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Letafati A, Taghiabadi Z, Roushanzamir M, Memarpour B, Seyedi S, Farahani AV, Norouzi M, Karamian S, Zebardast A, Mehrabinia M, Ardekani OS, Fallah T, Khazry F, Daneshvar SF, Norouzi M. From discovery to treatment: tracing the path of hepatitis E virus. Virol J 2024; 21:194. [PMID: 39180020 PMCID: PMC11342613 DOI: 10.1186/s12985-024-02470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 08/14/2024] [Indexed: 08/26/2024] Open
Abstract
The hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide. HEV is classified into eight genotypes, labeled HEV-1 through HEV-8. Genotypes 1 and 2 exclusively infect humans, while genotypes 3, 4, and 7 can infect both humans and animals. In contrast, genotypes 5, 6, and 8 are restricted to infecting animals. While most individuals with a strong immune system experience a self-limiting infection, those who are immunosuppressed may develop chronic hepatitis. Pregnant women are particularly vulnerable to severe illness and mortality due to HEV infection. In addition to liver-related complications, HEV can also cause extrahepatic manifestations, including neurological disorders. The immune response is vital in determining the outcome of HEV infection. Deficiencies in T cells, NK cells, and antibody responses are linked to poor prognosis. Interestingly, HEV itself contains microRNAs that regulate its replication and modify the host's antiviral response. Diagnosis of HEV infection involves the detection of HEV RNA and anti-HEV IgM/IgG antibodies. Supportive care is the mainstay of treatment for acute infection, while chronic HEV infection may be cleared with the use of ribavirin and pegylated interferon. Prevention remains the best approach against HEV, focusing on sanitation infrastructure improvements and vaccination, with one vaccine already licensed in China. This comprehensive review provides insights into the spread, genotypes, prevalence, and clinical effects of HEV. Furthermore, it emphasizes the need for further research and attention to HEV, particularly in cases of acute hepatitis, especially among solid-organ transplant recipients.
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Affiliation(s)
- Arash Letafati
- Department of Virology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Zahra Taghiabadi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Mahshid Roushanzamir
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
- Department of Pharmacological and Biomolecular Science, University of Milan, Milan, Italy
| | - Bahar Memarpour
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
- Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Saba Seyedi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | | | - Masoomeh Norouzi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Saeideh Karamian
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Arghavan Zebardast
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Marzieh Mehrabinia
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Omid Salahi Ardekani
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Tina Fallah
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Fatemeh Khazry
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Samin Fathi Daneshvar
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
| | - Mehdi Norouzi
- Department of Virology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran
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Ferreira NE, da Costa AC, Kallas EG, Silveira CGT, de Oliveira ACS, Honorato L, Paião HGO, Lima SH, de M. Vasconcelos D, Côrtes MF, Costa SF, Mendoza TRT, Gomes HR, Witkin SS, Mendes-Correa MC. Encephalopathy Caused by Human Parvovirus B19 Genotype 1 Associated with Haemophilus influenzae Meningitis in a Newborn. Curr Issues Mol Biol 2023; 45:6958-6966. [PMID: 37754223 PMCID: PMC10529629 DOI: 10.3390/cimb45090439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 09/28/2023] Open
Abstract
Parvovirus B19 infection is associated with a wide range of clinical manifestations, from asymptomatic to severe neurological disorders. Its major clinical symptoms, fever and rash, are common to multiple viruses, and laboratory tests to detect B19 are frequently not available. Thus, the impact of B19 on public health remains unclear. We report the case of a 38-day old girl admitted to São Paulo Clinical Hospital, Brazil, with an initial diagnosis of bacterial meningitis, seizures, and acute hydrocephalus. Antibiotic therapy was maintained for one week after admission and discontinued after negative laboratory results were obtained. Nine days after symptoms onset, a cerebral spinal fluid (CSF) sample revealed persistent pleocytosis. The complete B19 complete genome was subsequently identified in her CSF by a metagenomic next-generation sequencing approach. This report highlights the possible involvement of B19 in the occurrence of acute neurological manifestations and emphasizes that its possible involvement might be better revealed by the use of metagenomic technology to detect viral agents in clinical situations of unknown or uncertain etiology.
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Affiliation(s)
- Noely Evangelista Ferreira
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Antonio C. da Costa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Esper G. Kallas
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
| | - Cassia G. T. Silveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo 05403-000, Brazil; (C.G.T.S.); (A.C.S.d.O.)
| | - Ana Carolina S. de Oliveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo 05403-000, Brazil; (C.G.T.S.); (A.C.S.d.O.)
| | - Layla Honorato
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Heuder G. O. Paião
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Silvia H. Lima
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Dewton de M. Vasconcelos
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Marina F. Côrtes
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Silvia F. Costa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Tania R. T. Mendoza
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
| | - Hélio R. Gomes
- Laboratório de Investigação Médica LIM 15, Hospital da Clinicas da, Faculdade de Medicina da, Universidade de São Paulo, São Paulo 01246-903, Brazil;
| | - Steven S. Witkin
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA
| | - Maria C. Mendes-Correa
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (N.E.F.); (A.C.d.C.); (E.G.K.); (L.H.); (H.G.O.P.); (S.H.L.); (M.F.C.); (S.F.C.); (T.R.T.M.)
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil; (D.d.M.V.); (S.S.W.)
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Monteiro VS, Baía-da-Silva DC, Silva VA, Pivoto João GA, Marinho EPM, Cubas-Vega NC, Val FFA, Perez-Gomez AS, Monte RL, Mota A, Lacerda MVG, Souza Bastos M. Neurological Manifestations Associated with Parvovirus B19 Infection in Immunocompetent Children: Case Series and Systematic Review. J Trop Pediatr 2021; 67:fmab078. [PMID: 34545404 DOI: 10.1093/tropej/fmab078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
An increasing number of reports have described human parvovirus B19 infection in association with a variety of neurological manifestations, especially in children. This study assessed the clinical and laboratory outcomes found in a case series of immunocompetent children who tested positive for parvovirus B19 by qualitative polymerase chain reaction assays of cerebrospinal fluid, in a tertiary referral center in the western Brazilian Amazon. We screened 178 children with clinically diagnosed central nervous system infections (meningoencephalitis). Of these, five (2.8%) were positive for parvovirus B19. A literature review also presented herein identified a further 50 cases of parvovirus B19 with neurological manifestations. Thus, even if the classic signs of parvovirus B19 infection are absent, such as the well-known rash, children with signs of neurological infection should also be evaluated for parvovirus B19 infection.
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Affiliation(s)
- Vinícius Silva Monteiro
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Djane Clarys Baía-da-Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
- Instituto Leônidas and Maria Deane, Fiocruz, Manaus 69.057-070, Brazil
| | - Valderjane Aprigio Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Guilherme Augusto Pivoto João
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Eveny Perlize Melo Marinho
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
| | - Nadia Carolina Cubas-Vega
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Fernando Fonseca Almeida Val
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Aline Stephanie Perez-Gomez
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Rossiclea Lins Monte
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
| | - Adolfo Mota
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus 69040-000, Brazil
| | - Michele Souza Bastos
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas 69040-000, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Amazonas, Manaus 69077-000, Brazil
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Alves AD, Melgaço JG, Cássia Nc Garcia RD, Raposo JV, de Paula VS, Araújo CC, Pinto MA, Amado LA. Persistence of Parvovirus B19 in liver from transplanted patients with acute liver failure. Future Microbiol 2021; 15:307-317. [PMID: 32286103 DOI: 10.2217/fmb-2019-0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: In this study, we investigated the presence of B19V in liver tissues from patients with acute liver failure (ALF) and evaluated the viral activity in infected liver. Methods: Serum and liver samples from 30 patients who underwent liver transplantation for ALF were investigated for B19V infection by real-time PCR, serological tests and examination of B19V mRNA (transcript) expression in the liver. Results: The serum and liver samples from seven patients were B19V DNA positive (103-105 copies/ml). Most of them presented detectable anti-B19V IgG, indicating persistent infection. B19V mRNA was detected in all patients, demonstrating intra-hepatic replication. Conclusion: B19V infection of the liver during the course of non-A-E ALF suggested a role of B19V, which produced the worst outcome in co-infected patients and in patients with cryptogenic ALF, in liver damage.
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Affiliation(s)
- Arthur Dr Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Juliana G Melgaço
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Rita de Cássia Nc Garcia
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Jessica V Raposo
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Vanessa S de Paula
- Laboratório de Virologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Marcelo A Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Luciane A Amado
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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5
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Cnc Garcia RD, Leon LA. Human parvovirus B19: a review of clinical and epidemiological aspects in Brazil. Future Microbiol 2021; 16:37-50. [PMID: 33438475 DOI: 10.2217/fmb-2020-0123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Since the first evidence of human parvovirus B19 (B19V) infection in late 80s, several studies have been conducted to clarify the spectrum of clinical diseases in Brazil. B19V infection is prevalent in the general population and has exhibited a cyclical pattern of occurrence every 4-5 years, with the predominance of genotype 1 over 3b. During epidemic periods the wide range of clinical conditions, such as ertythema infectiosum, arthropathy, transient aplastic crisis, nonimmune hydrops fetalis and B19V-hepatitis were diagnosed. However, many infections are likely asymptomatic or have a self-limiting clinical course and are not readly diagnosed. Besides, the similarity of the symptoms of ertythema infectiosum to other rash diseases and the broadly circulation of arboviruses makes differential diagnosis more difficult. In this article, we provide a historical comprehensive overview of the research on parvovirus B19 conducted in Brazil, with a focus on the clinical and epidemiological aspects of the infection.
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Affiliation(s)
- Rita de Cnc Garcia
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense (UFF), Rua Professor Hernani Melo 101, Niterói, RJ 22430 190, Brazil
| | - Luciane Aa Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, RJ 21040 360, Brazil
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Rawla P, Raj JP, Kannemkuzhiyil AJ, Aluru JS, Thandra KC, Gajendran M. A Systematic Review of the Extra-Hepatic Manifestations of Hepatitis E Virus Infection. Med Sci (Basel) 2020; 8:E9. [PMID: 32033102 PMCID: PMC7151617 DOI: 10.3390/medsci8010009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/30/2020] [Accepted: 01/30/2020] [Indexed: 02/06/2023] Open
Abstract
Hepatitis E virus (HEV) is a non-enveloped, positive-sense, single-stranded RNA icosahedral virus belongs to the genus Orthohepevirus within the Hepeviridae family. HEV infection can be asymptomatic, or it can cause icteric or fulminant hepatitis. Off late, there have been a number of publications reporting the extra-hepatic manifestations of HEV infection, and this systematic review is aimed at summarizing the available evidence in this regard. Two independent investigators searched PubMed, PubMed Central and Embase databases using the search string "(((hepatitis E) AND (Extrahepatic OR Extra-Hepatic))) OR ((Hepatitis E) AND (Neurology OR Cardiology OR Respiratory OR Lung OR Gastrointestinal OR musculoskeletal OR immunology OR pulmonary)) Filters: Abstract availability, English language, and Human studies". The extra-hepatic manifestations reported in each of the selected articles were classified and reported as neurological, cardiovascular, and hematological and miscellaneous manifestations. The total number of various manifestations reported in our study were n = 324. These include neurological manifestations (n = 178/324 (54.94%)), cardiovascular and hematological manifestations (n = 113/324 (34.88%)), gastro-intestinal/pancreaticobiliary manifestations (n = 24/324 (7.41%)) and other rarer manifestations involving systems such as renal (n = 4/324; 1.24%), endocrine (n = 1/324; 0.31%), dermatology (n = 1/324; 0.31%), respiratory (n = 1/324; 0.31%), muscular (n = 1/324; 0.31%) and immune system (n = 1/324; 0.31%). Thus, HEV can have extra-hepatic manifestations affecting any system of the human body. Further research is needed to elucidate the underlying pathophysiological manifestations of these extra-hepatic manifestations and to prove causal association with HEV.
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Affiliation(s)
- Prashanth Rawla
- Department of Medicine, Sovah Health, Martinsville, VA 24112, USA
| | - Jeffrey Pradeep Raj
- Department of Clinical Pharmacology, Seth G.S. Medical College & King Edward Memorial Hospital, Mumbai 400012, India;
| | - Alan Jose Kannemkuzhiyil
- St. Johns Medical College, St. John’s National Academy of Health Sciences, Bengaluru, Karnataka 560034, India;
| | - John Sukumar Aluru
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02212, USA;
| | - Krishna Chaitanya Thandra
- Department of Pulmonary and Critical Care Medicine, Sentara Virginia Beach General Hospital, Virginia Beach, VA 23454, USA;
| | - Mahesh Gajendran
- Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX 79905, USA;
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Shi R, Long C, Dai Y, Huang Q, Gao Y, Zhang N, Chen Y, Liu S, Ma Q, Quan L, Zhang Y, Luo B. Bongkrekic acid poisoning: Severe liver function damage combined with multiple organ failure caused by eating spoiled food. Leg Med (Tokyo) 2019; 41:101622. [DOI: 10.1016/j.legalmed.2019.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 01/24/2023]
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Kishore J, Kishore D. Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito. Indian J Med Res 2019; 148:373-384. [PMID: 30666000 PMCID: PMC6362725 DOI: 10.4103/ijmr.ijmr_533_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human parvovirus B19 (B19V) causes myriads of clinical diseases; however, owing to lack of awareness and undetermined clinical impact, it has failed to become a virus pathogen of global concern. Cryptically, B19V causes significant morbidity and mortality. Half of the world population and 60 per cent of Indians are known to be serologically naive and are at risk of acquiring B19V infections. Cumulatively, our data showed 21.3 per cent B19V-infected patients with juvenile chronic arthropathy, recurrent abortions, multi-transfused thalassaemia and leukaemia. In addition, B19V-infected cases that ended fatally included patients with pure red cell aplasia, fulminant hepatitis and haemophagocytic syndrome. Novel clinical associations of B19V observed were amegakaryocytic thrombocytopaenia, myositis and non-occlusive ischaemic gangrene of bowel. B19V possesses multiple receptors which are distributed widely in human tissues. Vascular endothelial cell infection by B19V causes endothelialitis and vasculitic injuries besides antibody-dependent enhancement which empowered B19V to cause multiorgan diseases. Owing to lack of suitable animal model for B19V, true causal role remains to be determined, but numerous reports on B19V infections substantiate a causal role in multiorgan diseases. Hence, B19V infections need to be recognized, investigated and treated besides making efforts on vaccine developments.
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Affiliation(s)
- Janak Kishore
- Division of Virology, Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Divya Kishore
- Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
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9
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Leon LAA, Marchevsky RS, Gaspar AMC, Garcia RDCNC, Almeida AJD, Pelajo-Machado M, Castro TXD, Nascimento JPD, Brown KE, Pinto MA. Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure. Mem Inst Oswaldo Cruz 2016; 111:258-66. [PMID: 27074255 PMCID: PMC4830115 DOI: 10.1590/0074-02760160013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/11/2016] [Indexed: 12/19/2022] Open
Abstract
This study was conducted to analyse the course and the outcome of the liver disease
in the co-infected animals in order to evaluate a possible synergic effect of human
parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus
monkeys were inoculated with serum obtained from a fatal case of B19V infection
and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV
and B19V, liver enzyme levels, viraemia, haematological changes, and
necroinflammatory liver lesions were used for monitoring the infections.
Seroconversion was confirmed in all infected groups. A similar pattern of B19V
infection to human disease was observed, which was characterised by high and
persistent viraemia in association with reticulocytopenia and mild to moderate
anaemia during the period of investigation (59 days). Additionally, the intranuclear
inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus
and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte
counts were more evident in the co-infected group. The present results demonstrated,
for the first time, the susceptibility of cynomolgus to B19V infection, but it did
not show a worsening of liver histopathology in the co-infected group.
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Affiliation(s)
- Luciane Almeida Amado Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Ana Maria Coimbra Gaspar
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Adilson José de Almeida
- Hospital Universitário Gaffrée e Guinle, Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Marcelo Pelajo-Machado
- Laboratório de Patologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Tatiana Xavier de Castro
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Jussara Pereira do Nascimento
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Kevin E Brown
- Virus Reference Department, Health Protection Agency, London, UK
| | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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10
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Kerr JR. A review of blood diseases and cytopenias associated with human parvovirus B19 infection. Rev Med Virol 2015; 25:224-40. [PMID: 25962796 DOI: 10.1002/rmv.1839] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 12/12/2022]
Abstract
Parvovirus B19 is a single-stranded DNA virus which preferentially targets the erythroblast resulting in red cell aplasia, which is temporary in immunocompetent persons. Since the discovery of B19 virus in 1975, a wide variety of blood diseases and cytopenias affecting several blood cell lineages have been documented during or following B19 infection. These include cytopenias affecting the erythroid, megakaryoblastoid, myeloid and lymphoid lineages, as well as a variety of bicytopenias, pancytopenia, bone marrow necrosis / fat embolism syndrome, myelodysplastic syndrome, leucoerythroblastopenia, and hemophagocytic lymphohistiocytosis. B19 infection may also complicate and precede the course of acute leukemia, the significance of which remains to be determined. This review describes the current state of knowledge of the abnormalities of individual blood cell lineages encountered during parvovirus B19 infection, over the almost 40 years since its discovery, and reveals some very interesting themes, which improve our understanding of the pathogenesis of B19 infection with particular reference to the bone marrow.
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Affiliation(s)
- Jonathan R Kerr
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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11
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Bihari C, Rastogi A, Rangegowda D, Chowdhury A, Saxena P, Garg H, Sarin SK. Parvovirus B19 associated acute hepatitis and hepatosplenomegaly. Clin Res Hepatol Gastroenterol 2014; 38:e9-10. [PMID: 23886765 DOI: 10.1016/j.clinre.2013.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 06/19/2013] [Accepted: 06/26/2013] [Indexed: 02/04/2023]
Affiliation(s)
- Chhagan Bihari
- Department of Hematology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India.
| | - Archana Rastogi
- Department of Pathology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
| | - Devraj Rangegowda
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
| | - Ashok Chowdhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
| | - Priyanka Saxena
- Department of Hematology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
| | - Hitendra Garg
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
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12
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Parvovirus b19 associated hepatitis. HEPATITIS RESEARCH AND TREATMENT 2013; 2013:472027. [PMID: 24232179 PMCID: PMC3819764 DOI: 10.1155/2013/472027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/10/2013] [Accepted: 09/04/2013] [Indexed: 12/21/2022]
Abstract
Parvovirus B19 infection can present with myriads of clinical diseases and syndromes; liver manifestations and hepatitis are examples of them. Parvovirus B19 hepatitis associated aplastic anemia and its coinfection with other hepatotropic viruses are relatively underrecognized, and there is sufficient evidence in the literature suggesting that B19 infections can cause a spectrum of liver diseases from elevation of transaminases to acute hepatitis to fulminant liver failure and even chronic hepatitis. It can also cause fatal macrophage activation syndrome and fibrosing cholestatic hepatitis. Parvovirus B19 is an erythrovirus that can only be replicate in pronormoblasts and hepatocytes, and other cells which have globosides and glycosphingolipids in their membrane can also be affected by direct virus injury due to nonstructural protein 1 persistence and indirectly by immune mediated injury. The virus infection is suspected in bone marrow aspiration in cases with sudden drop of hemoglobin and onset of transient aplastic anemia in immunosuppressed or immunocompetent patients and is confirmed either by IgM and IgG positive serology, PCR analysis, and in situ hybridization in biopsy specimens or by application of both. There is no specific treatment for parvovirus B19 related liver diseases, but triple therapy regimen may be effective consisting of immunoglobulin, dehydrohydrocortisone, and cyclosporine.
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13
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Kishore J, Srivastava M, Choudhary N. Standardization of B19 IgG ELISA to study the seroepidemiology of parvovirus B19 in North Indian voluntary blood donors. Asian J Transfus Sci 2011; 4:86-90. [PMID: 20859505 PMCID: PMC2937302 DOI: 10.4103/0973-6247.67022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Backgound and Objectives: Parvovirus B19 (B19) being a non-enveloped DNA virus is hence thermo-stable to the current methods of viral inactivation. Therefore transfusion of blood or its component from a viremic donor to non-immune recipients may result in transfusion-transmitted B19 infection with occasional sinister complications. The serologically naïve blood donor population in our country has not been studied. Hence a study was designed to find the sero-status of B19 virus in normal voluntary blood donor population (relatives of recipients) as an indirect measure of the susceptibility to B19 in north Indians together with seroepidemiology of B19. Methods: An in-house anti-B19 IgG ELISA was standardized using cloned, baculovirus expressed, and purified VP1/VP2 capsid proteins as antigen. Anti-B19 IgG antibodies in sera (diluted 1:400) of 1000 healthy voluntary blood donors (18-60 years; mean 30.5 years) were analyzed and their epidemiologic data were documented. Results: A total of 399 (39.9%) donors were seropositive for B19 virus. Seroprevalence was higher in males than females (44% vs 27%) and it increased with increasing age (P<0.01). Socioeconomically, B19 IgG antibody positivities were 61.8%, 61.1%, and 44.4% in low, medium, and high income groups respectively with unskilled laborers having higher seroprevalence in low (48.5%) and middle (58.7%) income group (P<0.05). Housing conditions revealed B19 seroprevalence as 42.6% in donors living in small houses compared to 20.4% in larger houses (P<0.01) but no difference with religion. Conclusions: Seroprevalence to B19 in normal voluntary blood donors was low leaving a large proportion of north Indians susceptible to B19 infection.
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Affiliation(s)
- Janak Kishore
- Department of Microbiology, Sanjay Gandhi Post Graduate Institue of Medical Sciences, Lucknow-226014, India
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14
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Seizure and hepatosplenomegaly-rare manifestation of parvovirus B-19: a case report and review of the literature. J Trop Med 2011; 2011:287914. [PMID: 21760806 PMCID: PMC3134170 DOI: 10.1155/2011/287914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Accepted: 04/07/2011] [Indexed: 11/29/2022] Open
Abstract
Parvovirus B19 is the etiologic agent of erythema infectiosum (fifth disease), a fever-rash illness
occurring in childhood. We present a 10 month old child with high grade fever for 10 days,
generalized tonic-clonic seizure, bilateral cervical lymphadenopathy, generalized maculopapular
rash, hematemesis and malena. Bone marrow aspiration and liver biopsy were done. EBV
serology and parvovirus PCR were also performed. Bone marrow aspiration and biopsy showed
giant pro-erythroblast consistent with parvovirus infection. PCR showed amplification of
parvovirus genomic sequences. Present case highlights an atypical presentation of Parvovirus
B19 infection as fever, rash and hepatosplenomegaly.
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15
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Poole BD, Kivovich V, Gilbert L, Naides SJ. Parvovirus B19 nonstructural protein-induced damage of cellular DNA and resultant apoptosis. Int J Med Sci 2011; 8:88-96. [PMID: 21278893 PMCID: PMC3030141 DOI: 10.7150/ijms.8.88] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 01/13/2011] [Indexed: 12/19/2022] Open
Abstract
Parvovirus B19 is a widespread virus with diverse clinical presentations. The viral nonstructural protein, NS1, binds to and cleaves the viral genome, and induces apoptosis when transfected into nonpermissive cells, such as hepatocytes. We hypothesized that the cytotoxicity of NS1 in such cells results from chromosomal DNA damage caused by the DNA-nicking and DNA-attaching activities of NS1. Upon testing this hypothesis, we found that NS1 covalently binds to cellular DNA and is modified by PARP, an enzyme involved in repairing single-stranded DNA nicks. We furthermore discovered that the DNA nick repair pathway initiated by poly(ADPribose)polymerase and the DNA repair pathways initiated by ATM/ATR are necessary for efficient apoptosis resulting from NS1 expression.
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Affiliation(s)
- Brian D Poole
- Huck Institute for Life Sciences, Pennsylvania State University College of Medicine/Milton S. Hershey Medical Center, Hershey, PA, USA
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