Effects of transfusion on human erythrovirus B19‐susceptible or ‐infected pediatric recipients in a genotype 3–endemic area

Abstract

Human erythrovirus (parvovirus) B19 is transmitted by transfusion of blood, blood components, and plasma derivatives and is resistant to most viral inactivation methods. B19 genotype 3 is prevalent in Ghana, and no related clinical information is available. This study assessed the transmission of B19 genotype 3 by transfusion and the potential effect of transfused B19 antibodies in viremic recipients. Immunological aspects of B19 genotype 3 infection in children mainly transfused for acute malarial anemia were examined. Molecular and serologic methods adapted to genotype 3 were developed and used. Among 114 donor-recipient pairs from Ghana, two donations contained B19 DNA and specific antibodies, and no evidence of transmission was found. B19 immunoglobulin G (IgG)-containing whole blood was transfused to 14 B19 DNA-positive recipients. Three recipients with detectable levels of IgG to B19 failed to clear viremia 1 to 2.3 months after transfusion. Ten recipients without IgG to VP2 before transfusion cleared the virus but failed to develop an immune response to B19 within 1 to 2 months after transfusion. Only 1 patient who received little specific IgG by transfusion produced detectable antibodies. Low levels of B19 genotype 3 DNA associated with specific IgG are not infectious by transfusion. Viral clearance and apparent down regulation of immune response to B19 may be related to removal of the viral antigens by transfused antibodies and/or immunomodulatory effect of transfusion.