Seroprevalence of parvovirus B19 and its clinical effect among anaemic SCA patients in Northeastern Nigeria

Abstract

Sickle cell anaemia (SCA) is a globally widespread genetic disorder affecting 5% of the world's over 6 billion people. Parvovirus infection and the resulting aplastic crisis is a recognised complication in individuals with SCA. Aplastic crisis increases the need for blood transfusion and its attendant risk of Transfusion Transmissible Infection (TTI). Hence there is a vicious cycle in which Parvovirus B19 causes aplastic crisis which in turn causes increased transfusion need; and transfusion increases risk of transfusion transmissible infection in which parvovirus B19 is included in certain parts of the world. Sickle cell anaemia is associated with foetal death and infection with parvovirus B19 increases the risk to early mortality. The objective of this study was to determine the seroprevalence of parvovirus B19 among SCA and compare with that of controls in the study area. Furthermore clinical and laboratory profile of subjects were analysed to identify possible correlation with parvovirus B19 seropositivity and explore the possibility of involvement of white cell and platelets. A total of 90 subjects comprising 45 consecutive SCA case subjects and 45 age-and sex-matched non SCA controls were studied in a cross sectional comparative study. Ten millilitres of blood was drawn from the antecubital fossa of each subject after obtaining informed consent. The 10mls of blood was divided into two aliquots, 4.5 mls was added into EDTA anticoagulated bottle and was used for basic complete blood count (CBC), while the remaining 5mls was added into a plain specimen container allowed to clot and serum obtained to test for anti-parvovirus B19 IgG and IgM using an immunochromatography based technique specifically BIOCARD TM Parvo B19 diagnostic test kit. There was male preponderance in the study. The SCA subjects comprised 26 males and 19 females (male to female ratio = 1.4:1), while the non-SCA controls comprised 25 males and 20 females (male to female ratio 1.3:1).. The analysis of anti-parvovirus B19 IgG antibody revealed a prevalence of 23.3% among SCA cases with 18.9% among controls. The haematological profile is not affected by IgG seropositivity. However pregnancy outcome revealed that the total number of stillbirths is 12 among IgG seropositive SCA cases which is higher than the 6 encountered in IgG seronegative SCA subjects; the difference is statistically significant (p=0.04).

Prevalence and Factors Associated With Human Parvovirus B19 Infection in Sickle Cell Patients Hospitalized in Tanzania

“…The prevalence reported in this study is higher than that reported in Kenya (2.7%) from 264 hospitalized non-SCD children with severe anemia and 23.3% and 27.3% from non-SCD with aplastic anemia in Northern Nigeria and India respectively 4,5,7. However, other studies reported a higher prevalence of HPV B19, 30.2% in non SCD with severe anemia in PNG, and 32.1% in Brazil 6,11.…”

“…Prevalence of severe anemia in non-SCD patients with Parvovirus B19 has been reported previously to be 2.7% in Kenya and 30.2% in Papua New Guinea (PNG) 4,6. A prevalence of 23.3%, 27.3% and 32.1% in non SCD with aplastic anemia were also reported in Northern Nigeria, India and Brazil respectively 5,7,8. However, a prevalence of 37.6% was reported in SCA population in Eastern Saudi Arabia 1…”

“…Parvovirus B19 is a small, single-stranded DNA virus of family parvoviridae and genus Erythrovirus which shows tropism to bone marrow and has been implicated in erythema infectiosum and other hematological disorders 1,2. The virus has high tropism towards red blood cells (RBCs) progenitors 1–3. Sickle cell disease (SCD) patients are at high risk of infection due to an increase in RBC progenitor division; this is for compensating the deficiency of circulating RBC which is a common feature in SCD 4…”

“…HPV B19 is of interest because it causes transient aplastic anemia in SCD and is mostly associated with hemolytic disease 5. HPV B19 is currently considered a disease of public health importance, particularly among patients with SCD.…”

An Expert Review of Pharmacogenomics of Sickle Cell Disease Therapeutics: Not Yet Ready for Global Precision Medicine

“…These studies have been replicated in patients living with SCD in Tanzania and Cameroon (Makani et al, 2011;Mtatiro et al, 2014;Pule et al, 2015;Wonkam et al, 2014a). Interestingly, the expression of these modifiers is amenable to therapeutic manipulation (Bukar et al, 2013;Canver et al, 2015;Xu et al, 2011), leading to new hope for treatment routes for SCD (Orkin, 2016).…”