Seroinfection of Antibodies to Toxoplasma gondii, Parvovirus B19, Treponema pallidum, and HIV in a Pregnant Attending a Medical Center in Northern Peru.

Parvovirus B19 in Solid Organ Transplant Recipients

Increased prevalence of parvovirus B19 infection among pregnant women in central Italy and genomic analysis.

Human Parvovirus B19

OBJECTIVE: The goal of this study was to modify and optimize the screening and diagnostic procedures of unexplained recurrent abortion. Antithyroid antibodies, parvovirus B19 (B19V) and cytomegalovirus (CMV) infections, which were usually overlooked in clinical practice of handling cases of recurrent abortion, were studied to evaluate their role in the pathogenesis of recurrent first trimester abortion. Also , we tried to elucidate the importance of detection of these agents and whether it should be routine prenatal investigations of women with unexplained recurrent abortion. STUDY DESIGN: sixty women with unexplained recurrent first trimester abortion were the study group and thirty term healthy pregnant women, were selected as a control. Placental and fetal tissues were analyzed for B19V and CMV deoxyribonucleic acids using nested polymerase chain reaction (PCR) assay. Also sera were analyzed for T3, T4 and TSH levels, the presence of antithyroid antibodies (thyroglobulin and thyroid peroxidase), CMV specific IgM antibodies and parvovirus B19-DNA by dot blot hybridization assay. RESULTS: Parvovirus B19-DNA was demonstrated in nearly one third of the aborted products (19/60 - 31.67 %) and 6.67% of the placentas of the control group, that represent highly significant difference (P 0.05). In contrast, only 5 aborting women (8.33 %) and a woman of the control group (3.33%) were CMV-IgM seropositive, that also represent non significant changes (P > 0.05). Antithyroglobulin antibody levels were significantly higher in aborting women (7/60) than control (P 0.05). We did not find any significant relation between thyroid autoimmunity and viral infections (B19V & CMV) in women with unexplained recurrent first trimester miscarriage. CONCLUSION: Parvovirus B19 infection was found to be an important pathogenic agent in recurrent first trimester abortion. It is essential to investigate for B19Vinfection among pregnant women with recurrent abortion. This significant finding demonstrates the usefulness of a sensitive molecular tool, PCR assay of viral DNA to aid in the diagnosis. However, testing for cytomegalovirus infection and antithyroid antibodies are not essential as routine prenatal investigations and should be restricted to certain patients with unexplained recurrent pregnancy loss.

OBJECTIVE: The goal of this study was to modify and optimize the screening and diagnostic procedures of unexplained recurrent abortion. Antithyroid antibodies, parvovirus B19 (B19V) and cytomegalovirus (CMV) infections, which were usually overlooked in clinical practice of handling cases of recurrent abortion, were studied to evaluate their role in the pathogenesis of recurrent first trimester abortion. Also , we tried to elucidate the importance of detection of these agents and whether it should be routine prenatal investigations of women with unexplained recurrent abortion. STUDY DESIGN: sixty women with unexplained recurrent first trimester abortion were the study group and thirty term healthy pregnant women, were selected as a control. Placental and fetal tissues were analyzed for B19V and CMV deoxyribonucleic acids using nested polymerase chain reaction (PCR) assay. Also sera were analyzed for T3, T4 and TSH levels, the presence of antithyroid antibodies (thyroglobulin and thyroid peroxidase), CMV specific IgM antibodies and parvovirus B19-DNA by dot blot hybridization assay. RESULTS: Parvovirus B19-DNA was demonstrated in nearly one third of the aborted products (19/60 - 31.67 %) and 6.67% of the placentas of the control group, that represent highly significant difference (P 0.05). In contrast, only 5 aborting women (8.33 %) and a woman of the control group (3.33%) were CMV-IgM seropositive, that also represent non significant changes (P > 0.05). Antithyroglobulin antibody levels were significantly higher in aborting women (7/60) than control (P 0.05). We did not find any significant relation between thyroid autoimmunity and viral infections (B19V & CMV) in women with unexplained recurrent first trimester miscarriage. CONCLUSION: Parvovirus B19 infection was found to be an important pathogenic agent in recurrent first trimester abortion. It is essential to investigate for B19Vinfection among pregnant women with recurrent abortion. This significant finding demonstrates the usefulness of a sensitive molecular tool, PCR assay of viral DNA to aid in the diagnosis. However, testing for cytomegalovirus infection and antithyroid antibodies are not essential as routine prenatal investigations and should be restricted to certain patients with unexplained recurrent pregnancy loss.

Congenital anemia caused by parvovirus B19 infection.

Human parvovirus B19 causes a wide range of complications in pregnant women including abortion, severe fetal anemia, non-immune hydrops fetalis, and even intrauterine fetal death. However, there is a dearth of information on the prevalence of the virus among pregnant women in southwestern Nigeria. Blood samples were collected from 231 pregnant women and screened for antibodies to human parvovirus B19 IgM and IgG using an enzyme immunosorbent assay kits. Of the 231 women, 31 were in their first trimester, 146 were in their second trimester, and 54 were in their third trimester. Forty-five (20%) were positive for parvovirus B19 IgG antibodies, 10 (4%) were positive for parvovirus B19 IgM antibodies, and 176 (76%) had no detectable parvovirus B19 antibodies. Twenty-eight (19%) of the 146 pregnant women in their second trimester were positive for parvovirus B19 IgG antibody while three (2%) of the 146 were positive for parvovirus B19 IgM antibody. It is evident that there is a high prevalence of human parvovirus B19 among pregnant women in south-western Nigeria. This suggests that there is an active transmission of the virus in the community; it is therefore necessary to conduct more studies on the virus in pregnant women in Nigeria to ascertain its effect on the fetus.

Introduction B19 virus (B19V) and bocavirus 1 (HBoV1) are human pathogenic parvoviruses that are prevalent worldwide and are responsible for a diverse and not yet fully established spectrum of clinical manifestations.Objective To screen B19V and HBoV1 in patients with clinical manifestations associated with acquisition of the infection during gestation.Methods A retrospective, observational study was performed that included serum samples from patients without a previous known aetiology. B19V and HBoV1 were determined by end-point PCR. Positive samples were genotyped.Results A total of 106 serum samples were analysed, 61 from pregnant women and 45 from neonates and paediatric patients. None were positive for HBoV1, while B19V was detected in 37/106 [34.9 %, 95 % confidence interval (CI): 26.5–44.4] of the samples studied. In the group of pregnant women, 28/61 (45.9 %, 95 % CI: 34.0–58.3) were B19V-positive, and 2 of them had foetal anaemia followed by hydrops and foetal death, 3 were associated with a history of recurrent pregnancy loss and there was 1 case of spontaneous abortion. B19V was also detected in cases of maternal febrile exanthema, polyhydramnios, oligohydramnios and foetal ascites. In the group of children, 9/45 (20.0 %, 95 % CI: 10.9–33.8) neonatal patients were B19V-positive, and this was associated with foetal hydrops, TORCH syndrome and cardiac alterations. The nucleotide sequences analysed confirmed the identity of B19V genotype 1.Conclusions We found no evidence to indicate the presence of HBoV1 in maternal blood or in the newborns/paediatric patients (hence providing no support for the supposed vertical transmission). On the other hand, the high frequency of B19V in the pathologies studied indicates the importance of molecular diagnosis in both the mother and the child. Future efforts should contribute to early detection and characterization of infections.

To estimate the incidence of human parvovirus B19 among pregnant women before and during an epidemic, to elucidate possible sociodemographic and medical risk factors during pregnancy and to estimate the association between parvovirus B19 infection and negative pregnancy outcome. Prospective study among pregnant women followed from their first antenatal visit before 24 full weeks of gestation until delivery. Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark, November 1992 to February 1994. 3,596 pregnant women were invited to participate. The women were examined at first antenatal visit in the period from November 1992 to February 1994 and at delivery. The last delivery was in August 1994 and samples were thus collected before and during a large parvovirus B19 epidemic in Denmark January to September 1994. A blood sample for parvovirus B19 serology was taken at enrollment and from the umbilical cord at delivery. Three questionnaires were completed during 2nd and 3rd trimesters and a registration form at delivery. In total, 3,174 (87.6%) were enrolled and 79.5% completed the study. The prevalence of B19 IgG seropositivity at the first antenatal visit before 24 full weeks of gestation was 66% . The cumulative prevalence proportion of acute parvovirus B19 infection during pregnancy among IgG negative women was found to be 10.3% (IgM seropositivity and/or IgG seroconversion). The IgG seroconversion incidence increased significantly from 1.0% to 13.5% among 932 seronegative pregnant women before and during the epidemic, respectively (P < 0.001). Independent risk factors related to increased risk of B19 infection during pregnancy, adjusted for other sociodemographic and medical factors, were: children at home (adjusted OR 2.1, 95% CI 1.3-3.2); serious medical disease (adjusted OR 3.0, 95% CI 1.0-8.5); and a stressful job (adjusted OR 1.8, 95% CI 1.0-3.3). Parvovirus B 19 IgM seropositivity was associated with events of late spontaneous abortions and stillbirths (crude OR 9.9; 95% CI 3.3-29.4). Before and during an epidemic of acute B19 infection incidences were measured among pregnant women to be 1.0% and 13.5%, respectively. Three factors, significantly increasing the risk of acute B19, were identified as: having children at home; suffering from serious medical diseases; and having a stressful job. IgM positivity for parvovirus B19 was associated with negative outcome of pregnancy.

The incidence of human parvovirus B19 infection is unknown. A retrospective analysis of clinical and laboratory findings was carried out in patients diagnosed with human parvovirus B19 infection in 2011 in a virologic laboratory of a single centre in Hungary. Clinical and laboratory data of patients with proven human parvovirus B19 infection were analysed using in- and out-patient files. In 2011, 72 patients proved to have human parvovirus B19 infection with the use of enzyme immunoassay. The clinical diagnoses of these patients were as follows: human parvovirus B19 infection (30.6%), transient aplastic crisis (16.7%), arthritis (8.3%) and acute hepatitis (4.1%). Symptoms of each of the four phases of the infection occurred in various combinations with the exception of the monophase of cheek exanthema. This occurred without the presence of other symptoms in some cases. Leading symptoms and signs were exanthema (in 74.6% of cases), haematological disorders (in 69% of cases), fever (in 54.9% of cases) and arthritis (in 33.8% of cases). Several atypical dermatological symptoms were also observed. Acute arthritis without exanthema was noted in 8 patients. Of the 72 patients with proven human parvovirus B19 infection there were 7 pregnant women, and one of them had hydrops foetalis resulting spontaneous abortion. In 16 patients (22.5%) human parvovirus B19 IgG was undetectable despite an optimal time for testing. The observations of this study may contribute to a better recognition of clinical symptoms of human parvovirus B19 infection.

Parvovirus B19 has been associated by some investigators with cases of severe hepatitis. The aim of the present study was to determine the presence of active parvovirus B19 infection among 129 Brazilian patients with non-A-E hepatitis. The patients were assayed for antibodies against parvovirus B19, IgM class, by ELISA. In IgM-positive cases, parvovirus B19 DNA was assayed by PCR in serum and liver tissue and parvovirus VP1 antigen in liver tissue was assayed by immunohistochemistry. Antibodies against parvovirus B19, IgM class, were detected in 3 (2.3%) of 129 patients with non-A-E hepatitis. Previous surgery and blood transfusions were reported by these 3 patients. One patient was a 56-year-old female with severe hepatitis, with antimitochondrial antibody seropositivity and submassive necrosis at liver biopsy, who responded to corticosteroid therapy. Strong evidence for active parvovirus B19 infection was found in this patient, with parvovirus B19 DNA being detected by PCR in liver tissue. Furthermore, parvovirus VP1 antigen was also detected in liver tissue by immunohistochemistry. The other two IgM-positive patients were chronic hepatitis cases, but active infection was not proven, since neither viral DNA nor antigen were detected in their liver tissues. This and other reports suggest a possible relation between parvovirus B19 infection and some cases of hepatitis.

TB prevention strategies and unanswered questions for pregnant and postpartum women living with HIV: the need for improved evidence.

ObjectivesImplemented public health measures to avoid the spread of SARS-CoV-2, influenced the circulation of various viral infections including parvovirus B19. Notably, pregnancies affected by parvovirus B19 have a high risk for severe fetal anemia and fetal demise. This study evaluates changes in parvovirus infection rates after the SARS-CoV-2 pandemic.MethodsThis was a retrospective cohort-study assessing the prevalence of parvovirus B19 among pregnant women at a tertiary referral center in Austria from January 2013 to December 2023 with particular interest in the influence of the COVID-19 pandemic on infection rates of parvovirus B19. Women who had PCR testing for parvovirus due to suspicion of infection were included in this study. To compare infection rates before, during, and after the pandemic, three study groups were defined in concordance with Austrian public health measures: A pre-pandemic group (Group 1) including all pregnant women who tested for parvovirus B19 from January 2013 to the beginning of the COVID-19 lockdown in March 2020, a pandemic group (Group 2) including all patients who had PCR testing during the COVID-19 lockdown and a post-pandemic group (Group 3) including all patients who had PCR testing from the end of the pandemic in April 2023 to December 2023.ResultsA total of 251 pregnant women who had PCR testing for parvovirus B19 during the study period were identified, including 27 women with a positive test result. In the pre-pandemic group (n = 141) 14 women had a positive test result, in the pandemic group (n = 83) 3 women tested positive and in the post-pandemic group (n = 27) 10 women tested positive. The overall prevalence of parvovirus B19 was 0.108, and annually, it varies from 0.000 in 2021 to 0.355 in 2023. Considering the predefined study groups, the highest prevalence was demonstrated in the post-pandemic group (0.370), whereas the lowest was in the pandemic group (0.036). In the pre-pandemic group, the prevalence was 0.099. Prevalence of the predefined study groups differed significantly (p ≤ 0.001).ConclusionThis study demonstrates a significant rise of parvovirus B19 infections among pregnant women after the COVID-19 pandemic indicating a major impact of the pandemic and associated public health measures on parvovirus B19 infection rates.

Background: Parvovirus B19 infection causes a wide range of complication in pregnant women including spontaneous abortion, severe fetal anaemia, non-immune hydrops fetalis and even intrauterine fetal death, erythema infectiosum (5th) disease and aplastic crisis. Objective: To perform molecular detection of human Parvovirus B19 among pregnant women attending antenatal clinic in Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria. Materials and Methods: This is a cross-sectional study conducted among 92 consented pregnant women, between the ages of 20-40 years who are attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital Anambra State, Nigeria, from May 2020-November 2020. A total of 92 blood specimen was collected from the pregnant women. Result: Out of the 20 IgM positive samples analyzed for Parvovirus B19 DNA, 13(65.0%) had Parvovirus B19 DNA and 7(35.0%) were negative for Parvovirus B19 DNA. Prevalence of Parvovirus B19 DNA in relation to gestational age was highest (69.2%) among pregnant women who were in their 2nd trimester and the prevalence was lowest (0.0%) among pregnant women who were in their 3rd trimester. Prevalence of Parvovirus B19 in relation to history of blood transfusion was highest (100.0%) among pregnant women who have had transfusion history and the prevalence was lowest (0.0%) among pregnant women who had no transfusion history. Conclusion: The frequency rate of Parvovirus B19 DNA seropostivity was highest (65.0%) among the pregnant women investigated. The association of Parvovirus B19 DNA seroposivity with gestation age and history of blood transfusion was statistically significant.

The frequency of fetopathogenic viruses and Toxoplasma gondii infections in the TORCH group (Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex virus) together with Parvovirus B19 (B19) in pregnant women with bad obstetric history (BOH) and/or concurrent pregnancy complications was investigated. Sixty women (20-35 years) with BOH and/or antecedent pregnancy complications were studied. Twenty-nine healthy pregnant women matched for age, parity and gestational age served as controls. Sera were analyzed for IgM antibodies for B19 and TORCH agents by ELISA. Cord blood and 33 placental tissues from six malformed newborns were tested for B19 DNA by PCR. Out of 60 high-risk pregnant women, 47 (78%) had BOH while 23 (38.3%) had underlying complications including polyhydramnios (n=10), oligohydramnios (n=6) and intrauterine growth restriction (n=7). Adverse outcomes occurred in 36 (60%) high-risk cases. All 16 cases with polyhydramnios/oligohydramnios resulted in preterm stillbirths while the remaining 20 cases resulted in seven abortions, six newborns with congenital malformations, four full-term stillbirths and three cases of non-immune hydrops fetalis (NIHF). IgM positivity to T. gondii, rubella, cytomegalovirus, herpes simplex virus and B19 virus was 8.3%, 15%, 30%, 3.3% and 13.6% respectively. B19 infection caused NIHF in three cases and cardiac anomaly in one. All placental tissues and cord blood were negative for B19 DNA. None of the controls had IgM antibodies to any pathogen. Women with BOH and/or pregnancy complications had a high frequency of TORCH and parvovirus B19 infections causing fetal wastage, IUGR, NIHF and congenital malformations.