Anti-parvovirus B19 IgM Antibodies Research Articles

ROLE OF BACTERIAL COLONIZATION IN TRACHEAL SECRETIONS AMONG INTENSIVE CARE UNIT PATIENTS

Purpose: Parvovirus B19 (B19) is associated with a wide range of diseases in humans, whose severity depends on the immunological and haematological status of the host. Objective: To determine the incidence of B19 DNA and specific IgM and IgG frequency among patients suffering from different haematological malignancies and to determine the viral load using real-time PCR. Materials and Methods: A total of 70 patients were included in the study, in addition to a control group consisting of 20 apparently healthy volunteers. B19 DNA quantitative analysis was performed using real-time PCR while screening for IgM and IgG anti-B19 antibodies was performed using ELISA. Results: B19 DNA was detected in 26 patients (36.14%) and 3 controls (15%) using real-time PCR. Anti-parvovirus B19 IgM antibodies were detected in 9 patients (12.6%) and 2 controls (10%). Anti-parvovirus B19 IgG antibodies were detected in 32 patients (45.71%) and 5 controls (25%). The difference between the patient and control groups was found to be statistically non-significant in all of the three tests (P < 0.05). The difference in B19 incidence among patients receiving multiple transfusions and non-transfused patients was also found to be statistically non-significant (P < 0.05). Conclusion: We found a high incidence of B19 infection among patients diagnosed with different types of haematological malignancies. We recommend that all cases of haematological disorders should be examined for specific antibodies and tested for the presence of B19 DNA in serum by PCR technique.

Detection of human parvovirus B19 in cancer patients using ELISA and real-time PCR

Purpose: Parvovirus B19 (B19) is associated with a wide range of diseases in humans, whose severity depends on the immunological and haematological status of the host. Objective: To determine the incidence of B19 DNA and specific IgM and IgG frequency among patients suffering from different haematological malignancies and to determine the viral load using real-time PCR. Materials and Methods: A total of 70 patients were included in the study, in addition to a control group consisting of 20 apparently healthy volunteers. B19 DNA quantitative analysis was performed using real-time PCR while screening for IgM and IgG anti-B19 antibodies was performed using ELISA. Results: B19 DNA was detected in 26 patients (36.14%) and 3 controls (15%) using real-time PCR. Anti-parvovirus B19 IgM antibodies were detected in 9 patients (12.6%) and 2 controls (10%). Anti-parvovirus B19 IgG antibodies were detected in 32 patients (45.71%) and 5 controls (25%). The difference between the patient and control groups was found to be statistically non-significant in all of the three tests (P < 0.05). The difference in B19 incidence among patients receiving multiple transfusions and non-transfused patients was also found to be statistically non-significant (P < 0.05). Conclusion: We found a high incidence of B19 infection among patients diagnosed with different types of haematological malignancies. We recommend that all cases of haematological disorders should be examined for specific antibodies and tested for the presence of B19 DNA in serum by PCR technique.

Molecular and serological assessment of parvovirus B19 infections among sickle cell anemia patients

Parvovirus B19 is a cause of hemolysis and red blood cell aplasia in patients with sickle cell anemia. The present study aimed to assess parvovirus B19 infection among sickle cell anemia patients. All patients (n = 138) included in the study were sickle cell anemia patients. Blood donors were used as a control group. Assessment of parvovirus B19 antibodies and viral DNA was performed using established methods of detection and B19 recomBlot assay. Detectable levels of parvovirus B19 IgG were found in 52 samples (37.6%) whereas anti-parvovirus B19 IgM antibodies were detected in four (2.89 %) patients of the sickle-cell anemia group. Anti-B19 IgM-positive samples contained B19-viral DNA. These four patients presented with fever, malaise, pallor and no cutaneous rash. Anti-parvovirus B19 antibodies were detected in 22 (39.3%) of the control blood donors group. Anti-parvovirus B19 IgM antibodies were not detected in the control group. Using the recomBlot assay, 58 test samples (42%) were found to contain detectable levels of Parvovirus B19 antibodies. All the samples that were positive for parvovirus B19 IgG by the ELISA were also positive by the recomBlot assay. Six samples were only positive by the recomBlot assay and not by the ELISA. Two of these six samples were positive for B19 viral DNA. Establishing the extent of parvovirus B19 infection in sickle cell anemia patients will help in proper management of aplastic crisis in such patients. The B19 recomBlot assay may be suitable as a confirmatory assay.

Symptomatic, prolonged Parvovirus B19 infection and accompanying illness in otherwise healthy adults

Results In a 21-month period, 11 patients (7 females and 4 males), with a mean age of 36.9 (range 27-46) years with a symptomatic Parvovirus B19 infection were recorded and followed-up. Intrafamiliar exposure and occupational (health care) exposure were identified in two cases each. Clinical signs and symptoms included fever (100% of cases), polyarthralgia (90%), followed by headache (80%), anemia (70%), and rash. A mild-tomoderate myelosuppression of all hematological lines characterized 8 cases of 11 (72.7%), while increased serum transaminases were associated in 63.6% of patients. Three patients of ours deserved hospitalization (mean 10.8 days of admission), and five more cases were followed on Day-Hospital basis (for a median 75-day period); in four patients a treatment with i.v. highdosage human immunoglobulins was performed. Elevated levels of specific serum anti-Parvovirus B19 IgM antibodies were detected in all cases. In a 33-year-old female a severe anemia and a persisting headache, vomiting, and neck stiffness, led to RBC transfusion and a diagnosis of meningoencephalitis, with positive search of IgM antibodies and Parvovirus B19 viremia (detected by RT-PCR) in the cerebrospional fluid which lasted up to three months, despite treatment with i.v. serum immunoglobulins.

Symptomatic, long-term Parvovirus B19 infection in otherwise healthy adults

Background: Parvoviridae are part of air-, parenteral- and perinatal-transmitted ubiquitous viruses, whose associated signs and symptoms strongly depend on patient's age and immune defence. Methods: All cases of symptomatic Parvovirus B19 infection in otherwise healthy adults which came to our attention since spring 2006 were prospectively investigated and followedup. Results: In a 21-month period, 11 patients (7 females and 4 males), with a mean age of 36.9 (range 27-46) years with a symptomatic Parvovirus B19 infection were recorded and followed-up. Intrafamiliar exposure and occupational (health care) exposure were identified in two cases each. Clinical signs and symptoms included fever (100% of cases), polyarthralgia (90%), followed by headache (80%), anemia (70%), and rash. A mild-to-moderate myelosuppression of all hematological lines characterized 8 cases of 11 (72.7%), while increased serum transaminases were associated in 63.6% of patients. Three patients of ours deserved hospitalization (mean 10.8 days of admission), and five more cases were followed on Day-Hospital basis (for a median 75-day period); in four patients a treatment with i.v. highdosage human immunoglobulins was performed. Elevated levels of specific serum anti-Parvovirus B19 IgM antibodies were detected in all cases. In a 33-year-old female a severe anemia and a persisting headache, vomiting, and neck stiffness, led to RBC transfusion and a diagnosis of meningoencephalitis, with positive search of IgM antibodies and Parvovirus B19 viremia (detected by RT-PCR) in the cerebrospional fluid which lasted up to three months, despite treatment with i.v. serum immunoglobulins. Conclusion: Parvovirus B19 infection may play a significant role also in adult, immunocompetent subjects, and the disease sometimes is not mild and self-limiting, requiring admission and/or frequent outpatient interventions in a significant number of cases. The causes supporting a persistant infection in immunocompetent subjects have not been investigated to date, as well as the pathogenesis of myelosuppression and severe polyartrhalgia. Symptomatic Parvovirus B19 infection is still an underestimated clinical condition, and therapeutic perspectives are extremely limited until now. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive

Parvovirus B19 infection in Tunisian patients with sickle-cell anemia and acute erythroblastopenia

BackgroundHuman parvovirus B19 is the etiologic agent of erythema infectiosum in children. It is also associated with other clinical manifestations in different target groups. Patients with chronic hemolytic anemia are at high risk of developing acute erythroblastopenia following infection by the virus. They usually become highly viremic and pose an increased risk of virus transmission. Close monitoring of such high risk groups is required for epidemiologic surveillance and disease prevention activities. Here we report a molecular epidemiological study on B19 virus infection in Tunisian patients with chronic hemolytic anemia.MethodsThis study was conducted on 92 young chronic hemolytic anemia patients who attended the same ward at the National Bone Marrow Transplantation Center of Tunis and 46 controls from a different hospital. Screening for IgM and IgG anti-B19 antibodies was performed using commercially available enzyme immunoassays and B19 DNA was detected by nested PCR in the overlapping VP1/VP2 region. DNA was sequenced using dideoxy-terminator cycle sequencing technology.ResultsAnti-parvovirus B19 IgG antibodies were detected in 26 of 46 sickle-cell anemia patients, 18 of 46 β-thalassemia and 7 of 46 controls. Anti-parvovirus B19 IgM antibodies were detected only in 4 of the sickle-cell anemia patients: two siblings and two unrelated who presented with acute erythroblastopenia at the time of blood collection for this study and had no history of past transfusion. B19 DNA was detected only in sera of these four patients and the corresponding 288 bp nested DNA amplicons were sequenced. The sequences obtained were all identical and phylogenetic analysis showed that they belonged to a new B19 virus strain of Genotype1.ConclusionA new parvovirus B19 strain of genotype1 was detected in four Tunisian patients with sickle-cell anemia. Virus transmission appeared to be nosocomial and resulted in acute erythroblastopenia in the four patients. The possibility of independent transmission of this B19 variant to the patients is unlikely in light of the present epidemiological data. However this possibility cannot be ruled out because of the low genetic variability of the virus.

Agranulocytosis associated with parvovirus B19 infection in otherwise healthy patients

In the course of 6 years, 23 otherwise healthy patients with acute febrile illness and leukopenia were diagnosed as having acute parvovirus B19 infection. Five of these patients had agranulocytosis associated with acute parvovirus B19 infection and one had chronic agranulocytosis due to persistent parvovirus B19 infection. The diagnosis was made after positive anti-parvovirus B19 IgM antibodies were found in all of the patients and viral DNA was detected by PCR in four patients. Neutropenia and agranulocytosis appear to be much more frequently associated with parvovirus B19 infection than previously reported.

Differential Transmission of Parvovirus B19 in a Twin Gestation: A Case Report

Maternal infection with parvovirus B19 during pregnancy can cause aplastic anemia in the fetus. Severe anemia may lead to nonimmune hydrops or fetal demise. In the case reported, the demise of one twin was diagnosed by ultrasonography in an asymptomatic 21-year-old para 1-0-2-1 African American at the gestational age of 25 weeks. The deceased twin (A) was grossly hydropic with anasarca, ascites, pleural and pericardial effusions, and a thickened placenta. Parvovirus B19 DNA was found in the amniotic fluid of Twin A using the polymerase chain-reaction technique. Serial scans of Twin B showed normal growth and no evidence of hydrops. The pregnancy was managed expectantly until 29 weeks when delivery was indicated by maternal disseminated intravascular coagulation. Maternal IgM antiparvovirus B19 antibodies were detected at the time of delivery. Antiparvovirus B19 IgM antibodies were not present in Twin B. These serologic studies suggest a recent acute maternal infection and refute such an infection in Twin B. We present a case of differential transmission of parvovirus B19 in a twin pregnancy with in utero death of the infected twin and subsequent maternal disseminated intravascular coagulation.

Differential Transmission of Parvovirus B19 in a Twin Gestation: A Case Report

Maternal infection with parvovirus B19 during pregnancy can cause aplastic anemia in the fetus. Severe anemia may lead to nonimmune hydrops or fetal demise. In the case reported, the demise of one twin was diagnosed by ultrasonography in an asymptomatic 21-year-old para 1-0-2-1 African American at the gestational age of 25 weeks. The deceased twin (A) was grossly hydropic with anasarca, ascites, pleural and pericardial effusions, and a thickened placenta. Parvovirus B19 DNA was found in the amniotic fluid of Twin A using the polymerase chain-reaction technique. Serial scans of Twin B showed normal growth and no evidence of hydrops. The pregnancy was managed expectantly until 29 weeks when delivery was indicated by maternal disseminated intravascular coagulation. Maternal IgM antiparvovirus B19 antibodies were detected at the time of delivery. Antiparvovirus B19 IgM antibodies were not present in Twin B. These serologic studies suggest a recent acute maternal infection and refute such an infection in Twin B. We present a case of differential transmission of parvovirus B19 in a twin pregnancy with in utero death of the infected twin and subsequent maternal disseminated intravascular coagulation.

Human parvovirus B19 in cord blood of premature infants.

We investigated whether intrauterine parvovirus B19 infection is associated with premature birth by evaluating parvovirus B19 antibodies and DNA in umbilical cord blood from 76 premature infants. We performed enzyme-linked immunoadsorbent (ELISA) and polymerase chain reaction (PCR) assays to detect B19-specific IgM antibodies and parvovirus DNA. No parvovirus DNA was detected in cord blood sera, and no sample was positive for anti-parvovirus B19 IgM antibodies. Parvovirus appears unlikely to lead to premature birth.