Abstract
Clinical, biochemical and molecular evidence for the sickle cell anemia (SCA) crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates of anti-parvovirus b19 antibodies in a population of SCA patients and non-SCA healthy controls in Lagos, Nigeria. In this prospective cross-sectional study, we enrolled 73 confirmed SCA patients from 5 district hospitals in Lagos and 81 sex and age-matched non-SCA healthy controls. Serum sample from each study participant was screened for anti-parvovirus b19 by ELISA and PCR techniques. Standard biomedical assays were also done. Anti-parvovirus b19 IgM and IgG antibodies were detected in 22 (14.3%) and 97 (62.9%) of the 154 sera screened, 13 (17.8%) and 45 (61.6%) in SCA patients; 9 (11.1%) and 52 (64.2%) in non-SCA controls. The overall seronegativity rate was 19.5%. Parvovirus B19 DNA was found in 2 (11.1%) of the 18 IgM seropositive SCA serum samples screened. On the whole, parvovirus b19 infection was more commonly asymptomatic in non-SCA controls but caused significant elevation in liver enzymes in infected SCA patients (P < 0.05). The risk of acute parvovirus b19 infection increased 65 times during unsteady state among the SCA patients. Although no deaths of infected patients were recorded during the study, age below 12 years, hospitalization and overcrowded environment were risk factors for infection. We conclude that parvovirus b19 is common in SCA patients, incurring greater susceptibility to infections.
Highlights
Parvovirus B19, a non-enveloped 5.5 kb singlestranded DNA virus discovered in 1975, is a global health problem with variations in prevalence and incidence rates, clinical manifestations and sequelae in afflicted human populations within and between countries[1,2,3,4]
Parvovirus b19 infections cause aplastic anemia and may severely affect hematological parameters[5]. The occurrence of these manifestations is of grave concern in sickle cell anemia (SCA) patients as it increases the risks of recurrent crisis, hospitalization and early deaths[3,4]
Early detection of parvovirus b19 infection and better understanding of the pathologic course of infection is critical to reducing the burden of disease in SCA patients in every affected country of the world
Summary
Parvovirus B19, a non-enveloped 5.5 kb singlestranded DNA virus discovered in 1975, is a global health problem with variations in prevalence and incidence rates, clinical manifestations and sequelae in afflicted human populations within and between countries[1,2,3,4]. Parvovirus B19 antibodies and viremia in Nigerian sickle cell anaemia patients seroprevalence studies have shown that the prevalence rates of anti-parvovirus b19 IgG antibody range from 1 to 15% in children below 5 years, 15 to 30% in children between 5 to 19 years, 30 to 60 % in adults and 80% and above in the elderly population 6. Nigeria ranks among the highest in the global burden of sickle cell anemia (SCA) with crisis in patients arising from multiple etiologies. Parvovirus b19 infections cause aplastic anemia and may severely affect hematological parameters[5]. The occurrence of these manifestations is of grave concern in SCA patients as it increases the risks of recurrent crisis, hospitalization and early deaths[3,4]. Early detection of parvovirus b19 infection and better understanding of the pathologic course of infection is critical to reducing the burden of disease in SCA patients in every affected country of the world
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