Human Parvovirus B19 and Blood Products

Abstract

Background and objectives: Human B19 parvovirus (B19), identified in 1975, was only recognised as the causative agent of fifth disease in 1983. The incidence of viraemia is low, around 1 in 1,000, but is sufficient to ensure that most plasma pools for fractionation contain some virus. While infection usually occurs in childhood and is benign, chronic infection sometimes occurs and may be of concern in certain patient groups. Materials and methods: This review is based on a meeting held in March 1995, and addresses recent concerns regarding the potential transmission of B19 infection by pooled plasma products. Results: Recent data on the pathophysiology and assay of this virus are summarised along with possible approaches to donor screening, product screening, and virus removal. Only five cases of symptomatic infection have been reported in persons with haemophilia, but no technology for vims removal is established, and infection may be of concern in pregnant women, and in patients with enhanced red cell turnover or who are immunosuppressed, including those infected with human immunodeficiency vims, but only rarely in immunocompetent patients. Conclusions: For the future, well-validated assays relevant to vims infectivity are required if blood donations, plasma pools, or plasma products are to be screened, and an in-process vims inactivation step for B19 would be highly desirable. In the interim, non-plasma or recombinant products or a selective transfusion policy might be used in patient groups in which B19 infection is of particular concern. Further clinical data on the prognosis and impact of B19 infection are needed to justify both such policies and the future adoption of new technologies designed to reduce any excess B19 infectivity arising from transfused products.

Frequent infection with a viral pathogen, parvovirus B19, in rheumatic diseases of childhood

“…Despite the development and presence of B19-specific immune reactions, ϳ20% of all B19 infections show a prolonged state of viremia or viral persistence restricted to the synovial fluid, and viral genomes are detected in bone marrow or other organs, e.g., synovial tissue, liver, or myocardium, for several years after infection (4,8,12,13,19,27,(29)(30)(31)(32)(33). Compared with our age-matched control group and compared with healthy adult blood donors, who have been shown to contain B19 DNA in 7% and in 0.1% up to 0.6% of cases, respectively (34)(35)(36), viral genomes were detected in 35% of arthritis patients in the present study. In those cases in which DNA sequence analysis after PCR amplification was successful, parvovirus B19 genotype 1 genome sequences with minor nucleotide and amino acid changes were detected.…”

High-Sensitivity PCR Detection of Parvovirus B19 in Plasma

“…Consequently, B19 contamination of pooled blood products is of major significance, primarily due to the high physicochemical tolerance of B19 to many of the treatments used in plasma processing allied to the extremely high levels of viremia in acutely infected, and often asymptomatic, individuals (Ͼ10 12 genome equivalents/ml) (15). These factors combine to present significant challenges to manufacturers in terms of the production of B19-free material.…”

“…Nonetheless, the availability of these methods-combined with reliable methods for antibody detection and the introduction of international-standard preparations for the quantitation of B19 immunoglobulin G (IgG) and, more recently, B19 DNA-is leading to further improvements in the situation in which manufacturers had depended on the presence of high levels of B19 IgG alone, in pooled plasma products, as an indicator of product safety (9,13,15,17). Furthermore, a recent report has shown that 1 IU of B19 DNA equals 0.65 genome equivalent (1).…”

Nanoceramics for blood-borne virus removal

“…MF is the process of removing contaminants in the 0.025 to 10.0 µm range from fluids by passage through a microporous medium, such as a membrane filter. On the other hand, NF involves the filtration of minute particles using a membrane filter with extremely small 30 pores and is especially effective in the removal of non-enveloped viruses that are resistant to inactivation methods such as heat or solvent/detergent treatments [13][14][15][16][17]. The NF method uses a pressure driven separation process, with electrolyte selectivity dependent on the pore size provided by the membrane structure and the membrane pore potential characteristics.…”