Increased Risk of Parvovirus B19 Infection in Young Adult Cancer Patients Receiving Multiple Courses of Chemotherapy

Abstract

An increased human parvovirus B19 infection rate has been observed in immunocompromised hosts. In this study, we sought to determine the prevalence of parvovirus B19 infection in adult cancer patients receiving multiple courses of systemic chemotherapy. From March 1999 through April 2000, 59 men and 68 women, with a median age of 49 (18 to 79) years, were enrolled in this study. They had received an average of 7.1 (4 to 32) courses of systemic chemotherapy. The median duration from the date of starting chemotherapy to the date of blood sampling was 11 (4 to 88) months. Serum B19 immunoglobulin G (IgG) and IgM levels were examined by an enzyme-linked immunosorbent assay, and B19 DNA was examined by a nested PCR. A group of 400 healthy blood donors served as the control group. The overall prevalences of anti-B19 IgG in adult cancer patients and healthy blood donors were 61.4 and 25.0%, respectively (P < 0.01). Anti-B19 IgM and B19 DNA were not detectable in these anti-B19 IgG-seropositive individuals. A further age-stratified comparison revealed that only patients younger than 40 years had a significantly higher anti-B19 IgG seropositivity rate than the controls (19 of 39 versus 53 of 310; P < 0.001). The increased prevalence of B19 infection in these 39 adult patients younger than 40 years might be clinically significant, since unexplained anemia, a common sequela of B19 infection, was detected in 3 of 20 seronegative patients (15.0%) and in 12 of 19 seropositive patients (63.2%) (P < 0.005). The results of this study suggest that adult patients younger than 40 years and receiving multiple courses of systemic chemotherapy may have a significantly increased risk of B19 infection. Prospective studies to define the time course and clinical consequence of B19 infection in this group of patients are needed.Human parvovirus B19, the only parvovirus known to be pathogenic for humans, is a small DNA virus with a singlestranded linear genome which encodes one nonstructural protein, NS-1, and two viral capsid proteins, VP1 (83 kDa) and VP2 (58 kDa) (23). The virus exhibits a remarkable tropism for erythroid progenitor cells (6) and is frequently associated with anemia. Parvovirus B19 infection has also been implicated in a wide range of clinical manifestations, the outcome of which depends heavily on the physiologic status of the individual and the immune response against the virus (29).In immunologically healthy hosts, B19 may cause a number of acute, generally self-limiting diseases, notably, fifth disease or erythema infectiosum in children, acute polyarthritis in adults, and aplastic crisis in patients with chronic hemolytic anemia such as sickle cell anemia or hereditary spherocytosis (3,15,24,26). In pregnant women, B19 infection may result in the lysis of nucleated fetal red cells, hydrops fetalis, and subsequent spontaneous abortion and fetal death (16). B19 also has been found to be associated with glomerulonephritis, vasculitis, peripheral neuropathies, myocarditis, and fulminant hepatic failure (31). In immunoco...

Role of Viral Infections in Testicular Cancer Etiology: Evidence From a Systematic Review and Meta-Analysis

“…Additionally, subgroup and sensitivity analyses did not modify the results of the primary analysis, confirming their robustness. Parvovirus B-19 is the only parvovirus known to be pathogenic for humans (66). The virus exhibits a particular tropism for erythroid cells and can rarely cause dramatic complications in humans (67, 68).…”

Detection of Parvovirus B19 Infection in Thalasemic Patients in Isfahan Province, Iran

“…In immunologically healthy hosts, B19 infection can be benign or can occur without any signs or may cause erythema infectious in children and acute arthropathy in adults. In immunosuppressed patients, B19 infection may persist and lead to pure red cell aplasia, chronic anemia, and, less frequently, thrombocytopenia, pancytopenia, and neutropenia ( 10 - 12 ). During pregnancy, the virus can be transferred to the uterus, resulting in hydrops fetalis and fetal death ( 13 ).…”

Human parvovirus B19 in patients with aplastic anemia

“…An acute B19 infection is diagnosed by detecting B19 IgM antibodies or DNA. The mean duration of the IgM response is 2-4.8 months whereas B19 DNA usually lasts for 2-4 months [5]. The presence of parvovirus DNA in 10 (37.0%) patients indicates active or recent infection.…”