Parvovirus B19 Infection and Severe Anemia in Renal Transplant Recipients

Antonio Carraturo,Donatella Ottaviani,Brunello Biondi,Patrizia Menichelli,Maurizio Rossini,Valentina Catalani,Delia Terella

doi:10.1100/2012/102829

Abstract

Kidney transplant (KT) recipients can develop symptomatic Parvovirus (PV) B19 infections, frequently associated with persistent anemia. The aim of this study was to evaluate the prevalence and clinical significance of PV B19 infection in anemic and non-anemic KT patients. Overall, out of 64 patients monitored for the presence of PV B19 by real-time PCR, 2 (3.12%) had an active PV B19 infection, in absence of other viral coinfections. The 2 cases occurred in nonanemic kidney transplant patients group (2/50, 4%), while none of the anemic transplant patients (0/14) was found to suffer from this infection. Moreover, patients affected by active PV B19 infection showed viral loads not exceeding 1 × 105 genome copies/reaction. In conclusion, in this study, PV B19 infection was not common in renal transplant population and wasn't associated with severe anemia.

Highlights

Anemia is a frequent problem after renal transplantation: up to 39% of kidney transplant (KT) recipients suffer from chronic anemia and, of these patients, 9% suffer from a severe form, characterized by hemoglobin levels ≤11 g/dL for males and ≤10 g/dL for females [1, 2]
We evaluated the prevalence and clinical significance of Parvovirus B19 infection in anemic and nonanemic patients who had received a renal transplant for at least 6 months
For Polyomavirus JC/BK, Epstein-Barr virus (EBV), and Herpes simplex virus type 1 and type 2 (HSV) detection and quantification, viral DNA was extracted by the automated MagNA Pure LC system (Roche Diagnostics) according to the manufacturer’s instructions and the real-time PCR reactions were performed on the LightCycler instrument using LightMix Kit Polyomaviruses JC and BK (TIB MOLBIOL, Berlin, Germany), LightCycler EBV Quantification Kit (Roche Diagnostics), and LightCycler HSV 1/2 Detection Kit (Roche Diagnostics), respectively

Summary

Introduction

Anemia is a frequent problem after renal transplantation: up to 39% of kidney transplant (KT) recipients suffer from chronic anemia and, of these patients, 9% suffer from a severe form, characterized by hemoglobin levels ≤11 g/dL for males and ≤10 g/dL for females [1, 2]. Many evidence suggests that the anemic state in transplant recipients can be caused by Parvovirus (PV) B19 infection [3, 4]. Discovered in 1975, PV B19 is a small, nonenveloped, singlestranded DNA virus belonging to the Parvoviridae family [5]. This is a common pathogen in humans, and the expression of the infection depends on the host’s hematological and immunologic status. In immunosuppressed patients, including organ transplant recipients, B19 virus can persist for years due to impairment of the neutralizing antibody response and/or cellular immunity and it may be associated with chronic clinical manifestations, such as anemia and other cytopenias [3, 4]

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