anti-B19 IgG Antibodies Research Articles

Erythema nodosum manifestation of Parvovirus B19-associated reactive arthritis.

Parvovirus B19 virus-mediated viral inflammation and immune-complex deposition generate mainly short-term manifestations in the affected individuals. The objective of this study was to determine Parvovirus B19 infection in rheumatoid arthritis (RA) patients. The study employed 50 patients diagnosed with RA and 30 healthy individuals. Blood samples were collected from both groups. The blood samples were screened for Parvovirus B19 infection using polymerase chain reaction to detect B19 DNA and enzyme-linked immunosorbent assay to detect anti-B19 IgM and IgG. 17 (34%) of 50 patients tested positive for parvovirus B19 DNA. In contrast, the mortality rate in the control group was significantly lower (6.7%; p = 0.005). Anti-B19 IgG antibody levels differed significantly with patients and control (p = 0.007), whereas anti-B19 IgM Ab levels did not (p = 0.6). There was a significant correlation between viremia B19 and all measured parameters. Parvovirus-affected patients had significantly higher CRP and ESR, elevated DAS28 scores, and more joint pain compared to parvovirus (-) patients. Anti-CCP and RF values were significantly high in parvovirus (+) patients. Joint erosion was also prevalent in patients who tested positive for parvovirus. The findings of this study suggest that infection with parvovirus in patients with RA, and a possible role of this viral infection in the pathogenesis of RA may contribute to the pathogenesis of RA.

Molecular and Serological Assessment of Chronic Parvovirus B19 among Chronic Hemolytic Anemia Children

Background: Parvovirus B19 infections can suppress erythropoiesis and induce acute erythroblastopenia which is often referred to as transient aplastic crisis with hematological disorders especially chronic hemolytic anemia. Objectives: to detect the presence of parvovirus B19 (B19) DNA together with its IgG antibodies in the sera of children with chronic hemolytic anemia and in apparently healthy children in Menoufia University Hospitals and to detect the prevalence of chronic parvovirus B19 infection through detection of PCR among positive anti-parvo virus B19 IgG in different types of anemia. Methodology: The study was conducted on 60 children with chronic hemolytic anemia (40 children with chronic hemolytic anemia without a history of aplastic crisis and 20 children with chronic hemolytic anemia with a history of aplastic crisis) and 20 age and sex-matched apparently healthy children. All patients were subjected to full history taking, clinical examination and laboratory investigations. The presence of B19 IgG levels were measured by using anti-parvovirus B19 ELISA kits (EUROIMMUN), as well as detection of its DNA by nested-polymerase chain reaction technique. Results: Anti-parvovirus B19 IgG antibodies were detected in 62.5% and 100% of patients in group I and group II respectively. Only 20% in control group had a detectable level of anti-parvovirus B19 IgG. There were significant positive correlations between age of patients, frequency of transfusion, and transfusion index in both groups and the level of anti-parvovirus B19 IgG. Seven B19 IgG seropositive cases (14.3%) had B19 DNA. Although78% of children with f thalassemia major had a detectable level of anti- parvovirus B19 virus IgG antibodies, only 15.4% of them had B19 DNA. Children with sickle cell anemia were presented only in group II with aplastic crisis by percentage of 25%, where the prevalence of anti-B19 IgG antibodies among them was 100% but only one child had both anti-B19 IgG antibodies and B 19 DNA (20%).Patients who had anti- parvo virus B19 IgG and those who had both B19 DNA anti-parvo virus B19 IgG cases had a higher transfusion index compared to negative cases. Conclusion: All children with hematological disorders must be screened for B19. Direct detection of DNA by PCR needs to be performed along with serology in these children. Genotyping and quantification of the virus can be more useful for diagnosis and staging of infection.

Molecular diversity of human parvovirus B19 during two outbreaks of erythema infectiosum in Brazil

This study was conducted to provide information on the genetic diversity of human parvovirus B19 (B19V) circulating in the municipality of Niterói, Rio de Janeiro, Southeast Brazil during 1996–2006, a period with two distinct outbreaks of B19V infection: 1999–2000 and 2004–2005. A total of 27 sera from patients with erythema infectiosum and five sera from HIV-infected patients that tested positive for B19V DNA during the study period were analyzed. To genotype B19V strains, a semi-nested PCR for partial amplification of the capsid gene was performed and sequence analysis revealed that 31 sequences belonged to subgenotype 1a (G1a) of the main genotype 1 and one sequence was characterized as subgenotype 3b (G3b). The phylogenetic tree supported the division of the G1a into two well-defined clades with 1.3% of divergence. The low diversity of the G1a strains may be explained by the fact that all patients had acute B19V infection and 30/32 sera were collected during two distinct outbreaks. The G3b strain was from an HIV-infected patient who seroconverted to anti-B19 IgG antibodies in September/2005. This is the first report of G3b in the state of Rio de Janeiro.

Peripheral Blood Mononuclear Cells’ Proliferative Response to Human Parvovirus B19 Antigens in Patients with Rheumatoid Arthritis / Reimatoīdā Artrīta Slimnieku Perifēro Asiņu Mononukleāro Šūnu Proliferativā Atbilde Uz Cilvēka Parvovīrusa B19 Antigēniem

Abstract This study aimed to determine peripheral blood mononuclear cells’ (PBMC) proliferative response to parvovirus B19 (B19) antigens in rheumatoid arthritis (RA) patients and possible changes in proliferative response due to chemotherapy. Serum and blood samples of 52 RA patients and 25 sex and age matched healthy individuals were examined for the presence of anti-B19 IgG and IgM class antibodies and virus specific DNA sequence by the recomLine B19 test and nested polymerase chain reaction, respectively. The PBMC proliferative activity was estimated on the 3rd and 6th day of PBMC cultivation in the presence of virus and B19 VP1/VP2 peptide, using thymidine incorporation assay. On the 3rd day, PBMC response to B19 antigens was detected in 74.1% RA patients with active, in 44.8% - with remote and in 40% - with latent stage of persistent B19 infection, while in the control group the response was observed only in two individuals with active viral infection. On the 6th day, the response was found in 50% RA patients with active, 68.9% - with remote and in 80% - with latent stage of latent persistent infection as well as in 41.1% remotely infected control individuals. The highest PBMC mean stimulation indices were detected in the RA patients and control persons with active infection as well as in RA patients with latent stage of persistent viral infection. On the 3rd and 6th day, strong proliferative response was significantly more frequently observed in RA patients not receiving methotrexate treatment, compared to the patients receiving methotrexate treatment in different combinations with other drugs. RA patients had more frequent and faster response to B19 antigens than apparently healthy persons.

Seroprevalence of parvovirus B19 infection in patients with beta thalassemia major in Fayoum University Hospital

Background and objectivesPatients with beta thalassemia major are at higher risk of acquiring reticulocytopenia, and cessation of erythropoiesis after exposure to parvovirus B19. The aim of the study was to detect the seroprevalence of parvovirus B19 infection in children with transfusion dependent beta-thalassemia major through the detection of its specific IgM and IgG in their sera by Enzyme-linked Immunosorbent Assay (ELISA) in the Pediatric Department of Fayoum University Hospital. Materials and methodsA cross sectional descriptive study was carried out from July to September 2013, in the Pediatric Department of Fayoum University Hospital in Egypt. A total of fifty-five children with beta-thalassemia major aged from 2 to 16years were enrolled in the study. All patients were subjected to history taking, examination and investigations including; Complete blood count, serum creatinine, blood urea, hepatitis B surface antigen (HBsAg), anti hepatitis C virus antibody (anti HCV), reticulocytic count, anti B19 IgM and IgG. ResultsAnti-B19 IgM antibodies (recent infection) were detected in 14.5% (8 patients), while anti B19 IgG antibodies (prior infection) were detected in 18.2% (10 patients) of transfusion dependent thalassemic patients. There was a significant statistical correlation between the history of other siblings with beta thalassemia major, the hepatitis C virus and hepatitis B virus infection regarding absent, prior and recent infection. ConclusionParvovirus B19 infection is detected in high rates among children with beta thalassemia major. Measures to avoid iatrogenic and nosocomial transmission have to be implemented including screening of donated blood for B19 especially blood given to patients with hematological disorders. Also data from this study support the need for introduction of an approved B19 vaccine that primarily protects children with thalassemia major against that infection.

SAT0071 Dependence of rheumatoid arthritis disease aggressivity and activity on the presence of parvovirus B19 infection markers

BackgroundThe role of parvovirus B19 (B19) infection as an initiator of the classic erosive rheumatoid arthritis (RA) is being constantly debated. The main argument against etiological association of B19 with...

Risk of Transfusion-Transmitted Human Parvovirus B19 Infection in Anyigba and Lokoja, Kogi State – Nigeria

Risk of Transfusion-Transmitted Human Parvovirus B19 Infection in Anyigba and Lokoja, Kogi State – Nigeria

Serological study on parvovirus B19 infection in multitransfused thalassemia major patients and its transmission through donor units

Background:Human parvovirus B19 (B19) virus is a newly recognized agent for transfusion transmitted diseases. Beta-thalassemia major patients receive a hypertransfusion regimen, hence, are prone to acquire B19 infection; moreover, B19 escapes viral inactivation methods and donor units are not tested for B19, but there are just a couple of studies globally and none from the Asian continent. Hence, a study was designed to find the frequency of B19 infection and its transmission in multitransfused thalassemia patients.Materials and Methods:Ninety multitransfused beta-thalassemia major (thalassemia) patients, 32 controls (age, sex matched) without any history of transfusion were enrolled. Besides the donor units were tested in B19 un-infected patients. B19 specific IgG and IgM antibodies in the sera were analyzed by ELISA (in-house), using B19 VPI and VP2 recombinant and purified antigens; additionally HBsAg and anti-HIV and anti-HCV antibodies were tested for coexisting infections.Results:Seventy-three (81%) thalassemia patients tested positive for anti-B19 IgG antibodies as compared to seven (21%) in the controls group (P < 0.01), while anti-B19 IgM antibodies were detected in 37 (41.1%) compared to two (6.2%) in the controls (P < 0.01). Mean age of the thalassemia patient was eight years (range 2 – 18 years) and B19 infection was highest in the six-to-ten year range. Seropositivity increased with the number of transfusions. Two of the four HBsAg positive and five of the seven anti-HCV IgM antibody-positive patients also had anti-B19 IgM. After a six-month follow-up, four (25%) of the 16 seronegative patients seroconverted and anti-B19 IgM antibodies were detected in their donor units.Conclusions:Most of multitransfused thalassemics were B19 seropositive or had anti-B19 IgM; in the remaining uninfected group, B19 got transmitted through infected / IgM-positive donor units.

Standardization of B19 IgG ELISA to study the seroepidemiology of parvovirus B19 in North Indian voluntary blood donors

Backgound and Objectives:Parvovirus B19 (B19) being a non-enveloped DNA virus is hence thermo-stable to the current methods of viral inactivation. Therefore transfusion of blood or its component from a viremic donor to non-immune recipients may result in transfusion-transmitted B19 infection with occasional sinister complications. The serologically naïve blood donor population in our country has not been studied. Hence a study was designed to find the sero-status of B19 virus in normal voluntary blood donor population (relatives of recipients) as an indirect measure of the susceptibility to B19 in north Indians together with seroepidemiology of B19.Methods:An in-house anti-B19 IgG ELISA was standardized using cloned, baculovirus expressed, and purified VP1/VP2 capsid proteins as antigen. Anti-B19 IgG antibodies in sera (diluted 1:400) of 1000 healthy voluntary blood donors (18-60 years; mean 30.5 years) were analyzed and their epidemiologic data were documented.Results:A total of 399 (39.9%) donors were seropositive for B19 virus. Seroprevalence was higher in males than females (44% vs 27%) and it increased with increasing age (P<0.01). Socioeconomically, B19 IgG antibody positivities were 61.8%, 61.1%, and 44.4% in low, medium, and high income groups respectively with unskilled laborers having higher seroprevalence in low (48.5%) and middle (58.7%) income group (P<0.05). Housing conditions revealed B19 seroprevalence as 42.6% in donors living in small houses compared to 20.4% in larger houses (P<0.01) but no difference with religion.Conclusions:Seroprevalence to B19 in normal voluntary blood donors was low leaving a large proportion of north Indians susceptible to B19 infection.

Seroprevalence of parvovirus B19 in fibromyalgia syndrome

This study was aimed to evaluate the seroprevalence of parvovirus B19 in patients with fibromyalgia syndrome (FS). Seventy-five patients with FS (44.3 +/- 8.3) and 75 healthy controls (44.2 +/- 8.1) were evaluated. Serum anti-B19 IgM and IgG antibodies were measured by ELISA technique. Patients were questioned about duration of symptoms, characteristic features of FS, and symptoms related with viral infection preceding the onset of FS. No significant difference was found regarding the prevalence of anti-B19 IgM antibodies between the groups (p = 0.494). Seropositivity of anti-B19 IgG of the patients was significantly higher than control group (81.3% vs. 64% respectively, p = 0.027). No statistically significant differences were found regarding to the clinical features between fibromyalgia patients with IgG antibody compared to those without IgG antibody. Parvovirus B19 IgG seropositivity was found to be significantly higher in patients with FS. Parvovirus B19 infection might have a role in the etiopathogenesis of FS or might act as a triggering factor.

Human parvovirus B19 infection of monocytic cell line U937 and antibody-dependent enhancement

Human parvovirus B19 (B19) infects human erythroid lineage cells. Accumulating evidence also shows that B19 is detectable in nonerythroid lineage cells in vivo, but the mechanism of infection is still not clear. In this study, we explored the mode of B19 infection of human monocytic cell line U937. An in vitro infection study demonstrated B19 binding of U937 and slow replication of B19-DNA with B19-NS1 mRNA transcription. B19-DNA replication in U937 was accompanied by undetectable level of B19-VP1 mRNA transcription, indicating that B19 infection of U937 cells may be abortive. Levels of B19-DNA and B19-NS1 mRNA transcription increased in the presence of anti-B19 IgG antibodies, but this effect decreased in the presence of anti-Fc receptor antibodies, showing antibody-dependent enhancement by B19 infection. Antibody-dependent enhancement also caused the increased production of TNFα in U937. This study is the first to suggest B19 infection of nonerythroid lineage cells with antibody-dependent enhancement.

Parvovirus B19 infections serological diagnostics in rheumatic diseases

Objective. To study contamination with parvovirus B19 of a group of patients with rheumatic diseases (RD). Methods. 77 pts with RD (mean age 42,5 years, 79% female) admitted to Institute of Rheumatology of RAMS were examined. 34 of them had rheumatoid arthritis (RA), 11 - systemic lupus erythematosus (SLE) and Sjogren's disease (SD), 15 with osteoarthritis (OA) and seronegative spondyloarthritides (SS) and 17 with early (before a year) undifferentiated arthritis (EUA). Quantitative determination of IgM and IgG serum antibodies to parvovirus BI9 was performed by I FA with IBL kits (Hamburg, Germany). Results. Anti-B19 IgG antibodies were found in 52% of pts, IgM antibodies - only in one case. Mean antibodies values in pts with RD of disease duration less then 6 months were significantly higher then in pts with longer disease duration (21,5+36 U/ml and 8,4+14.7 U/ml respectively, p<0,05). Anti-B 19 antibodies were present in 62% of pts with RA, 53% of pts with EUA, 45% of pts with SD, 33% of pts with OA and SS. High levels of antibodies (4-10 times higher positivity threshold) were revealed in 13 pts with different RD with short duration of joint syndrome (6,3±7,6 months) and fever at presentation. A case of B19 parvovirus infection in a boy of 3 years age accompanied by symptoms of Still's disease is described.

Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the development aplastic crises.

The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE), Rio de Janeiro, during the year of 1994. This sample represents around 10% of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140) have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1% of patients. No statistically significant difference (p > 0.05) was seen between IgG antibody prevalence in male (27.8%) and female (35.5%) patients. Anti-B19 IgG antibodies were more frequent in older (37.6%) than younger (28.2%) than 20 years old patients, although this difference had no statistical significance (p > 0.05). Anti-B19 IgG antibody prevalence showed that 67.9% of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime.

Presence and significance of human parvovirus B19 DNA in synovial membranes and bone marrow from patients with arthritis of unknown origin

Acute rheumatologic symptoms are frequently associated with human parvovirus B19 (B19) infections. A nested PCR (nPCR) assay was used to test for the presence of parvovirus B19 DNA in synovial fluid and/or synovial membrane specimens obtained from a total of 90 patients with arthritis of unknown origin. Whereas only one out of 73 synovial fluid samples were found positive, 15 (16.7%) out of 90 patients had parvovirus B19 DNA in the synovium. B19 virus DNA was detected in nine bone marrow aspirates subsequently obtained from these 15 patients (60%). Whereas each one of the 15 corresponding blood samples contained anti-B19 IgG antibody, none contained anti-B19 IgM antibody and only one was positive for B19 virus DNA. The blood and synovial fluid samples that contained B19 virus DNA were obtained from the same patient, who also had B19 DNA in synovium and bone marrow. For one patient, two distinct synovial membrane specimens collected 10 months apart tested positive for B19 virus DNA. Parvovirus B19 DNA was also detected in synovial tissue of one out of nine nonarthritic patients serving as control group, who also had anti-B19 IgG circulating antibody. These data illustrate that human parvovirus B19 may persist in bone marrow and synovial tissues of patients with arthritis of unknown origin. In contrast, persistence of B19 virus DNA in synovial fluid is rare. The significance of parvovirus B19 DNA in synovium of healthy patients has to be established.

Evidence for persistence of human parvovirus B19 DNA in bone marrow

A nested polymerase chain reaction assay (nPCR) was used to investigate the potential of human parvovirus B19 DNA to persist in blood or bone marrow samples obtained either from blood donors or cadaveric bone donors or from patients presenting with clinical signs of parvovirus B19 infection. The presence of parvovirus B19 specific antibody in blood was tested by enzyme immunoassay (EIA). B19 virus genome was not detected in any blood sample of 115 blood donors, of whom 92 (80%) had anti-B19 IgG antibody only as an indication of past infection. In contrast; B19 virus DNA was detected in the bone marrow of 4 out of 45 bone donors. Each one of the serum samples available for 3 of these 4 individuals contained anti-B19 IgG antibody. Among 84 patients with clinical manifestations of parvovirus B19 infection, 17 (20%) had B19 virus DNA in bone marrow. Eight of the latter patients had anti-B19 IgG antibody in their blood but neither anti-B19 IgG nor B19 virus DNA. These data document the ability of parvovirus B19 DNA to persist in the bone marrow of asymptomatic individuals and patients with parvovirus B19 infection suspected on clinical grounds.

Human parvovirus B19 infections among exanthematic diseases notified as measles.

A total of 1397 sera collected from 1095 cases of exanthematic disease notified as measles in ES and RJ states during July 1992 to December 1994 were investigated. These sera were first tested for measles and rubella specific IgM. When they proved negative, they were tested for B19 specific IgM by an enzyme immunoassay. B19 infection was confirmed in 27 (2.5%) of these cases. Sera from 194 negative cases for measles and rubella IgM received from other Brazilian states were also investigated and B19 infection was confirmed for 11 of them. Sera from these 38 IgM positive cases for B19, were tested for anti-B19 IgG by an enzyme immunoassay and for B19 DNA by dot blot hybridization. Anti-B19 IgG antibodies were detected in most of the acute sera. B19 DNA was detected in the acute serum of one patient that had been splenectomized before. As the exanthem caused by human parvovirus infection may be clinically diagnosed as rubella, it could be important to diagnose B19 infection in Brazil since it is becoming prevalent as the cause of rash in countries where rubella is controlled by vaccination.

Association between human parvovirus B19 infection and arthritis.

To gain information concerning the association between parvovirus B19 infection and arthritis. Blood or synovial fluid, or both, from a total of 77 adult patients with various arthropathies (rheumatoid arthritis 13; mechanical arthropathies 11; crystal induced arthritis 13; idiopathic mono/oligoarthritis 25; suspicion of viral arthritis 15) were tested for the presence of the viral genome and anti-B19 antibodies. B19 DNA in blood and synovial fluid was investigated by nested polymerase chain reaction, and anti-B19 IgM and IgG antibodies were detected in blood by enzyme immunoassay. A recent parvovirus infection was documented by the presence of anti-B19 IgM antibodies in the blood of 13 patients. B19 DNA, together with anti-B19 IgM and IgG antibodies, were detected in the blood of seven patients who had an acute transient arthritis, putatively of viral origin. Viral DNA was detected in a synovial fluid sample and in the blood of one patient with monoarthritis who had an anti-B19 IgG response only. The prevalence of anti-B19 IgG antibody in these patients with various forms of arthritis (63%) was within the same range as that in the general population (blood donors). However, for the patients with clinical suspicion of viral arthritis, the increased seroprevalence of anti-B19 IgM and the presence of the B19 genome point to an association between human parvovirus infections and acute forms of arthritis.

Seroepidemiology of human parvovirus B19 using recombinant VP1 + VP2 particle antigen

Antibody prevalence to B19 virus in Japan was previously reported with 1973 and 1984 serum collections. Since then we have had two big epidemics of erythema infectiosum in Japan: 1986-87 and 1991-92. In an attempt to estimate how much those epidemics have affected seroprevalence to B19 virus infection, we studied seroepidemiology in three separate areas using a newly developed ELISA system consisting of recombinant VP1 + VP2 particle antigen. Total of 900 sera obtained in 1993 from healthy individuals living in northern, central and southwest parts of Japan were assayed for the presence of anti B19 IgG antibody. In the first, the new assay system was compared with our conventional assay system in which native B19 virus particles were used as antigen. Of 220 serum samples tested, 212 (96.4%) gave same results in both assays. Remaining 8 samples which gave variable results were those of near cut off values. We concluded that this new ELISA system can be recommended for seroepidemiological use. Antibody prevalence rates were 10% (0-4 y), 54% (5-9 y), 59% (10-14 y), 46% (15-19 Y), 38% (20-29 y), 48% (30-39 y), 64% (40-49y) and 76% (50 y-). No gender difference was observed. Comparison of antibody prevalences in 1973, 1984 and 1993 suggested that approximately 10% (about 8 million people) of the total population under 40 years of age acquired immunity to B19 virus during one epidemic period.

Parvovirus B19 infection during pregnancy and development of hydrops fetalis despite the evidence for pre-existing anti-B19 antibody: how reliable are serological results?

Background: Primary infection with human parvovirus B19 during pregnancy can lead to fetal hydrops, abortion, or stillbirth. However, reinfection in the presence of pre-existing anti-B19 antibody is generally assumed to have no significant effect on the developing fetus. Objectives: To describe a case of fetal loss at 28 weeks' gestation associated with parvovirus B19 infection which took place in a 26-year-old woman despite the evidence for pre-existing anti-B19 IgG antibodies. Study design: A nested-PCR assay for parvovirus B19 DNA was performed on maternal and fetal samples. Blood samples were tested by various enzyme immunoassays (EIA) for the presence of both anti-B19 IgM and IgG antibodies. Results: B19 DNA together with anti-B19 IgG antibody were detected in maternal blood at the time of intrauterine fetal demise. Amniotic fluid, chorionic villi and various fetal tissues also tested positive for viral DNA. In retrospect, presence of anti-B19 IgG antibody, but no viral DNA, was repeatedly demonstrated in maternal blood before infection took place. However, the serological results differed with the test system used. Conlusions: Provided that the positive serological results are reliable, the presence of anti-B19 IgG in blood samples collected as early as four years before pregnancy neither protected the mother from reinfection not the fetus from transplacental infection with B19 virus. However, discrepant (negative) serological results were also obtained depending on the test system used. Therefore, and in the light of the possible severe consequences of B19-infection during pregnancy, the means for assessment of the significance of anti-B19 titers have to be urgently established by development of both qualitative and quantitative anti-B19 IgM and IgG standards.

Transient Aplastic Crisis in Patients With Sickle Cell Disease

To determine (1) the proportion of cases of transient aplastic crisis (TAC) in patients with sickle cell disease due to B19 parvovirus infection in several years, (2) longitudinally, the immune response to B19 parvovirus infection, and (3) whether patients with sickle cell disease experience recurrent or chronic B19 parvovirus infection. Prospective evaluation of patients with sickle cell disease and TAC to find evidence of B19 parvovirus infection and, if present, to document the pattern of serologic response with time. Large urban teaching hospital. Patients younger than 18 years with sickle cell disease who were admitted to the hospital with a diagnosis of TAC or who developed TAC while in the hospital for other reasons. Follow-up serologic studies of B19 parvovirus infection were done in eight patients. Serum was tested for B19 parvovirus DNA/viral particles and specific anti-B19 parvovirus IgM and IgG antibodies. B19 parvovirus DNA/viral particles were detected in 11 (21%) of 53 patients with TAC. Specific anti-B19 parvovirus IgM antibodies were detected in 34 (64%) of the 53 patients. Overall, 36 (68%) of 53 patients with TAC had evidence of acute B19 parvovirus infection as shown by the detection of B19 DNA parvovirus and/or specific anti-B19 parvovirus IgM antibodies in acute-phase serum. Follow-up serologic studies in eight patients with acute infection revealed disappearance of B19 parvovirus DNA/viral particles and anti-B19 parvovirus IgM antibodies and persistence of anti-B19 parvovirus IgG antibodies for up to 3 1/2 years after the diagnosis of acute B19 parvovirus infection. No patient had evidence of recurrent or chronic B19 parvovirus infection. Approximately 70% of cases of TAC in patients with sickle cell disease identified in a 7-year period were caused by acute B19 parvovirus infection. Once detected, anti-B19 parvovirus IgG antibodies remain detectable for several years. There was no evidence of chronic or recurrent B19 parvovirus infection in patients with sickle cell disease.