed to determine whether or not PARV4 contamination of coagulation factors causes harm to the product recipients.
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Affiliation(s)
- B Schneider
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
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176
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NS1 specific CD8+ T-cells with effector function and TRBV11 dominance in a patient with parvovirus B19 associated inflammatory cardiomyopathy. PLoS One 2008; 3:e2361. [PMID: 18523634 PMCID: PMC2394660 DOI: 10.1371/journal.pone.0002361] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 05/03/2008] [Indexed: 01/14/2023] Open
Abstract
Background Parvovirus B19 (B19V) is the most commonly detected virus in endomyocardial biopsies (EMBs) from patients with inflammatory cardiomyopathy (DCMi). Despite the importance of T-cells in antiviral defense, little is known about the role of B19V specific T-cells in this entity. Methodology and Principal Findings An exceptionally high B19V viral load in EMBs (115,091 viral copies/μg nucleic acids), peripheral blood mononuclear cells (PBMCs) and serum was measured in a DCMi patient at initial presentation, suggesting B19V viremia. The B19V viral load in EMBs had decreased substantially 6 and 12 months afterwards, and was not traceable in PBMCs and the serum at these times. Using pools of overlapping peptides spanning the whole B19V proteome, strong CD8+ T-cell responses were elicited to the 10-amico-acid peptides SALKLAIYKA (19.7% of all CD8+ cells) and QSALKLAIYK (10%) and additional weaker responses to GLCPHCINVG (0.71%) and LLHTDFEQVM (0.06%). Real-time RT-PCR of IFNγ secretion-assay-enriched T-cells responding to the peptides, SALKLAIYKA and GLCPHCINVG, revealed a disproportionately high T-cell receptor Vbeta (TRBV) 11 expression in this population. Furthermore, dominant expression of type-1 (IFNγ, IL2, IL27 and T-bet) and of cytotoxic T-cell markers (Perforin and Granzyme B) was found, whereas gene expression indicating type-2 (IL4, GATA3) and regulatory T-cells (FoxP3) was low. Conclusions Our results indicate that B19V Ag-specific CD8+ T-cells with effector function are involved in B19V associated DCMi. In particular, a dominant role of TRBV11 and type-1/CTL effector cells in the T-cell mediated antiviral immune response is suggested. The persistence of B19V in the endomyocardium is a likely antigen source for the maintenance of CD8+ T-cell responses to the identified epitopes.
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177
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Baylis SA. Standardization of nucleic acid amplification technique (NAT)-based assays for different genotypes of parvovirus B19: a meeting summary. Vox Sang 2008; 94:74-80. [PMID: 18171331 DOI: 10.1111/j.1423-0410.2007.00992.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An extraordinary meeting of the International Working Group on the Standardization of Genome Amplification Techniques for the safety testing of blood, tissues and organs for blood borne pathogens was held on 2 March 2007, at the National Institute for Biological Standards and Control. The aim of the meeting was to investigate ways to harmonize results obtained for the detection and quantification of different genotypes of parvovirus B19 (B19V) DNA by control laboratories and manufacturers of plasma derivatives. The meeting explored issues of B19V such as the classification of B19V strains, the prevalence and distribution of different genotypes, the clinical and biological significance of different genotypes, the detection of different genotypes in plasma-derived products, and their susceptibility to virus-inactivation procedures. At this meeting and through subsequent studies, high titre, high volume samples have been identified representing different genotypes of B19V, which will be evaluated by collaborative study to prepare reference panels for the purposes of assay validation.
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Affiliation(s)
- S A Baylis
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, UK.
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178
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Rapid sequence change and geographical spread of human parvovirus B19: comparison of B19 virus evolution in acute and persistent infections. J Virol 2008; 82:6427-33. [PMID: 18417586 DOI: 10.1128/jvi.00471-08] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Parvovirus B19 is a common human pathogen maintained by horizontal transmission between acutely infected individuals. However, B19 virus can also be detected in tissues throughout the life of the host, although little is understood about the nature of such persistence. In the current study, we created large VP1/2 sequence data sets of plasma- and tissue (autopsy)-derived variants of B19 virus with known sample dates to compare the rates of sequence change in exogenous virus populations with those in persistently infected individuals. By using linear regression and likelihood-based methods (such as the BEAST program), we found that plasma-derived B19 virus showed a substitution rate of 4 x 10(-4) and an unconstrained (synonymous)-substitution rate of 18 x 10(-4) per site per year, several times higher than previously estimated and within the range of values for mammalian RNA viruses. The underlying high mutation frequency implied by these substitution rates may enable rapid adaptive changes that are more commonly ascribed to RNA virus populations. These revised estimates predict that the last common ancestor for currently circulating genotype 1 variants of B19 virus existed around 1956 to 1959, fitting well with previous analyses of the B19 virus "bioportfolio" that support a complete cessation of genotype 2 infections and their replacement by genotype 1 infections in the 1960s. In contrast, the evolution of B19 virus amplified from tissue samples was best modeled by using estimated dates of primary infection rather than sample dates, consistent with slow or absent sequence change during persistence. Determining what epidemiological or biological factors led to such a complete and geographically extensive population replacement over this short period is central to further understanding the nature of parvovirus evolution.
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179
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Weissbrich B, Süß-Fröhlich Y, Girschick HJ. Seroprevalence of parvovirus B19 IgG in children affected by juvenile idiopathic arthritis. Arthritis Res Ther 2008; 9:R82. [PMID: 17760961 PMCID: PMC2206386 DOI: 10.1186/ar2281] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 07/29/2007] [Accepted: 08/30/2007] [Indexed: 11/28/2022] Open
Abstract
Parvovirus (PV) B19 is the causative agent of the childhood disease erythema infectiosum. An association of PV B19 with chronic arthropathies, sometimes resembling rheumatoid arthritis or juvenile idiopathic arthritis (JIA), has repeatedly been described. Other studies, however, have failed to identify any such relationship. In order to study further whether there is a link between PV B19 and JIA, we determined the prevalence of PV B19 specific IgG antibodies in serum samples from children with rheumatoid diseases and compared it with the prevalence in unaffected children We reasoned that if there is an association between PV B19 and JIA, then the prevalence of PV B19 IgG in the children with JIA should be higher than in the control group. PV B19 IgG status was tested in 406 children with JIA and related diseases, and in 146 children constituting a control group. The percentage of PV B19 IgG positive children was not significantly elevated in the disease subgroups compared with age-matched control groups. In conclusion, our findings do not support the hypothesis that human parvovirus B19 is involved in the pathogenesis of JIA.
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Affiliation(s)
- Benedikt Weissbrich
- Institute of Virology and Immunobiology, University of Würzburg, Versbacher Str 7, 97078 Würzburg, Germany
| | - Yvonne Süß-Fröhlich
- Institute of Virology and Immunobiology, University of Würzburg, Versbacher Str 7, 97078 Würzburg, Germany
- Section of Paediatric Rheumatology, Immunology and Infectious diseases, Children's Hospital, University of Würzburg, Josef-Schneider-Str 2, 97080 Würzburg, Germany
| | - Hermann J Girschick
- Section of Paediatric Rheumatology, Immunology and Infectious diseases, Children's Hospital, University of Würzburg, Josef-Schneider-Str 2, 97080 Würzburg, Germany
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180
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Schneider B, Höne A, Tolba RH, Fischer HP, Blümel J, Eis-Hübinger AM. Simultaneous persistence of multiple genome variants of human parvovirus B19. J Gen Virol 2008; 89:164-176. [PMID: 18089740 DOI: 10.1099/vir.0.83053-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The species human parvovirus B19 (B19V) can be divided into three genotypes. In this study, we addressed the question as to whether infection of an individual is restricted to one genotype. As viral DNA is detectable in tissue for long times after acute infection, we examined 87 liver specimens from adults for the presence of B19V DNA. Fifty-nine samples were found to be positive, 32 of them for genotype 1, 27 for genotype 2 and four for genotype 3. In four samples, DNA of two genotypes was detected; samples from three individuals were positive for genotypes 1 and 2 and a sample from one individual was positive for genotypes 1 and 3. Surprisingly, significant sequence heterogeneity was observed at approximately 1 % of the nucleotides of the genotype 1 genomes from individuals with double genotype 1 and 2 infection. Controls using different enzymes for genome amplification and dilutions of the template verified that nucleotide heterogeneity was due to the presence of three or more genome variants of genotype 1. In summary, the evidence shows that individuals can be infected with two different genotypes, and B19V DNA can persist as a population of different genomes. The results may have implications for the understanding of the antiviral immune response and the development of vaccines against B19V.
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Affiliation(s)
- Beate Schneider
- Institute of Virology, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
| | - Andrea Höne
- Institute of Virology, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
| | - René H Tolba
- Department of Surgery, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
| | - Hans-Peter Fischer
- Institute of Pathology, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
| | - Johannes Blümel
- Paul-Ehrlich-Institut, Paul-Ehrlich-Straße 51-59, D-63225 Langen, Germany
| | - Anna M Eis-Hübinger
- Institute of Virology, University of Bonn, Sigmund-Freud-Straße 25, D-53105 Bonn, Germany
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181
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Schneider B, Fryer JF, Reber U, Fischer HP, Tolba RH, Baylis SA, Eis-Hübinger AM. Persistence of novel human parvovirus PARV4 in liver tissue of adults. J Med Virol 2008; 80:345-51. [PMID: 18098166 DOI: 10.1002/jmv.21069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Human parvovirus 4 (PARV4) is a recently identified virus whose biology, epidemiology and pathogenic potential have yet to be determined. Recently, it was reported that PARV4 DNA persists in tissues of some HIV-infected individuals, whilst PARV4 DNA was not detected in tissues of subjects not infected with HIV. In the present study, liver tissue from 87 individuals, none of who were infected with HIV, with the exception of a single subject, was analyzed for the presence of PARV4 DNA. Overall, PARV4 DNA was detected in 13 specimens (15%). In other tissues examined, PARV4 genotype 2 (also termed PARV5) DNA was detected in one of four paired bone marrow specimens. Tissue viral loads did not exceed 100 copies per microg of genomic DNA. In addition, serum samples from 40 of these individuals all tested negative for PARV4 DNA. In the subjects analyzed in this study, PARV4 genotype 2 appeared to be genetically more heterogeneous than PARV4 genotype 1. The results show that PARV4 DNA can be detected in liver, and that infection with PARV4 is not restricted to HIV-infected individuals. Previous studies showing the presence of PARV4 in plasma, suggest that during infection with PARV4, a viraemic stage occurs, allowing systemic spread to a variety of tissues.
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Affiliation(s)
- Beate Schneider
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
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182
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Wang JH, Zhang WP, Liu HX, Wang D, Li YF, Wang WQ, Wang L, He FR, Wang Z, Yan QG, Chen LW, Huang GS. Detection of human parvovirus B19 in papillary thyroid carcinoma. Br J Cancer 2008; 98:611-8. [PMID: 18212749 PMCID: PMC2243166 DOI: 10.1038/sj.bjc.6604196] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
To evaluate whether parvovirus B19, a common human pathogen, was also involved in papillary thyroid carcinoma (PTC), 112 paraffin-embedded thyroid specimens of benign nodules, papillary, medullary and follicular carcinomas, and normal controls were examined for B19 DNA and capsid protein by nested PCR, in situ hybridisation (ISH) and immunohistochemistry (IHC). The expression of the nuclear factor-κB (NF-κB) was investigated by IHC. The results showed B19 DNA commonly exists in human thyroid tissues; however, there were significant differences between PTC group and normal controls, and between PTC and nonneoplastic adjacent tissues (P<0.001). The presence of viral DNA in PTC neoplastic epithelium was confirmed by laser-capture microdissection and sequencing of nested PCR products. B19 capsid protein in PTC group was significantly higher than that of all the control groups and nonneoplastic adjacent tissues (P⩽0.001). Compared with control groups, the activation of NF-κB in PTC group was significantly increased (P⩽0.02), except for medullary carcinomas, and the activation of NF-κB was correlated with the viral protein presence (P=0.002). Moreover, NF-κB was colocalised with B19 DNA in the neoplastic epithelium of PTC by double staining of IHC and ISH. These results indicate for the first time a possible role of B19 in pathogenesis of PTC.
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Affiliation(s)
- J H Wang
- State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
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183
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Abstract
BACKGROUND AND OBJECTIVES Parvoviruses are small non-enveloped DNA viruses, relatively resistant to virus inactivation procedures. The recently identified human parvovirus PARV4, including a related genotype 2 virus (also termed PARV5), has been found to be a contaminant of pooled plasma used in the manufacture of plasma-derived products. This report describes an investigation to determine whether PARV4 is present in clotting factor concentrates. MATERIALS AND METHODS Factor VIII concentrates manufactured in the past 30-35 years were screened for PARV4 and human parvovirus B19 (B19V) sequences. Viral loads in products testing positive for PARV4 were quantified using a consensus TaqMan assay designed to a highly conserved region. DNA sequence analysis was performed to confirm the genotypes present. RESULTS From a total of 175 lots of factor VIII concentrate, 28 of these contained PARV4 sequences, and in two lots both genotypes 1 and 2 were found to be present. The highest viral loads observed exceeded 10(5) copies per ml. The majority of factor VIII concentrates testing positive for PARV4 were manufactured in the 1970s and 1980s. Human B19V was also a frequent contaminant of these products. CONCLUSIONS PARV4 was detected in 16% of factor VIII concentrates, particularly in older batches from the 1970s and 1980s. The significance in terms of the viral safety and potential transmission to recipients of these products is not yet known.
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Affiliation(s)
- J F Fryer
- Division of Virology, National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Hertfordshire EN6 3QG, UK
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184
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Shackelton LA, Hoelzer K, Parrish CR, Holmes EC. Comparative analysis reveals frequent recombination in the parvoviruses. J Gen Virol 2008; 88:3294-3301. [PMID: 18024898 DOI: 10.1099/vir.0.83255-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Parvoviruses are small single-stranded DNA viruses that are ubiquitous in nature. Infections with both autonomous and helper-virus dependent parvoviruses are common in both human and animal populations, and many animals are host to a number of different parvoviral species. Despite the epidemiological importance of parvoviruses, the presence and role of genome recombination within or among parvoviral species has not been well characterized. Here we show that natural recombination may be widespread in these viruses. Different genome regions of both porcine parvoviruses and Aleutian mink disease viruses have conflicting phylogenetic histories, providing evidence for recombination within each of these two species. Further, the rodent parvoviruses show complex evolutionary histories for separate genomic regions, suggesting recombination at the interspecies level.
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Affiliation(s)
- Laura A Shackelton
- Center for Infectious Disease Dynamics, Department of Biology, The Pennsylvania State University, Mueller Laboratory, University Park, PA 16802, USA
| | - Karin Hoelzer
- J.A. Baker Institute, Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Colin R Parrish
- J.A. Baker Institute, Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Edward C Holmes
- Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA.,Center for Infectious Disease Dynamics, Department of Biology, The Pennsylvania State University, Mueller Laboratory, University Park, PA 16802, USA
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185
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Human bocavirus in children with acute lymphoblastic leukemia. Eur J Pediatr 2008; 167:1011-5. [PMID: 18038236 PMCID: PMC7086950 DOI: 10.1007/s00431-007-0631-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 10/11/2007] [Accepted: 10/21/2007] [Indexed: 11/27/2022]
Abstract
A new human parvovirus, human bocavirus, has recently been identified in respiratory secretions, feces and serum. It is associated with lower and most likely also upper respiratory tract infections. Most commonly reported symptoms are cough, rhinorrhea, expiratory wheezing and fever, and the virus is preferentially detected in young children. We report three children with acute lymphoblastic leukemia who had acute febrile episodes with concomitant detection of human bocavirus in their respiratory secretions. One of them had five consecutive febrile episodes during 6 months, all associated with the presence of human bocavirus at varying viral loads, suggesting prolonged shedding or reactivation of the virus.
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186
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Kleinman SH, Glynn SA, Lee TH, Tobler L, Montalvo L, Todd D, Kiss JE, Shyamala V, Busch MP. Prevalence and quantitation of parvovirus B19 DNA levels in blood donors with a sensitive polymerase chain reaction screening assay. Transfusion 2007; 47:1756-64. [PMID: 17880600 DOI: 10.1111/j.1537-2995.2007.01341.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Blood donor parvovirus B19 DNA prevalence with sensitive nucleic acid test assays has recently been demonstrated to be higher than that found with assays designed to detect high viral titers in the plasma manufacturing sector. STUDY DESIGN AND METHODS Stored plasma aliquots from 5020 donations collected between 2000 and 2003 at seven US blood centers were tested. Testing was performed with a real-time B19 DNA polymerase chain reaction (PCR; TaqMan, Applied Biosystems) assay with a 50 percent limit of detection (LOD) of 1.6 IU per mL (95% confidence interval [CI], 1.2-2.1 IU/mL) and a 95 percent LOD of 16.5 IU per mL (95% CI, 10.6-33.9 IU/mL). Confirmation and quantitation of B19 DNA was accomplished by retesting of two additional subaliquots. Confirmed-positive specimens were tested for the presence of anti-B19 immunoglobulin M (IgM) and IgG with FDA-licensed assays. RESULTS B19 DNA prevalence was 0.88 percent (95% CI, 0.64%-1.2%). Among the 23 donations with B19 DNA titers of at least 20 IU per mL, the median DNA concentration was 105 IU per mL with an interquartile range of 42 to 481 IU per mL; the highest value was 1869 IU per mL. All B19 DNA-positive donations were positive for the presence of IgG and 10 (23%) were also positive for the presence of IgM; IgM seropositivity was associated with increasing DNA levels (p = 0.0013). CONCLUSION Low-level B19 DNA was detected in nearly 1 percent of donations. The 23 percent of DNA-positive donations with both IgM and IgG B19 antibody most likely represent acute resolving infection, whereas those with IgG but no IgM are most consistent with a more chronic and possibly persistent phase of B19 infection.
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187
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188
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Lehmann HW, Plentz A, von Landenberg P, Küster RM, Modrow S. Different patterns of disease manifestations of parvovirus B19-associated reactive juvenile arthritis and the induction of antiphospholipid-antibodies. Clin Rheumatol 2007; 27:333-8. [PMID: 17851708 DOI: 10.1007/s10067-007-0718-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 07/10/2007] [Accepted: 07/25/2007] [Indexed: 10/22/2022]
Abstract
Children with rheumatic oligo- and polyarthritis frequently establish persistent parvovirus B19 infections, which may be associated with the production of antiphospholipid antibodies. Reported in this paper are the data of five girls with polyarticular rheumatic diseases of different types and persistent parvovirus B19 infection associated in four cases with the presence of antibodies against phospholipids. Clinical parameters, virus load, and antiphospholipid-IgG levels were determined during an observation period up to 92 months. In two patients, erythema infectiosum preceded the development of arthritis and B19 viremia persisted. Two other girls showed antibodies against parvoviral structural proteins at time of the manifestation of the rheumatic disease. Subsequent samples also revealed persistent B19 infection. In the fifth patient, parvovirus B19-specific IgG antibodies were detected for the first time after 120 months of progressing disease at an age of 11 1/2 years. Five years later, quantitative polymerase chain reaction (PCR) revealed viral DNA. In a synovial tissue specimen subsequently obtained, parvovirus B19 structural proteins could be detected by immunohistochemistry. Three of five patients recovered completely without severe sequels. One patient is in remission under immunosuppressive therapy. The fifth patient suffers from progressive erosions despite intensive therapeutical efforts. In consequence, parvovirus B 19 should generally be taken into consideration as a trigger of various forms of juvenile arthritis and persistence of infection should be evaluated.
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189
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Simmonds P, Manning A, Kenneil R, Carnie FW, Bell JE. Parenteral transmission of the novel human parvovirus PARV4. Emerg Infect Dis 2007; 13:1386-8. [PMID: 18252117 PMCID: PMC2857296 DOI: 10.3201/eid1309.070428] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Transmission routes of PARV4, a newly discovered human parvovirus, were investigated by determining frequencies of persistent infections using autopsy samples from different risk groups. Predominantly parenteral routes of transmission were demonstrated by infection restricted to injection drug users and persons with hemophilia and absence of infection in homosexual men with AIDS and low-risk controls.
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Affiliation(s)
- Peter Simmonds
- Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh, Scotland, United Kingdom.
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190
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Koppelman MHGM, Rood IGH, Fryer JF, Baylis SA, Cuypers HTM. Parvovirus B19 genotypes 1 and 2 detection with real-time polymerase chain reaction assays. Vox Sang 2007; 93:208-15. [PMID: 17845257 DOI: 10.1111/j.1423-0410.2007.00957.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parvovirus B19 (B19V) DNA screening has been introduced to comply with European regulations for certain plasma products. Current commercial and some in-house B19V DNA assays fail to detect or under-quantify the recently identified genotypes 2 and 3. In this report, we describe 2-year experience with B19V DNA screening using the commercial assay from Roche (detecting only genotype 1) combined with an in-house assay (detecting genotypes 1, 2 and 3). This dual testing approach enables the identification of molecular variants of B19V. MATERIALS AND METHODS Between 2005 and 2007, approximately 2.6 million plasma donations were screened for B19V DNA loads exceeding 10(6) IU/ml using the Roche and the in-house real-time polymerase chain reaction assay. RESULTS A total of 232 plasma units were identified with B19V DNA loads above 10(6) IU/ml. Concordant results were observed for the majority of B19V positive samples; however, three of these showed discrepant results between the two assay systems. One was a B19V genotype 2 strain not detected by the Roche assay; another was a B19V genotype 1 strain with a mismatch in the 3'-end of the reverse primer and therefore under-quantified by the Roche assay; and the third one was also a B19V genotype 1 strain that gave an unusual amplification plot in the in-house assay due to a mismatch in the probe-binding site. CONCLUSIONS New, high viral load, B19V genotypes 2 and 3 infections are rare in blood donors tested by Sanquin. One case was found while testing 2.6 million donations. The prevalence of B19V genotype 1 variants not detected by commercial or in-house assays might be in the same range or even higher than the prevalence of B19V genotype 2 viruses, which remain undetected.
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191
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Fryer JF, Delwart E, Hecht FM, Bernardin F, Jones MS, Shah N, Baylis SA. Frequent detection of the parvoviruses, PARV4 and PARV5, in plasma from blood donors and symptomatic individuals. Transfusion 2007; 47:1054-61. [PMID: 17524097 DOI: 10.1111/j.1537-2995.2007.01235.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Plasma pools used in the manufacture of blood- and plasma-derived medicinal products are frequently contaminated with parvovirus B19. The presence of the novel human parvovirus PARV4 and a related variant PARV5 in manufacturing plasma pools was recently demonstrated. Another recently identified parvovirus, human bocavirus (HBoV), has been identified in respiratory samples from children with lower respiratory tract disease. STUDY DESIGN AND METHODS Recent and archived manufacturing plasma pools, as well as plasma from healthy blood donors (individual donations; pools of 16 donations) and febrile patients, were examined for the presence of PARV4 and PARV5 with conventional and TaqMan polymerase chain reaction assays. In addition, highly sensitive assays were used to examine the presence of HBoV DNA in manufacturing pools. RESULTS Of 351 recent manufacturing plasma pool samples, 14 (4%) tested positive for the presence of PARV4 and PARV5. This frequency was elevated in the archived pools. Viral loads ranged from less than 100 up to 4 million copies per mL plasma, with some pools containing a mixture of both viruses. In individual plasma samples from healthy blood donors and febrile patients, the frequencies of detection were 2 and 6 percent, respectively. No HBoV sequences were identified in manufacturing plasma pools (n = 167). CONCLUSION PARV4 and PARV5 are readily detected in manufacturing plasma pools, test pools (constructed from 16 donations), and individual donations derived from healthy blood donors. The prevalence of these viruses was increased in plasma samples from febrile patients. Despite the use of highly sensitive assays for HBoV, it was not possible to identify manufacturing plasma pools containing HBoV sequences.
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Affiliation(s)
- Jacqueline F Fryer
- Division of Virology, National Institute for Biological Standards and Control, Hertfordshire, United Kingdom
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192
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Abstract
Erythrovirus (parvovirus) B19 (B19) is a common human pathogen. It is a non-enveloped single-strand DNA virus packaging its genome in small tight capsids consisting of viral VP1 and VP2 proteins. It is now accepted that B19 is a relatively quickly evolving virus having diverged in several genetic variants recently identified. The main route of B19 transmission is respiratory, with a majority of infections occurring during childhood and manifesting as erythema infectiousum. B19 can also be transmitted vertically and via blood transfusion and organ transplantation. The majority of adult populations show immunological evidence of previous exposure to B19. Although the immune response is able to clear infection and provide life-long protection against B19, recent data suggest that in some, if not the majority, of individuals the acute phase of infection is followed by viral persistence in the blood or other tissues regardless of the host's immunocompetence. Transmission of B19 by blood and blood products and its resistance to common viral inactivation methods raises several blood safety questions, still unanswered. The diversity of B19 strains and the ability of the virus to persist in the presence of specific antibodies raise the issue of transmissibility by transfusion not so much to immunocompetent recipients but rather to the large proportion of recipients in whom there is some degree of immunodeficiency. The ability of the virus to reactivate in immunodeficient recipients may create difficulties in differentiating between transfusion transmission and reactivation.
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Affiliation(s)
- A Parsyan
- Division of Transfusion Medicine, Department of Haematology, University of Cambridge, UK.
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193
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Longhi E, Bestetti G, Acquaviva V, Foschi A, Piolini R, Meroni L, Magni C, Antinori S, Parravicini C, Corbellino M. Human parvovirus 4 in the bone marrow of Italian patients with AIDS. AIDS 2007; 21:1481-3. [PMID: 17589196 DOI: 10.1097/qad.0b013e3281e38558] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human parvovirus 4 (PARV4) is a recently discovered member of the Parvoviridae. We investigated the presence of this virus in bone-marrow aspirates of 35 Italian patients with AIDS. Viral DNA was detected by polymerase chain reaction in over 40% of patients (16/35). The infection was most prevalent in injection drug users (IDU; 12/18; 66.7%) as opposed to non-IDU (4/17; 23.5%). PARV4 infection is widespread in Italian patients with AIDS.
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Affiliation(s)
- Erika Longhi
- Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy
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194
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Hokynar K, Norja P, Hedman K, Söderlund-Venermo M. Tissue persistence and prevalence of B19 virus types 1–3. Future Virol 2007. [DOI: 10.2217/17460794.2.4.377] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Human parvovirus B19 is a minute ssDNA virus that causes a wide variety of diseases, including erythema infectiosum, arthropathy, anemias and fetal death. In addition to the B19 prototype, two new variants (B19 types 2 and 3) have been identified. After primary infection, B19 genomic DNA has been shown to persist in solid tissues of not only symptomatic but also of constitutionally healthy, immunocompetent individuals. The viral DNA persists as an intact molecule without persistence-specific mutations, and via a storage mechanism with life-long capacity. Thus, the mere presence of B19 DNA in tissue cannot be used as a diagnostic criterion, although a possible role in the pathology of diseases, for example through mRNA or protein production, cannot be excluded. The molecular mechanism, host-cell type and possible clinical significance of tissue persistence are yet to be elucidated.
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Affiliation(s)
- Kati Hokynar
- University of Helsinki, Haartman Institute, Department of Virology, PO Box 21 (Haartmaninkatu 3), FIN-00014, Finland
| | - Päivi Norja
- University of Helsinki, Haartman Institute, Department of Virology, PO Box 21 (Haartmaninkatu 3), FIN-00014, Finland
| | - Klaus Hedman
- University of Helsinki & Helsinki University Central Hospital Laboratory, Haartman Institute, Department of Virology, PO Box 21 (Haartmaninkatu 3), FIN-00014, Finland
| | - Maria Söderlund-Venermo
- University of Helsinki, Haartman Institute, Department of Virology, PO Box 21 (Haartmaninkatu 3), FIN-00014, Finland
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195
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Affiliation(s)
- Jacqueline F. Fryer
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | | | - David Padley
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - Sally A. Baylis
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
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196
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Fryer JF, Lucas SB, Padley D, Baylis SA. Parvoviruses PARV4/5 in hepatitis C virus-infected patient. Emerg Infect Dis 2007; 13:175-6. [PMID: 17370542 PMCID: PMC2725819 DOI: 10.3201/eid1301.061358] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jacqueline F. Fryer
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | | | - David Padley
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
| | - Sally A. Baylis
- National Institute for Biological Standards and Control, Potters Bar, United Kingdom
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197
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Ekman A, Hokynar K, Kakkola L, Kantola K, Hedman L, Bondén H, Gessner M, Aberham C, Norja P, Miettinen S, Hedman K, Söderlund-Venermo M. Biological and immunological relations among human parvovirus B19 genotypes 1 to 3. J Virol 2007; 81:6927-35. [PMID: 17409158 PMCID: PMC1933287 DOI: 10.1128/jvi.02713-06] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The human parvovirus B19 is now divided into three genotypes: type 1 (prototype), type 2 (A6- and LaLi-like), and type 3 (V9-like). In overall DNA sequence, the three virus types differ by approximately 10%. The most striking DNA dissimilarity, of >20%, is observed within the p6 promoter region. Because of the scarcity of data on the biological activities and pathogenetic potentials of virus types 2 and 3, we examined the functional characteristics of these virus types. We found the activities of the three p6 promoters to be of equal strength and to be most active in B19-permissive cells. Virus type 2 capsid protein VP2, alone or together with VP1, was expressed with the baculovirus system and was shown to assemble into icosahedral parvovirus-like particles, which were reactive in the hemagglutination assay. Furthermore, sera containing DNA of any of the three B19 types were shown to hemagglutinate. The infectivities of these sera were examined in two B19-permissive cell lines. Reverse transcription-PCR revealed synthesis of spliced B19 mRNAs, and immunofluorescence verified the production of NS and VP proteins in the infected cells. All three genotypes showed similar functional characteristics in all experiments performed, showing that the three virus types indeed belong to the same species, i.e., human parvovirus B19. Additionally, the antibody activity in sera from B19 type 1- or type 2-infected subjects (long-term immunity) was examined with homo- and heterologous virus-like particles. Cross-reactivity of 100% was observed, indicating that the two B19 genotypes comprise a single serotype.
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Affiliation(s)
- Anna Ekman
- Department of Virology, Haartman Institute, University of Helsinki, Helsinki, Finland
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198
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Manning A, Willey SJ, Bell JE, Simmonds P. Comparison of tissue distribution, persistence, and molecular epidemiology of parvovirus B19 and novel human parvoviruses PARV4 and human bocavirus. J Infect Dis 2007; 195:1345-52. [PMID: 17397006 PMCID: PMC7109978 DOI: 10.1086/513280] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Accepted: 12/04/2006] [Indexed: 12/16/2022] Open
Abstract
Background. PARV4 and human bocavirus (HBoV) are newly discovered human parvoviruses with poorly understood epidemiologies and disease associations. We investigated the frequencies of persistence, tissue distribution, and influence of immunosuppression on replication of these viruses. Methods. At autopsy, bone marrow, lymphoid tissue, and brain tissue from human immunodeficiency virus (HIV)—infected individuals with acquired immunodeficiency syndrome (AIDS) and those without AIDS and from HIV-uninfected individuals were screened for parvovirus B19, PARV4, and HBoV DNA by means of quantitative polymerase chain reaction analyses. Results. B19 DNA was detected both in HIV-infected study subjects (13 of 24) and in HIV-uninfected study subjects (8 of 8), whereas PARV4 DNA was detected only in HIV-infected study subjects (17 of 24). HBoV DNA was not detected in any study subjects. The degree of immunosuppression with HIV infection did not influence B19 or PARV4 viral loads. B19 or PARV4 plasma viremia was not detected in any study subjects (n = 76; viral load <25 DNA copies/mL). A significantly older age distribution was found for study subjects infected with B19 genotype 2, compared with those infected with B19 genotype 1. Two genotypes of PARV4 were detected; study subjects carrying prototype PARV4 (genotype 1) were younger (all born after 1958) than those infected with genotype 2 (PARV5; study subjects born between 1949 and 1956). Conclusions. Tight immune control of replication of B19 and PARV4 was retained despite profound immunosuppression. Recent genotype replacement of PARV4, combined with absent sequence diversity among genotype 1 sequences, suggests a recent, epidemic spread in the United Kingdom, potentially through transmission routes shared by HIV.
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Affiliation(s)
- Ashleigh Manning
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
| | - Samantha J. Willey
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
| | - Jeanne E. Bell
- Neuropathology Unit, Western General Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter Simmonds
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
- Reprints or correspondence: Dr. Peter Simmonds, Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh, EH9 1QH, United Kingdom ()
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199
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Franssila R, Hedman K. Infection and musculoskeletal conditions: Viral causes of arthritis. Best Pract Res Clin Rheumatol 2007; 20:1139-57. [PMID: 17127201 DOI: 10.1016/j.berh.2006.08.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Several viruses cause postinfectious arthritis. The disease is a typical manifestation of arthritogenic alphaviruses, rubella virus and human parvovirus B19. In addition, arthritis is not uncommon after infection by HIV, cytomegalovirus, hepatitis B virus, hepatitis C virus, or Epstein-Barr virus (EBV). Also prolonged arthritis may result from viral infections, particularly with alphaviruses and human parvovirus B19. Viruses such as EBV and B19 may have significant roles in initiating chronic arthropathies, which in some cases may be indistinguishable from rheumatoid arthritis.
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Affiliation(s)
- Rauli Franssila
- Department of Virology, Haartman Institute, University of Helsinki and HUCH Laboratory Division, Haartmaninkatu 3, FI-00290 Helsinki, Finland.
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