Distribution of parvovirus B19 DNA in blood compartments and persistence of virus in blood donors

Abstract

Introduction Because the receptor for Parvovirus B19 (B19V) is on erythrocytes, we investigated B19V distribution in blood by in-vitro spiking experiments and evaluated viral compartmentalization and persistence in natural infection. Methods Two whole blood protocols (ultracentrifugation and a rapid RBC lysis/removal protocol) were evaluated using quantitative real-time PCR. Whole blood (WB) was spiked with known concentrations of B19V and recovery in various blood fractions was determined. The rapid RBC lysis/removal protocol was then used to compare B19V concentrations in 104 paired whole blood and plasma samples collected longitudinally from 43 B19V infected donors with frozen specimens in the REDS Allogeneic Donor and Recipient Repository (RADAR). Results In B19V spiking experiments, ~one-third of viral DNA was recovered in plasma and two-thirds was loosely bound to erythrocytes. In the IgM positive stage of infection in blood donors when plasma B19V DNA concentrations were > 100 IU/mL, median DNA concentrations were ~30-fold higher in WB than in plasma. In contrast, when IgM was absent and when the B19V DNA concentration was lower, the median whole blood to plasma ratio was ~1. Analysis of longitudinal samples demonstrated persistent detection of B19V in WB but declining ratios of WB/plasma B19V with declining plasma VL levels and loss of IgM-reactivity. Conclusions The WB/plasma B19V DNA ratio varies by stage of infection. Further study is required to determine if this is related to the presence of circulating DNA-positive erythrocytes derived from B19V infected erythroblasts, B19V-specific IgM mediated binding of virus to cells, or other factors.

Prevalence and Viral Load of Human Parvovirus B19 (B19V) Among Blood Donors in South-East Brazil

“…However, the mean duration of B19V viremia in the infected donors was 21.5 months (approximately 2 years), which demonstrates prolonged viral carriage [12]. Persistent low B19V DNA in blood donors has also been demonstrated by other authors [6,13]. The VL detection variability in the different studies (including our findings), probably depends on the different sensitivity of the used diagnostic method.…”

Persistence of Parvovirus B19 (B19V) DNA and humoral immune response in B19V‐infected blood donors

“…More than 10 years ago, the consensus was that long persistence of B19V is rare except in immunodeficient patients . Since then, it has become evident, with the availability of more sensitive NAT tests , that B19V DNA might persist for a long time in non‐immunodeficient patients and even in otherwise healthy blood donors . We recently reported the persistence of B19V DNA and hypothesized that viraemia in B19V infection may last considerably more than a year .…”

Characterization of Markers of the Progression of Human Parvovirus B19 Infection in Virus DNA-Positive Plasma Samples

“…The 32 B19V DNA-positive and the 13 B19V DNA-negative samples were arranged along an estimated hypothetical curve according to the B19V DNA load (IU/ml in ordinate axis) and the type of marker(s) detected (time of antibody response in abscissa axis), resulting in a profile of the evolution of B19V infection [6,8,11,12,14,16,17]. …”

“…They are detectable about 15 days post infection, with a peak at day 35-40 [16]. They remain high for several months and persist in the long term [12,17]. …”