Risk factors and long-term outcomes of parvovirus B19 infection in kidney transplant patients.

Abstract

Parvovirus B19 is a small, non-enveloped, single-stranded DNA virus with a special affinity for the erythroid progenitor cells of the bone marrow. The first case of parvovirus B19 infection in a kidney transplant recipient (KTR) was reported in 1986. Data on the risk factors and specific clinical characteristics of parvovirus B19 infection remain insufficient. We screened 602 KTRs for parvovirus B19 infection using parvovirus B19 polymerase chain reaction (PCR) from January 1990 to April 2016, and the clinical characteristics of patients with positive results were compared to those of age- and gender-matched patients with negative PCR results. A total of 39 KTRs tested positive for parvovirus B19, and they were compared to 78 age- and gender-matched patients among 563 KTRs who had negative PCR results. In all, 89.7% of positive cases were reported within the first year after kidney transplantation. In multivariate analyses, deceased-donor kidney transplantation (odds ratio [OR] 9.067, 95% confidence interval [CI] 1.668-49.275, P=.011), use of tacrolimus (OR 3.607, 95% CI 1.024-12.706, P=.046), PCR test within 1year of kidney transplantation (OR 12.456, 95% CI 2.674-58.036, P=.001), and hemoglobin levels (OR 0.559, 95% CI 0.351-0.889, P=.014) showed significant correlations with parvovirus B19 infection. Graft survival did not differ between the two groups during the follow-up period of 111.68±54.54months (P=.685 by log-rank test). The identification of factors related to positive parvovirus B19 PCR results may promote the early detection of parvovirus B19 infection. Further studies are needed to elucidate the characteristics of parvovirus B19 infection in kidney transplantation.