The association between Parvovirus B19 infection and persistent anaemia in renal transplant recipients

Abstract

BackgroundThe immunosuppressive drug therapy makes post-transplant recipients are at risk of developing both primary viral diseases and reactivation of persistent viruses. There are published case reports and studies on Parvovirus B19 infection in organ transplant recipients which have led to persistent anaemia secondary to lengthy suppression of erythropoiesis. ObjectiveTo assess the association between persistent unexplained anaemia and Parvovirus B19 infection amongst renal transplant recipients MethodsA matched case-control study was conducted in five government transplant centres in Sri Lanka by recruiting 42 cases and 42 controls prospectively. Cases were defined as adult renal transplant recipients with moderate to severe persistent unexplained anaemia. Quantitative PCR assay was performed for the quantification of Parvovirus B19 DNA in plasma of cases and controls and positive samples were further tested for the presence of IgG antibodies against Parvovirus B19. ResultsPost-transplant unexplained persistent anaemia was identified in 5.6% (95% CI: 4.21–7.42%) of the screened population. Parvovirus B19 infection was detected in one patient amongst 42 cases (2.2%), and no controls had confirmed Parvovirus B19 infection. The odds ratio for the association between persistent anaemia (outcome) and Parvovirus B19 infection (exposure) was 3.0723 (95% CI: 0.1216–77.5982) for persistent anaemia and parvoviraemia. (P-value: 0.4957). ConclusionThe finding of 5.6% of post-transplant unexplained persistent anaemia amongst RTRs demonstrates its importance as a significant modifiable morbidity factor in the modern renal transplant era. The association between Parvovirus B19 infection and persistent anaemia in Sri Lankan renal transplant recipients was not demonstrated by this study.