Association between human parvovirus B19 and arthropathy in Belém, Pará, north Brazil

Abstract

A total of 220 patients with arthropathy were selected in Belém, Pará between January 1994 and December 2000, and screened for the presence of human parvovirus B19 IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA). A subgroup (n = 132) of patients with high levels of antibodies (either IgM+/IgG+ or IgM-/IgG+) were examined for the presence of DNA by polymerase chain reaction/nested PCR. Recent/active infection (detection of IgM and/or IgG-specific antibodies and presence of viral DNA) was identified in 47.7% of the 132 individuals with arthropathy. In our study, women were significantly more affected (59.7%) than men (35.4%) (P = 0.0006). The age group of 11-20 years (84.6%), among female patients, and 21-30 years (42.1%), among male, were those with the highest incidence rates. The analysis of the temporal distribution of B19-associated arthropaties showed a cyclic pattern, with peak incidence rates occuring at 3-5 year intervals. Significant diference (P = 0.01) was observed when comparing both the highest (39.0%) and the lowest (11.0%) seropositivity rates for the years of 1995 and 2000, respectively. The interfalangial joints of hands and feet were mostly affected, with 50.0% and 48.0% of cases among both women and men, respectively. In a smaller proportion, other joints such as those of knee, ankle, pulse and shoulder were affected. As for the duration, symptoms lasted 1 to 5 days in 54.0% of the individuals, whereas in 46.0% of them the disease lasted 6-10 days, if considered the subgroup (n = 63) of patients with recent/active infection by parvovirus B19. In our study, joint clinical manifestations occurred symmetrically. Our results indicate that B19 may be an important agent of arthropathies in our region, and this underscores the need for specific laboratory diagnosis when treating patients suffering from acute arthropathy, mainly pregnant women.

Molecular characterization of human erythrovirus B19 strains obtained from patients with several clinical presentations in the Amazon region of Brazil

“…Interestingly, genotype 1 was more frequently found in women in three of the four clinical groups (data not shown), corroborating previous findings from patients with AP in the Amazon (Freitas et al, 2002). Moreover, we observed a statistically higher proportion of patients within cluster B with HD than in clusters A1 or A2.…”

“…Extensive serological surveys among both urban and remote Amazonian communities have revealed a wide range of prevalence rates (Freitas et al, 1990(Freitas et al, , 1993(Freitas et al, , 1999(Freitas et al, , 2002. In this report, we describe the prevalence and relative frequency of erythrovirus genotypes in sera of patients with distinct clinical conditions in the Amazon region.…”

Parvovirus B19 infections in state of Rio de Janeiro, Brasil: 526 sera analyzed by IgM-enzyme-linked immunosorbent assay and polymerase chain reaction

“…In Belém, state of Pará, it was demonstrated IgM, IgG and PCR positivity for infection by B19 in 47.7% of individuals presenting arthropaty (Freitas et al 2002). In patients suffering non-A-E hepatitis, B19 infection was confirmed by IgM-ELISA in 2.3% (Pinho et al 2001).…”

Acute parvovirus B19 infection presenting as rheumatoid arthritis mimic

“…[10] IgG antibody testing is used for predicting progression of acute infection to chronic arthropathy. [11] Demonstration of viral DNA is important for diagnosis in immunocompromised hosts. [1213]…”