Prevalence of Parvovirus B19 and Parvovirus V9 DNA and Antibodies in Paired Bone Marrow and Serum Samples from Healthy Individuals

Abstract

Parvovirus B19 (hereafter referred to as B19) exhibits a marked tropism to human bone marrow (BM), and infection may lead to erythema infectiosum, arthropathy, hydrops fetalis, and various hematologic disorders. Recently, a distinct parvovirus isolate termed V9 with an unknown clinical spectrum was discovered. In contrast to the many studies of B19 serology and viremia, valid information on the frequency of B19 or V9 DNA in the BM of healthy individuals is limited. To develop a reference value, paired BM and serum samples from healthy subjects were tested for the presence of B19 and V9 DNA and specific antibodies. Immunoglobulin M (IgM) was not found in any of the serum samples. The prevalence of IgG showed a gradual and steady increase from 37% in children aged 1 to 5 years to 87% in people aged >50 years. When 190 well-characterized subjects were examined, B19 DNA was detected in the BM of 4 individuals (2.1%; 95% confidence interval, 0.58 to 5.3%) while none of the paired serum samples showed evidence of circulating viral DNA. V9 DNA was not found in any of the BM or serum samples. The finding of B19 DNA probably indicated a primary infection in one 7-year-old individual and reinfection or reactivation of persistent infection in the remaining three persons, aged 47 to 58 years. Serving as a benchmark for future studies, these findings are useful when interpreting epidemiologic data, performing BM transplantation, or considering clinical implications of parvovirus infection.Human parvovirus B19 (hereafter referred to as B19) is a member of the genus Erythrovirus of the family Parvoviridae (18). B19 exhibits a marked tropism to human bone marrow (BM) and replicates only in erythroid progenitor cells (3). Infection may lead to erythema infectiosum, arthropathy, hydrops fetalis, and various hematologic disorders, including aplastic crisis, chronic anemia, and idiopathic thrombocytopenic purpura (3). Diagnosis of B19 relies on serology and the detection of viral DNA by PCR or dot blot analysis. A possible emerging parvovirus isolate termed V9 with an unknown clinical spectrum and markedly different from B19 (Ͼ11% nucleotide disparity) was recently discovered (19). Sequencing, combined with PCR studies, has since demonstrated the need for specific and differentiated techniques when examining samples for possible B19 or V9 viremia (11). Conversely, cloning and production of the V9 capsid proteins and subsequent enzymelinked immunosorbent assay studies have revealed a 100% serologic cross-reactivity between the B19 and V9 isolates (13).The prevalence of immunoglobulin G (IgG) antibodies directed against B19 ranges from 15 to 60% in children 6 to 19 years old: and from 30 to 60% in adults and is more than 85% in the geriatric population (1,7,22). The frequency of B19 viremia in voluntary blood donors has been estimated at rates of 1:167 to 1:35,000 (11,14,17,(22)(23)(24). As opposed to the many studies on B19 serology and viremia, information on the presence of B19 DNA in the BM of healthy individuals is limited. Thou...

Sustained CD8 + T-Cell Responses Induced after Acute Parvovirus B19 Infection in Humans

“…Other responses may have been missed either because they occurred very early or were not detected using 15-or 20-mer peptides. B19 is not classically persistent in normal infection and is present only in about 2% of bone marrow samples from healthy subjects (8). However, it seems clear that B19 infection is not to be immunologically described by the paradigm of lytic nonpersistent viruses that postulates rapid viral clearance and contraction of the initial cytotoxic-Tcell burst in the absence of antigenic drive (3,10).…”

“…Indeed, for three out of five individuals, B19 DNA was detected in peripheral blood for over 6 months. It is possible that B19 persists beyond this time in the bone marrow, in which prolonged replication has been observed (8,19). Most responses were directed to NS, while two individuals also responded to an epitope in VP2.…”

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

“…The inability to develop an efficient neutralizing immune response, as observed mainly in immunosuppressed individuals but also in otherwise healthy individuals, may result in the failure to eliminate the virus, thus leading to persistent infection and the possible occurrence of chronic diseases, such as chronic anemia or arthropathies (14). Viral persistence has been documented for several tissues, including bone marrow, synovium, and skin, but in these cases the pathogenicity of the virus remains undetermined (16,19).Genetic analysis of human erythrovirus has so far focused mainly on parvovirus B19 strains. Full-length and partial sequence data have shown a low degree of genetic diversity among B19 strains (less than 2%), with a slightly higher degree of variability among viral strains from distinct epidemiological settings and geographical areas (up to 4.8% divergence for the most distant strains).…”

The investigation of parvovirus B19 infection in patients with haematological disorders by using PCR and ELISA techniques

“…It is known that the B19 infection is either due to reactivation of a latent infection in a general immunosuppression situation or it is the result of a prolonged primary infection in an immunocompromised individual [17].…”