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Miller MJ, Perinet L, Alter HJ, Conry-Cantilena K, De Giorgi V. Natural History Studies, a Natural Next Step to Study Emerging Transfusion-Transmitted Infections. Transfus Med Rev 2024; 38:150820. [PMID: 38364616 DOI: 10.1016/j.tmrv.2024.150820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Maureen J Miller
- Infectious Diseases Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA.
| | - Lara Perinet
- Infectious Diseases Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Harvey J Alter
- Infectious Diseases Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Kathleen Conry-Cantilena
- Infectious Diseases Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Valeria De Giorgi
- Infectious Diseases Section, Department of Transfusion Medicine, National Institutes of Health Clinical Center, Bethesda, MD, USA
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2
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Vuković V, Patić A, Ristić M, Kovačević G, Hrnjaković Cvjetković I, Petrović V. Seroepidemiology of Human Parvovirus B19 Infection among the Population of Vojvodina, Serbia, over a 16-Year Period (2008-2023). Viruses 2024; 16:180. [PMID: 38399956 PMCID: PMC10893261 DOI: 10.3390/v16020180] [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: 01/06/2024] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to estimate the serological status and dynamic changes in the prevalence of Parvovirus B19 (PVB19) antibodies within the general population residing in the northern part of the Republic of Serbia (Province of Vojvodina) during a 16-year period. Serum samples were analyzed for Human PVB19-specific IgM and IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Throughout the study period, the overall seroprevalence was 49.51%. Approximately 10% of patients exhibited a serologic profile positive for PVB19 IgM antibodies. Notably, seroprevalence varied significantly, ranging from 9.12% in the pediatric cohort (ages 1-4 years) to 65.50% in the adult demographic (40-59 years old). Seroprevalence was higher (51.88%) among women compared to men (42.50%). Immunologically naive pregnant women in the age groups 26-36 and 36-45 years had 45% (OR = 0.55, 95% CI: 0.31-1.00) and 52% (OR = 0.48; 95% CI: 0.24-0.94) lower odds of having negative IgM and IgG compared to those in age group 16-25 years old. Improved knowledge of the epidemiology of PVB19 may assist clinicians in the differential diagnosis of PVB19 clinical manifestations. The PVB19 detection is particularly important for monitoring individuals in risk groups such as women of reproductive age, medical staff, patients with hematological disorders, and those with immunodeficiency.
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Affiliation(s)
- Vladimir Vuković
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Aleksandra Patić
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Mioljub Ristić
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Gordana Kovačević
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
| | - Ivana Hrnjaković Cvjetković
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
- Department of Microbiology with Parasitology and Immunology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Vladimir Petrović
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia; (A.P.); (M.R.); (G.K.); (I.H.C.); (V.P.)
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
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3
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Leelaviwat N, Armin S, Mekraksakit P, Nugent K. Reactivation of Parvovirus B19 Infection: An Uncommon Trigger of Macrophage Activation Syndrome in Adult-Onset Still's Disease. Cureus 2023; 15:e37231. [PMID: 37162784 PMCID: PMC10164221 DOI: 10.7759/cureus.37231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/11/2023] Open
Abstract
A 40-year-old woman presented with four weeks of intermittent high-grade fever, cough, and joint pain, and two weeks of a generalized rash. She was found to have adult-onset Still's disease (AOSD) and rapidly developed macrophage activation syndrome (MAS) on the second day of admission. Among infectious etiologies, Epstein-Barr virus and members of the herpes virus family are common triggers of MAS. However, our patient was found to have reactivation/recurrence of parvovirus B19 infection as the cause; this is an uncommon trigger reported infrequently in the medical literature. Despite intensive treatment, the patient passed away.
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Affiliation(s)
- Natnicha Leelaviwat
- Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Sabiha Armin
- Internal Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Kenneth Nugent
- Internal Medicine/Pulmonary and Critical Care Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
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4
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Human Parvovirus B19 Infection Among Blood Donors in North-East of Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.97856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Human parvovirus B19 is a single-stranded DNA and non-enveloped virus which belongs to the Parvoviridae family. The virus spreads through respiratory secretions and perinatal blood. B19 may cause serious complications in patients with cellular immunodeficiency that have no detectable antibodies to B19, such as aplastic crises in solid organs. Objectives: The present study aimed to investigate the prevalence of parvovirus B19 and to evaluate the presence of B19 DNA among blood donors in Golestan Province. Methods: Sera of 400 blood donors in Golestan Province who were negative for HIV, HbsAg, and HCV were tested for both IgG and IgM anti-B19 virus antibodies using the ELISA method, following which all sera were tested for the presence of B19 DNA by semi-nested PCR. Results: 242 (out of 400) subjects (60.5%; 95% CI) were positive for anti-B19 IgG, and 158 were negative for IgG antibody (39.5%; 95% CI). Moreover, all asymptomatic blood donors were negative for anti-B19 IgM. No viral genome was found in serum samples of donors. Conclusions: Since no viral genome was found in the donors' serum samples and the relatively high prevalence of anti HPV- B19 IgG in blood donors, it can be concluded that the possibility of B19 transmission through blood transfusion is low. However, special caution should be taken when transfusing blood to the high-risk groups such as pregnant women, immune-deficient patients, and those with hematological problems, particularly regarding IgG anti- HPV- B19 antibodies (HPV- B19-safe).
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5
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Stramer SL. Parvovirus B19 and recipient safety: is it time to do more? Transfus Med 2020; 30:243-244. [PMID: 32567077 DOI: 10.1111/tme.12703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
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6
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Alain CB, Antoine LK, Bizette BN, Dahlia P, Dophie TB, Jérémie MM, Donatien KNN, Steve AM. The human parvovirus B19/human immunodeficiency virus co-infection in healthy eligible voluntary blood donors at the Blood Transfusion National Center in Kinshasa. Pan Afr Med J 2020; 35:69. [PMID: 32523647 PMCID: PMC7255965 DOI: 10.11604/pamj.2020.35.69.21018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/19/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Parvovirus B19 (PVB19) is one of several viruses transmissible by blood transfusion. Levels of exposure to PVB19 among HIV-infected voluntary blood donors are comparable to those among HIV-negative controls because, in blood donors, the PVB19 infection is transmitted mainly via the respiratory route. Thus, we hypothesize that the seroprevalence of PVB19 in HIV-positive blood donors is equal to the seroprevalence of PVB19 in HIV-negative blood donors. The objective of this study was to compare the seroprevalence of PVB19 between asymptomatic HIV-positive and HIV-negative blood donors. Methods A random sample of 360 eligible blood donors were firstly examined for HIV antibodies by using ELISA automaton and so were categorized as HIV-positive donors and HIV-negative donors. Then the two categories of donors were examined for PVB19 IgG and IgM by using ELISA kits. The seroprevalence of PVB19 in HIV-positive donors was compared to that of HIV-negative donors by using chi-square test or Fisher's exact test. All statistical analyzes were performed with SPSS 21. Results The prevalences of PVB19 IgG and IgM in HIV-positive blood donors were 92.1% (35 of 38) and 44.7% (17 of 38), respectively and those in control group were 89.1% (287 of 322) and 46.3% (149 of 322), respectively. But for both IgG and IgM the difference was not statistically significant (p > 0.05). Conclusion This research confirms our hypothesis: the seroprevalence of PVB19 in HIV-positive blood donors is equal to the seroprevalence of PVB19 in HIV-negative blood donors.
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Affiliation(s)
- Chabo Byaene Alain
- Department of Immunology and Regenerative Medicine, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.,Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Lufimbo Katawandja Antoine
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Bizeti Nsangu Bizette
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Pambu Dahlia
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Tshibuela Beya Dophie
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Muwonga Masidi Jérémie
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Ahuka Mundeke Steve
- Department of Medical Biology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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7
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van Hoeven LR, Janssen MP, Lieshout-Krikke RW, Molenaar-de Backer MW. An assessment of the risk, cost-effectiveness, and perceived benefits of anti-parvovirus B19 tested blood products. Transfusion 2019; 59:2352-2360. [PMID: 31032994 DOI: 10.1111/trf.15324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/14/2019] [Accepted: 03/03/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Parvovirus B19 (B19V) can cause severe anemia, hydrops foetalis, and even death in vulnerable patients. To prevent transfusion-transmitted B19V infection of at-risk patients, B19V antibody screening of blood donors was implemented. The cost-effectiveness of this intervention is unclear, as the likelihood of transmission through blood and subsequent complications for recipients are unknown. This study estimates the cost-effectiveness of anti-B19V donor screening in the Netherlands. STUDY DESIGN AND METHODS The estimates needed for the cost-effectiveness model were: the occurrence of B19V in Dutch blood donors, the number of anti-B19V tested products required by hospitals, the likelihood of morbidity and mortality given B19V infection, treatment costs, and screening costs. These estimates were obtained from literature and observational data. When data were unavailable, structured expert judgment elicitation and statistical modeling were applied. RESULTS The costs of preventing one transfusion transmitted B19V infection are estimated at €68,942 (€42,045 - €102,080). On average, 1.25 cases of morbidity and 0.12 cases of mortality are prevented annually. Although the perceived risk of transfusion transmitted B19V infection was low, half of the treating physicians favored anti-B19V screening. CONCLUSION The estimated mortality and morbidity caused by B19V infection was low in the risk groups. The cost-effectiveness ratio is similar to other blood safety screening measures. No guidance exists to evaluate the acceptability of this ratio. The explicit overview of costs and effects may further guide the discussion of the desirability of B19V safe blood products.
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Affiliation(s)
- Loan R van Hoeven
- Donor Medicine Research Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, The Netherlands
| | - Mart P Janssen
- Donor Medicine Research Transfusion Technology Assessment Department, Sanquin Research, Amsterdam, The Netherlands
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8
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Alves ADR, Cubel Garcia RDCN, Cruz OG, Pinto MA, Amado Leon LA. Quantitative real-time PCR for differential diagnostics of parvovirus B19 infection in acute liver failure patients. Expert Rev Mol Diagn 2019; 19:259-266. [DOI: 10.1080/14737159.2019.1582333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Arthur Daniel Rocha Alves
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Marcelo Alves Pinto
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Luciane Almeida Amado Leon
- Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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9
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Juhl D, Hennig H. Parvovirus B19: What Is the Relevance in Transfusion Medicine? Front Med (Lausanne) 2018; 5:4. [PMID: 29450198 PMCID: PMC5799219 DOI: 10.3389/fmed.2018.00004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/09/2018] [Indexed: 01/17/2023] Open
Abstract
Parvovirus B19 (B19V) has been discovered in 1975. The association with a disease was unclear in the first time after the discovery of B19V, but meanwhile, the usually droplet transmitted B19V is known as the infectious agent of the “fifth disease,” a rather harmless children’s illness. But B19V infects erythrocyte progenitor cells and thus, acute B19V infection in patients with a high erythrocyte turnover may lead to a life-threatening aplastic crisis, and acutely infected pregnant women can transmit B19V to their unborn child, resulting in a hydrops fetalis and fetal death. However, in many adults, B19V infection goes unnoticed and thus many blood donors donate blood despite the infection. The B19V infection does not impair the blood cell counts in healthy blood donors, but after the acute infection with extremely high DNA concentrations exceeding 1010 IU B19V DNA/ml plasma is resolved, B19V DNA persists in the plasma of blood donors at low levels for several years. That way, many consecutive donations that contain B19V DNA can be taken from a single donor, but the majority of blood products from donors with detectable B19V DNA seem not to be infectious for the recipients from several reasons: first, many recipients had undergone a B19V infection in the past and have formed protective antibodies. Second, B19V DNA concentration in the blood product is often too low to infect the recipient. Third, after the acute infection, the presence of B19V DNA in the donor is accompanied by presumably neutralizing antibodies which are protective also for the recipient of his blood products. Thus, transfusion-transmitted (TT-) B19V infections are very rarely reported. Moreover, in most blood donors, B19V DNA concentration is below 1,000 IU/ml plasma, and no TT-B19V infections have been found by such low-viremic donations. Cutoff for an assay for B19V DNA blood donor screening should, therefore, be approximately 1,000 IU/ml plasma, if a general screening of blood donors for single donation blood components is considered at all: for the overwhelming majority of transfusion recipients, B19V infection is not relevant as well as for the blood donors. B19V DNA screening of vulnerable patients after transfusion seems to be a more reasonable approach than general blood donor screening.
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Affiliation(s)
- David Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Holger Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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10
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Nagaharu K, Sugimoto Y, Hoshi Y, Yamaguchi T, Ito R, Matsubayashi K, Kawakami K, Ohishi K. Persistent symptomatic parvovirus B19 infection with severe thrombocytopenia transmitted by red blood cell transfusion containing low parvovirus B19 DNA levels. Transfusion 2017; 57:1414-1418. [PMID: 28369973 DOI: 10.1111/trf.14088] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/29/2016] [Accepted: 01/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Transfusion-mediated human parvovirus B19 (PVB19) infection is rare but often causes severe hematologic disorders. In Japan, routine blood donor screening for PVB19 antigen (detection sensitivity, 106.4 IU/mL) using a chemiluminescent enzyme immunoassay (CLEIA) was introduced in 2008. However, there is no consensus on the minimal infectious dose of PVB19 permissible for red blood cells (RBCs). CASE REPORT A 64-year-old man, who had received hemodialysis for diabetic nephropathy for 5 years, underwent an RBC transfusion for anemia caused by hemorrhagic enterocolitis. He developed persistent high fever and progressive thrombocytopenia. He was diagnosed with PVB19 infection when a marrow examination showed giant erythroblasts, and his serum was positive for PVB19 DNA. His serum was negative for PVB19 immunoglobulin (Ig)M and IgG before transfusion, but positive for both after transfusion. This PVB19 infection was deemed to be transmitted by the RBC transfusion because low levels of PVB19 DNA (1.10 × 104 IU/mL) were detected in one of the blood donors. A DNA homology test of PVB19 showed complete genomic identity between the virus in the donor and our patient. CONCLUSION We report a patient who developed persistent PVB19 infection from an RBC transfusion containing low levels of PVB19. This is the second case of transfusion-mediated PVB19 infection since the introduction of CLEIA in 2008. Transmission may occur in immunocompromised patients lacking PVB19-neutralizing antibodies. The report of further such cases will allow the establishment of minimal threshold values and more effective screening tests for PBV19 transmission through RBC products.
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Affiliation(s)
- Keiki Nagaharu
- Department of Hematology and Oncology, Suzuka General Hospital, Suzuka, Mie Prefecture, Japan
| | - Yuka Sugimoto
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Mie Prefecture, Japan
| | - Yuji Hoshi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Takanori Yamaguchi
- Department of Hematology and Oncology, Suzuka General Hospital, Suzuka, Mie Prefecture, Japan
| | - Ryugo Ito
- Department of Hematology and Oncology, Suzuka General Hospital, Suzuka, Mie Prefecture, Japan
| | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Keiki Kawakami
- Department of Hematology and Oncology, Suzuka General Hospital, Suzuka, Mie Prefecture, Japan
| | - Kohshi Ohishi
- Blood Transfusion Service, Mie University Hospital, Tsu, Mie Prefecture, Japan
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11
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Abstract
Parvovirus B19 (B19V) and human bocavirus 1 (HBoV1), members of the large Parvoviridae family, are human pathogens responsible for a variety of diseases. For B19V in particular, host features determine disease manifestations. These viruses are prevalent worldwide and are culturable in vitro, and serological and molecular assays are available but require careful interpretation of results. Additional human parvoviruses, including HBoV2 to -4, human parvovirus 4 (PARV4), and human bufavirus (BuV) are also reviewed. The full spectrum of parvovirus disease in humans has yet to be established. Candidate recombinant B19V vaccines have been developed but may not be commercially feasible. We review relevant features of the molecular and cellular biology of these viruses, and the human immune response that they elicit, which have allowed a deep understanding of pathophysiology.
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Affiliation(s)
- Jianming Qiu
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Neal S Young
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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12
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Bouafsoun A, Hannachi N, Smaoui H, Boubaker SH, Kazdaghli K, Laabidi D, Boukadida J, Kechrid A. [Seroprevalence of human parvovirus B19 in children with fever and rash in the North of Tunisia]. ACTA ACUST UNITED AC 2016; 109:165-71. [PMID: 27385036 DOI: 10.1007/s13149-016-0502-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 04/12/2016] [Indexed: 01/30/2023]
Abstract
The aim of the study is to evaluate the prevalence of specific antibodies anti-human parvovirus B19 (PVB19) immunoglobulin M (IgM) and IgG in children with fever and rash. This study involved 257 children aged from 7 months to 15 years with febrile rash unrelated to measles and rubella (seronegative for IgM). The sera were examined by immunoenzymatic assay. Detection of antibodies of PVB19 was done by enzyme-linked immunosorbent assay (Elisa). In our study, prevalence of immunoglobulin G (IgG) and IgM were 44 and 11.3%, respectively. Clinically, children with positive IgM serology had submitted an erythema infectiosum (13/29 cases), myocarditis (1 case), encephalitis (1 case), severe sickle cell anemia (7 cases), and immunocompromised (7 cases). The incidence rate of viral infection was 11.3%; most of the cases of PVB19 infection occurred between the months of May and August. Incidence was higher in the 10-15 years age group (21%). The prevalence of IgG antibody varied and increased with age, it rises from 38.2% in preschool children (19 months-4 years) to 53.5% in those aged between 4.5 and 15 years, reaching 58% in the 10-15 years age group. The four risk factors of PVB19 infection are: (1) those aged between 4.5 and 9 years, which is the most affected age group (P = 0.0018); (2) female gender in children aged between 19 months and 4 years (P = 0.037); (3) transfusion and (4) immune deficiency (P = 0.022 and P = 0.001, respectively). The study of the prevalence of PVB19 infection shows that viral infection is acquired early in childhood, increases with age; viral transmission is favored by the community life. Because of the widespread vaccination program against measles and rubella, the systematic search of PVB19 in front of eruptive fevers becomes important.
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Affiliation(s)
- A Bouafsoun
- Unité de recherche UR12ES01, faculté de médecine de Tunis, université de Tunis El-Manar, Tunis, Tunisie. .,Service de microbiologie, hôpital d'enfants Béchir-Hamza, 1006 Bab-Saadoun, Tunis, Tunisie.
| | - N Hannachi
- Laboratoire de microbiologie, hôpital Farhat-Hached de Sousse, Sousse, Tunisie
| | - H Smaoui
- Unité de recherche UR12ES01, faculté de médecine de Tunis, université de Tunis El-Manar, Tunis, Tunisie.,Service de microbiologie, hôpital d'enfants Béchir-Hamza, 1006 Bab-Saadoun, Tunis, Tunisie
| | - S H Boubaker
- Unité de recherche UR12ES01, faculté de médecine de Tunis, université de Tunis El-Manar, Tunis, Tunisie.,Service de microbiologie, hôpital d'enfants Béchir-Hamza, 1006 Bab-Saadoun, Tunis, Tunisie
| | - K Kazdaghli
- Service de pédiatrie A, hôpital d'enfants Béchir-Hamza de Tunis, Tunis, Tunisie
| | - D Laabidi
- Unité de recherche UR12ES01, faculté de médecine de Tunis, université de Tunis El-Manar, Tunis, Tunisie.,Service de microbiologie, hôpital d'enfants Béchir-Hamza, 1006 Bab-Saadoun, Tunis, Tunisie
| | - J Boukadida
- Laboratoire de microbiologie, hôpital Farhat-Hached de Sousse, Sousse, Tunisie
| | - A Kechrid
- Unité de recherche UR12ES01, faculté de médecine de Tunis, université de Tunis El-Manar, Tunis, Tunisie.,Service de microbiologie, hôpital d'enfants Béchir-Hamza, 1006 Bab-Saadoun, Tunis, Tunisie
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13
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Jain A, Jain P, Prakash S, Kumar A, Khan DN, Seth A, Gupta S, Kant R. Genotype 3b of human parvovirus B19 detected from hospitalized children with solid malignancies in a North Indian tertiary care hospital. J Med Virol 2016; 88:1922-9. [PMID: 27116539 DOI: 10.1002/jmv.24560] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 11/07/2022]
Abstract
Human parvovirus B19 (B19V) infection is known to cause serious consequences in immuno-compromized individuals. The present cross sectional study was designed to estimate the prevalence and genotype distribution of B19V in children receiving chemotherapy for solid malignancies at a tertiary care hospital in North India during October 2013 to May 2015. Serum samples from all the patients were tested for anti-B19V IgM and IgG antibodies and for B19V-DNA as soon as received. Samples testing positive for B19V-DNA were subjected to viral load estimation and to genotype determination by sequencing. Total 96 children were enrolled of which 9 (9.3%), 32 (33.3%), and 25 (26%) tested positive for anti-B19V IgM, anti-B19V IgG, and B19V-DNA, respectively. The viral load of B19V-DNA positive children ranged from 5.5 × 10(2) to 3.5 × 10(12) copies/ml. Accordingly children were divided into three groups: group I, with acute infection (n = 25); group II, previously exposed (n = 27), and group III, negative for B19V infection or with inappropriate antibody response (n = 44). B19V positivity was significantly associated (P-value < 0.0001) with a history of blood transfusion in the past 6 months, severe anemia (hemoglobin levels <6 gm%) and thrombocytopenia (platelets <150,000/cu.mm.). Sequence analysis of 21 of 25 DNA positive samples showed that all of them were Genotype 3b that clustered into three groups. All the sequences within each cluster were identical. The nucleotide identity of the sequences suggests a nosocomial outbreak of B19V during the study period. Children on chemotherapy for solid tumors should be routinely screened for B19V infection by both serology and PCR. J. Med. Virol. 88:1922-1929, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Amita Jain
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Parul Jain
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Shantanu Prakash
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Archana Kumar
- Department of Pediatrics, King George's Medical University, Lucknow, India
| | - Danish N Khan
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Akansha Seth
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Shikha Gupta
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Ravi Kant
- Vice Chancellor, King George's Medical University, Lucknow, India
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Gowland P, Fontana S, Stolz M, Andina N, Niederhauser C. Parvovirus B19 Passive Transmission by Transfusion of Intercept® Blood System-Treated Platelet Concentrate. Transfus Med Hemother 2016; 43:198-202. [PMID: 27403092 DOI: 10.1159/000445195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/02/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pathogen reduction methods for blood components are effective for a large number of viruses though less against small, non-enveloped viruses such as Parvovirus B19 (B19V). This article describes the passive transmission by transfusion of two B19V-contaminated pooled platelet concentrates (PCs) which were treated with the Intercept® blood pathogen reduction system. CASE REPORTS Two transfusion cases of B19V-contaminated Intercept-treated pooled PCs were described. Due to the analysis delay, the PCs were already transfused. The viral content of each donation was 4.87 × 10(10) IU/ml in case 1and 1.46 × 10(8) IU/ml in case 2. B19V (52 IU/ml) was detected in the recipient of the case 1 PC, whereas no virus could be detected in the case 2 PC recipient. A B19V IgM response and a transient boost of the underlying B19V IgG immune status and was observed in recipient 1. Recipient of the case 2 PC remained B19V IgG- and IgM-negative. B19V DNA sequence and phylogenetic analysis revealed a 100% homology between donor and recipient. CONCLUSION This report describes passive B19V transmission by a PC with very high B19 viral load which elicited a transient boost of the B19V immunity, but not by a PC with a lower B19V content, suggesting that there is a B19 viral load threshold value at which B19V inactivation is exceeded.
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Affiliation(s)
- Peter Gowland
- Interregional Blood Transfusion SRC, Bern, Switzerland
| | | | - Martin Stolz
- Interregional Blood Transfusion SRC, Bern, Switzerland
| | - Nicola Andina
- University Clinic of Haematology and Central Haematology Laboratory, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland
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Antipova AY, Nikishov ON, Khamitova IV, Semenov AV, Bichurina MA, Kuzin AA, Lavrentieva IN. A SCREENING RESEARCH OF PLASMA BLOOD DONORS FOR MARKERS PARVOVIRUS INFECTION. ACTA ACUST UNITED AC 2015. [DOI: 10.15789/2220-7619-2015-2-171-174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Juhl D, Özdemir M, Dreier J, Görg S, Hennig H. Look-back study on recipients of Parvovirus B19 (B19V) DNA-positive blood components. Vox Sang 2015; 109:305-11. [PMID: 26053938 DOI: 10.1111/vox.12295] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/01/2015] [Accepted: 04/08/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES To assess the relevance of Parvovirus B19 (B19V) DNA at low to intermediate concentrations in blood donors for the recipients of their blood components. MATERIAL AND METHODS We studied recipients of B19V DNA-positive blood components [red blood cell concentrates (RBCs), pooled platelet concentrates and fresh frozen plasma]. This included archived pretransfusion samples as well as follow-up samples investigated by ELISA or NAT and genome sequence analysis. RESULTS In 132 out of 424 recipients, we could detect no anti-B19V IgG before transfusion. In 67 out of 132 sero-negative recipients, a follow-up sample was available. Sixty-five of these received blood components from donors with <10(4) IU B19V DNA/ml plasma and had no evidence of transfusion-transmitted (TT)-B19V infection. Homology in genome sequences in donor and recipient provided evidence for a TT-B19V infection in two recipients. Both patients received RBC containing 3.4 × 10(6) and 1.8 × 10(4) IU B19V DNA/ml plasma, respectively. The anti-B19V IgG titres in the donors were 2 and 76 IU/ml plasma, respectively. The antibodies in the second donor were directed against capsid proteins and are thus considered as potential neutralizing antibodies. CONCLUSIONS TT-B19V infections through blood components with low (<10(4) IU/ml plasma) B19V DNA concentrations did not occur in our study. One of the TT-B19V infections occurred from RBC with intermediate B19V DNA concentration despite the presence of potential neutralizing antibodies in the donor, but its clinical significance was low.
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Affiliation(s)
- D Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - M Özdemir
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - J Dreier
- Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany
| | - S Görg
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
| | - H Hennig
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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Bonjoch X, Obispo F, Alemany C, Pacha A, Rodríguez E, Xairó D. Characterization of Markers of the Progression of Human Parvovirus B19 Infection in Virus DNA-Positive Plasma Samples. Transfus Med Hemother 2015; 42:233-8. [PMID: 26557815 DOI: 10.1159/000381979] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 12/05/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Accurate characterization of the infection stage in parvovirus B19(B19V)-positive plasma donations would help establish the donation deferral period to contribute to a safe fractionation pool of plasma. METHODS Viral DNA load of 74 B19V DNA-positive plasma samples from whole blood donations was determined by titration using nucleic acid testing. Markers of cellular (neopterin) and humoral (B19V-specific IgM and IgG) immune response were determined by ELISA in 32 B19V DNA-positive samples and in 13 B19V DNA-negative samples. The infection progression profile was estimated according to B19V DNA load and the presence of immune response markers. RESULTS B19V DNA load in the 74 samples was 10(6)-10(13) IU/ml. The distribution of 14 out of 32 selected B19V DNA-positive samples plus 2 B19V DNA-negative samples with no immune response marker followed along an upward curve according to B19V DNA load. After the peak, the distribution of 18 immune marker-positive samples followed along a downward curve according to their B19V DNA load and was grouped as follows: neopterin (n = 4), neopterin+ IgM (n = 8), neopterin + IgM + IgG (n = 3), IgM + IgG (n = 2), IgM (n = 1). There were 11 B19V DNA-negative IgG-positive samples. CONCLUSION This study of B19V-DNA load and levels of neopterin, IgM, and IgG allows for reliable characterization and distribution into the different stages of B19V infection.
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Affiliation(s)
- Xavier Bonjoch
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
| | - Francesc Obispo
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
| | - Cristina Alemany
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
| | - Ana Pacha
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
| | - Esteban Rodríguez
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
| | - Dolors Xairó
- Analysis Division, Grifols, Biomat S.A., Parets del Vallès, Barcelona, Spain
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Affiliation(s)
- Radhika Dasararaju
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marisa B. Marques
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
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19
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Juhl D, Görg S, Hennig H. Persistence of Parvovirus B19 (B19V) DNA and humoral immune response in B19V-infected blood donors. Vox Sang 2014; 107:226-32. [PMID: 24916600 DOI: 10.1111/vox.12162] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/30/2014] [Accepted: 05/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parvovirus B19 (B19V) DNA seems to persist in the plasma of B19V-infected blood donors. The relevance of this for recipients of single-donor blood components is yet unclear. MATERIAL AND METHODS We studied serial archive and follow-up samples from 75 B19V-infected blood donors to obtain more data about the duration and degree of viraemia and the presence of IgG and IgM anti-B19V. IgG antibodies were further characterized by Western blot analysis in 29 donors. RESULTS In 411 B19V DNA-positive samples collected, we found high concentrations (>10(6) IU B19V DNA/ml plasma) in five. B19V DNA persisted for a mean of 21·5 months (range: 2·3-52·4; 95% confidence interval, 19·1-23·9 months) in all donors. Only 15 such samples had either no or low-titre IgG anti-B19V. IgG antibodies were predominantly directed against epitopes on the minor capsid protein VP1, thus probably of neutralizing type with high avidity. IgM anti-B19V was detectable in 9/13 samples with high DNA concentrations. CONCLUSIONS The vast majority of single-donor blood components with detectable B19V DNA are probably not infectious for their recipients because DNA is at only low levels and the donors also have potentially neutralizing antibodies with high avidity. Anti-B19V IgM testing does not identify every donation with high B19V DNA concentrations, but, in addition to B19V NAT testing, donors with persistent IgG anti-B19V might be considered 'B19V-safe' for single-donor blood components.
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Affiliation(s)
- D Juhl
- Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany
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20
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A serious parvovirus B19 genotype 2 infection not detected in a commercial PCR assay. J Clin Virol 2014; 60:70-2. [PMID: 24589313 DOI: 10.1016/j.jcv.2014.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 01/01/2014] [Accepted: 01/17/2014] [Indexed: 11/23/2022]
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21
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Sakata H, Matsubayashi K, Ihara H, Sato S, Kato T, Wakisaka A, Tadokoro K, Yu MYW, Baylis SA, Ikeda H, Takamoto S. Impact of chemiluminescent enzyme immunoassay screening for human parvovirus B19 antigen in Japanese blood donors. Transfusion 2013; 53:2556-66. [DOI: 10.1111/j.1537-2995.2012.03949.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 09/18/2012] [Accepted: 09/18/2012] [Indexed: 12/26/2022]
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22
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Stramer SL, Dodd RY. Transfusion-transmitted emerging infectious diseases: 30 years of challenges and progress. Transfusion 2013; 53:2375-83. [PMID: 23926897 PMCID: PMC7169683 DOI: 10.1111/trf.12371] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/07/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Susan L. Stramer
- Biomedical Services, Scientific Support OfficeAmerican Red CrossGaithersburgMaryland
| | - Roger Y. Dodd
- American Red Cross Holland LaboratoryRockvilleMaryland
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23
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Abstract
Parvovirus B19 is a widespread human pathogenic virus, member of the Erythrovirus genus in the Parvoviridae family. Infection can be associated with an ample range of pathologies and clinical manifestations, whose characteristics and outcomes depend on the interplay between the pathogenetic potential of the virus, its adaptation to different cellular environments, and the physiological and immune status of the infected individuals. The scope of this review is the advances in knowledge on the biological characteristics of the virus and of virus-host relationships; in particular, the interactions of the virus with different cellular environments in terms of tropism and ability to achieve a productive replicative cycle, or, on the contrary, to establish persistence; the consequences of infection in terms of interference with the cell physiology; the process of recognition of the virus by the innate or adaptive immune system, hence the role of the immune system in controlling the infection or in the development of clinical manifestations. Linked to these issues is the continuous effort to develop better diagnostic algorithms and methods and the need for development of prophylactic and therapeutic options for B19V infections.
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Affiliation(s)
- Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, and Microbiology, S.Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
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24
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Alternative blood products and clinical needs in transfusion medicine. Stem Cells Int 2012; 2012:639561. [PMID: 22567025 PMCID: PMC3337502 DOI: 10.1155/2012/639561] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 12/30/2011] [Indexed: 01/19/2023] Open
Abstract
The primary focus of national blood programs is the provision of a safe and adequate blood supply. This goal is dependent on regular voluntary donations and a regulatory infrastructure that establishes and enforces standards for blood safety. Progress in ex vivo expansion of blood cells from cell sources including peripheral blood, cord blood, induced pluripotent stem cells, and human embryonic stem cell lines will likely make alternative transfusion products available for clinical use in the near future. Initially, alloimmunized patients and individuals with rare blood types are most likely to benefit from alternative products. However, in developed nations voluntary blood donations are projected to be inadequate in the future as blood usage by individuals 60 years and older increases. In developing nations economic and political challenges may impede progress in attaining self-sufficiency. Under these circumstances, ex vivo generated red cells may be needed to supplement the general blood supply.
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Kishore J, Srivastava M, Choudhury N. Serological study on parvovirus B19 infection in multitransfused thalassemia major patients and its transmission through donor units. Asian J Transfus Sci 2011; 5:140-3. [PMID: 21897592 PMCID: PMC3159243 DOI: 10.4103/0973-6247.83239] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Human parvovirus B19 (B19) virus is a newly recognized agent for transfusion transmitted diseases. Beta-thalassemia major patients receive a hypertransfusion regimen, hence, are prone to acquire B19 infection; moreover, B19 escapes viral inactivation methods and donor units are not tested for B19, but there are just a couple of studies globally and none from the Asian continent. Hence, a study was designed to find the frequency of B19 infection and its transmission in multitransfused thalassemia patients. Materials and Methods: Ninety multitransfused beta-thalassemia major (thalassemia) patients, 32 controls (age, sex matched) without any history of transfusion were enrolled. Besides the donor units were tested in B19 un-infected patients. B19 specific IgG and IgM antibodies in the sera were analyzed by ELISA (in-house), using B19 VPI and VP2 recombinant and purified antigens; additionally HBsAg and anti-HIV and anti-HCV antibodies were tested for coexisting infections. Results: Seventy-three (81%) thalassemia patients tested positive for anti-B19 IgG antibodies as compared to seven (21%) in the controls group (P < 0.01), while anti-B19 IgM antibodies were detected in 37 (41.1%) compared to two (6.2%) in the controls (P < 0.01). Mean age of the thalassemia patient was eight years (range 2 – 18 years) and B19 infection was highest in the six-to-ten year range. Seropositivity increased with the number of transfusions. Two of the four HBsAg positive and five of the seven anti-HCV IgM antibody-positive patients also had anti-B19 IgM. After a six-month follow-up, four (25%) of the 16 seronegative patients seroconverted and anti-B19 IgM antibodies were detected in their donor units. Conclusions: Most of multitransfused thalassemics were B19 seropositive or had anti-B19 IgM; in the remaining uninfected group, B19 got transmitted through infected / IgM-positive donor units.
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Affiliation(s)
- Janak Kishore
- Departments of Microbiology and Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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27
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Lee TH, Kleinman SH, Wen L, Montalvo L, Todd DS, Wright DJ, Tobler LH, Busch MP. Distribution of parvovirus B19 DNA in blood compartments and persistence of virus in blood donors. Transfusion 2011; 51:1896-908. [PMID: 21303368 PMCID: PMC3591477 DOI: 10.1111/j.1537-2995.2010.03035.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Because the receptor for parvovirus B19 (B19V) is on red blood cells (RBCs), we investigated B19V distribution in blood by in vitro spiking experiments and evaluated viral compartmentalization and persistence in natural infection. STUDY DESIGN AND METHODS Two whole blood (WB) protocols (ultracentrifugation and a rapid RBC lysis and removal protocol) were evaluated using quantitative real-time polymerase chain reaction. WB was spiked with known concentrations of B19V and recovery in various blood fractions was determined. The rapid RBC lysis and removal protocol was then used to compare B19V concentrations in 104 paired WB and plasma samples collected longitudinally from 43 B19V-infected donors with frozen specimens in the REDS Allogeneic Donor and Recipient Repository (RADAR). RESULTS In B19V spiking experiments, approximately one-third of viral DNA was recovered in plasma and two-thirds was loosely bound to RBCs. In the immunoglobulin (Ig)M-positive stage of infection in blood donors when plasma B19V DNA concentrations were greater than 100 IU/mL, median DNA concentrations were approximately 30-fold higher in WB than in plasma. In contrast, when IgM was absent and when the B19V DNA concentration was lower, the median WB-to-plasma ratio was approximately 1. Analysis of longitudinal samples demonstrated persistent detection of B19V in WB but declining ratios of WB to plasma B19V with declining plasma viral load levels and loss of IgM reactivity. CONCLUSIONS The WB-to-plasma B19V DNA ratio varies by stage of infection, with 30-fold higher concentrations of B19V DNA in WB relative to plasma during the IgM-positive stage of infection followed by comparable levels during persistent infection when only IgG is present. Further study is required to determine if this is related to the presence of circulating DNA-positive RBCs derived from B19V-infected erythroblasts, B19V-specific IgM-mediated binding of virus to cells, or other factors.
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Affiliation(s)
| | - Steven H. Kleinman
- Westat, Rockville, MD
- University of British Columbia Vancouver, BC, Canada
| | - Li Wen
- Blood Systems Research Institute, San Francisco, CA
| | | | | | | | | | - Michael P. Busch
- Blood Systems Research Institute, San Francisco, CA
- University of California, San Francisco, CA
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Slavov SN, Kashima S, Pinto ACS, Covas DT. Human parvovirus B19: general considerations and impact on patients with sickle-cell disease and thalassemia and on blood transfusions. ACTA ACUST UNITED AC 2011; 62:247-62. [DOI: 10.1111/j.1574-695x.2011.00819.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
PURPOSE OF REVIEW As clinical trials are in progress involving porcine islet cell transplantation, microbial safety remains a key issue. Therefore, in the context of pig-to-human xenotransplantation, we provide an overview of the recent progress in the studies of relevant viruses including well known problematic viruses, such as herpesviruses and porcine endogenous retroviruses (PERV) in addition to some emerging issues regarding other pathogens. RECENT FINDINGS The ability of herpesvirus to infect across species barriers is probably underestimated and requires monitoring and control of both xenograft donors and recipients for latent infection. Exclusion from donors and recipient monitoring for other exogenous pathogens including newly identified Parvovirus-4 are warranted. The availability of the swine whole genome sequence may help to characterize and select donor animals with less PERV infectivity. Rigorous PERV monitoring in both clinical and preclinical xenotransplantation experiments must be included in clinical protocols. SUMMARY A wide range of pathogens, both viruses and bacteria, pose potential safety problems in xenotransplantation, highlighting the importance of prescreening of the donor animals, and careful monitoring and follow-up of the patients.
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Fasano C, Kanduc D. Selfness-nonselfness in designing an anti-B19 erythrovirus vaccine. SELF/NONSELF 2011; 2:114-119. [PMID: 22299063 PMCID: PMC3268997 DOI: 10.4161/self.2.2.16190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 06/14/2011] [Accepted: 06/15/2011] [Indexed: 11/19/2022]
Abstract
Although B19 erythrovirus infection may be associated with severe clinical outcomes, especially in early infancy, pregnancy and in immunocompromised or hemolytic subjects, no vaccine is currently available. Using the concept that effective immune responses to an infectious agent may be restricted to the specific peptidome unique to that agent, we analyzed primary amino acid sequence of B19 erythrovirus, searching for peptide motifs to be used in vaccine formulations. Here, we identify and describe a set of unique viral peptides that may guarantee both high efficacy and practically no cross-reactive autoimmune responses in anti-B19 immunotherapeutic approaches.
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Affiliation(s)
- Candida Fasano
- Department of Biochemistry and Molecular Biology; University of Bari; Bari, Italy
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Satake M, Hoshi Y, Taira R, Momose SY, Hino S, Tadokoro K. Symptomatic parvovirus B19 infection caused by blood component transfusion. Transfusion 2011; 51:1887-95. [PMID: 21332725 DOI: 10.1111/j.1537-2995.2010.03047.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although a risk of transfusion-transmitted human parvovirus B19V (TT-B19V) infection has been a concern, there have been very few reports of clinically relevant TT-B19V caused by the transfusion of a B19V-containing blood component. It has therefore been a matter of debate whether a universal B19V screening with an appropriate sensitivity is required. STUDY DESIGN AND METHODS Through the Japanese Red Cross hemovigilance system, clinical reports on possible TT-B19V were collected from 1999 to 2008, during which B19V donor screening (sensitivity, 10(10) IU/mL) was conducted and repository blood samples from donors were available. RESULTS Eight patients with TT-B19V caused by component transfusion have been identified. Four patients developed sustained anemia and pure red blood cell (RBC) aplasia and one patient developed pancytopenia. The underlying diseases in these five patients were either hematologic malignancy or hemolytic diseases. The viral loads of the responsible components for these cases ranged from 10(3) to 10(8) IU/mL. Two patients who underwent surgical treatment without any hematologic disorder exhibited only moderate symptoms. The B19V DNA sequence identity between a patient and the linked blood donor was confirmed in five of the eight patients. All of the components responsible for the eight cases were positive for anti-B19V immunoglobulin (Ig)M. CONCLUSION Vulnerability to serious B19V-related hematologic disorders depended on the patient's underlying disease state of an enhanced erythropoiesis, not on the viral load of the component transfused. To prevent clinically relevant TT-B19V, a strategy is suggested in which patients at risk of acquiring RBC aplasia or pancytopenia are targeted.
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Kooistra K, Mesman HJ, de Waal M, Koppelman MHGM, Zaaijer HL. Epidemiology of high-level parvovirus B19 viraemia among Dutch blood donors, 2003-2009. Vox Sang 2010; 100:261-6. [DOI: 10.1111/j.1423-0410.2010.01423.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Servant-Delmas A, Laperche S, Mercier M, Michel Y, Garbarg-Chenon A, Boyeldieu D, Pelissier E, Lefrère JJ. Limits of sequencing and phylogenetic analysis to assess B19V transmission by single-donor blood component. Vox Sang 2010; 100:254-5. [PMID: 20735810 DOI: 10.1111/j.1423-0410.2010.01390.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Reinheimer C, Allwinn R, Doerr HW, Wittek M. Seroepidemiology of parvovirus B19 in the Frankfurt am Main area, Germany: evaluation of risk factors. Infection 2010; 38:381-5. [PMID: 20556472 DOI: 10.1007/s15010-010-0035-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 05/25/2010] [Indexed: 10/19/2022]
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