Detection of viral genome in the myocardium: Lack of prognostic and functional relevance in patients with acute dilated cardiomyopathy

Idiopathic dilated cardiomyopathy and persistent viral infection: Lack of association in a controlled study using a quantitative assay

“…Unfortunately we were not able to analyse the entity of the inflammatory reaction in our samples, and thus this hypothesis remains outstanding. When taken together, our data are consistent with the notion that parvovirus B19 is widely present in the general population [19,21,38], and do not support a role for this virus as a specific causative agent of DCM. In agreement with our results, in a recent case-control study, therapy with Interferon-␤ failed in improving clinical status and functional characteristics of patients with DCM and viral myocardial persistence (92% positive for parvovirus B19) [39].…”

Myocarditis in Childhood: An Update on Etiology, Diagnosis and Management

“…These findings support the postulation of Bowles et al that different viruses have various pathogenic mechanisms such as lymphocyte-dependent vs. macrophage-dependent (Bowles et al, 2005). Nevertheless, PVB19 DNA has also been revealed in the myocardium of healthy donors (Donosa et al, 2005), in hearts of adults with dilated cardiomyopathy (Lotze et al, 2004), and in hearts of the patients with lupus and amyloidosis (Kuethe et al, 2007), despite the number of subjects studies was small. From these results, the question arises whether PVB19 certainly cause the underlying heart disease or whether it is just spectator attending in the heart as a result of former infection which is usual in young adults or children.…”

Diagnosis and Treatment of Myocarditis in Children in the Current Era

“…106 However, another study 91 found only persistent immunohistological signs of inflammation, not persistent positive histology or viral presence, to be predictive of poor outcomes. Other studies 107,108 have questioned whether the presence of virus in patients with chronic dilated cardiomyopathy has a functional or prognostic relevance and argue against a role for antiviral therapy. 109 Antiviral therapy might have its greatest efficacy in the very early stages of myocarditis.…”

“…A small case study 110 demonstrated viral clearance, improvement in left ventricular size and function, and symptomatic improvement with the use of subcutaneous interferon-β in enteroviral and adenoviral myocarditis. A subsequent randomized, placebo-controlled phase II trial has been performed in adult virus + inflammatory dilated cardiomyopathy and by report 4,5,108,109,111 showed some clinical benefit but a diminished response in terms of viral clearance with parvovirus B19 and human herpesvirus 6 infections. This trial, however, has not been yet been published in full form.…”