Parvovirus B19: implications for transfusion medicine. Summary of a workshop

Abstract

This 1-day workshop showed that the infectivity of B19 DNA in donor blood and the neutralizing action of different antibodies present in the donated blood are not yet fully understood. It is possible that B19-induced anemia and reticulocytopenia are not being recognized in transfused recipients other than those in specific risk groups. The testing of blood components for any infectious agent is usually clinically driven, and, if B19 NAT were recommended at the present time in other than plasma products, a CMV-like model might prove appropriate; that is, virus screening would be performed on blood components destined for high-risk groups only. Currently, there is insufficient evidence to recommend universal testing, especially for single units. Workshop participants recommended that basic research continue in the scientific areas addressed. If clinical trials were to be developed, participants recommended that they include special risk groups such as seronegative pregnant women and children with malignancies who are receiving chemotherapy.

Identification and Characterization of Persistent Human Erythrovirus Infection in Blood Donor Samples

“…The data collected in this study suggest that specific IgG-containing whole blood or blood components might be infectious, primarily in immunodeficient recipients receiving immunosuppressive drugs for bone marrow or organ transplantation but also in immunocompetent patients who have not been previously exposed to human erythrovirus. Infection by transfusion containing less than 10 4 geq/ml has been reported in immunocompetent recipients (3,5). A systematic study of susceptible blood recipients with different immune statuses, transfused with blood components taken from persistently infected donors, needs to be conducted to determine the clinical relevance of this condition in the transfusion setting.…”

Detección de ADN de parvovirus B19 en donantes de sangre de tres hospitales en Santiago, Chile

“…Por otro lado, se detectó la presencia de ADN de B19 con carga viral baja en 1 paciente (donante 66, Tabla 2). Este donante presentó anticuerpos IgG al momento del aná-lisis, y ausencia de IgM (dato no mostrado), lo que sugiere que se trataría de un individuo con infección persistente, fenómeno ya descrito en este tipo de poblaciones 18,20,25 . Últimamente, con el uso de técnicas moleculares más sensibles, se ha podido determinar que la presencia de ADN de B19 en la población general es más frecuente de lo que se había descrito y se ha demostrado que este agente puede persistir en forma crónica en distintos tejidos en el hombre [26][27] .…”

“…Las implicancias transfusionales de este fenómeno son signifi cativas en tres de los cuatro casos detectados, debido a que sobrepasan en nivel crítico de carga viral aceptado como límite de riesgo transfusional (10 3,5 genoma equivalentes/ml) 25 . En cambio, en el donante de carga viral baja, las implicancias transfusionales son discutibles.…”

Pure red cell aplasia due to parvovirus B19 infection after liver transplantation: A case report and review of the literature

“…Accordingly, avoiding PVB19 exposure to patients, virus screening of blood products before transfusion and testing organ donors prior to transplantation may be considered as preventive strategies. Since transmission via blood products is rare, universal blood screening is not recommended, though the risk of PVB19 infection is of great concern for blood and blood product suppliers [14] . Strategies for reducing the viral load in the manufacture plasma pool by discarding PVB19-DNA-positive donations and developing new strong virus inactivation methods are recommended to these suppliers.…”