Transfusion‐transmitted human parvovirus B19 infection in a thalassemic patient

Zanella, Alberto; Rossi, Francesca Gaia; Cesana, Clara; Foresti, A; Nador, F; Binda, A.; Lunghi, G.; Cappellini, Maria Domenica; Furione, Milena; Sirchia, G.

doi:10.1046/j.1537-2995.1995.35996029163.x

Cited by 73 publications

(48 citation statements)

References 27 publications

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“…The primary route of transmission of B19V is the respiratory tract (via aerosol droplets), with a majority of infections occurring during childhood, but the infection may also be transmitted by organ transplantation and especially by transfusion of blood components, in particular by packed red cells from blood collected during the short preseroconversion viremic phase (17,42,101).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Advances in Human B19 Erythrovirus Biology

Servant‐Delmas

Lefrère

Morinet³

et al. 2010

J Virol

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Since its discovery, human parvovirus B19 (B19V), now termed erythrovirus, has been associated with many clinical situations (neurological and myocardium infections, persistent B19V DNAemia) in addition to the prototype clinical manifestations, i.e., erythema infectiosum and erythroblastopenia crisis. In 2002, the use of new molecular tools led to the characterization of three different genotypes of human B19 erythrovirus. Although the genomic organization is conserved, the geographic distribution of the different genotypes varies worldwide, and the nucleotidic divergences can impact the molecular diagnosis of B19 virus infection. The cell cycle of the virus remains partially unresolved; however, recent studies have shed light on the mechanism of cell entry and the interactions of B19V proteins with apoptosis pathways.Before the recent descriptions of human bocavirus (2) and human parvovirus 4 (PARV4) (41), parvovirus B19 ([B19V] or erythrovirus B19) was the only known member of the Parvoviridae family to infect humans. The Erythrovirus genus contains B19V, erythroviruses that infect several simian species, and the parvovirus from Manchurian chipmunks (87a). These viruses share the remarkable property of replicating in and destroying erythroid progenitors. This strong in vitro tropism explains the difficulties in studying the replicative cycle of these viruses; indeed, the in vitro production and culture of erythroid progenitor cells remain delicate. An infectious B19V clone was described only recently (102), and its use, although mostly limited and allowing only a small amount of progeny production, led to constructions of recombinant viruses that were helpful in understanding the steps of the virus life cycle and the toxicity of the virus. Discovered in 1975 (19), B19V can cause a wide range of mild and self-limiting clinical manifestations, such as erythema infectiosum (fifth disease) and oligoarthritis (98). B19V infection can also cause acute anemia by aplastic crisis in patients whose red blood cells have shortened survival times (i.e., patients with sickle cell disease, thalassemia, spherocytosis, or any disorder of hemoglobin gene expression or red cell membrane constitution), chronic anemia in patients with congenital immunodeficiencies or human immunodeficiency virus (HIV) infection or who are undergoing chemotherapy for malignancies or organ transplants (48, 58), and hydrops fetalis or intrauterine death in infected fetuses (86). Recently, cases of neurological manifestations have been associated with B19V infection (22), as have myocardium infections (4,5,47,83), and the spectrum of B19V-linked diseases may further increase. CLINICAL MANIFESTATIONSThe primary route of transmission of B19V is the respiratory tract (via aerosol droplets), with a majority of infections occurring during childhood, but the infection may also be transmitted by organ transplantation and especially by transfusion of blood components, in particular by packed red cells from blood collected during the short preseroconversion vi...

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Section: Clinical Manifestationsmentioning

confidence: 99%

Advances in Human B19 Erythrovirus Biology

Servant‐Delmas

Lefrère

Morinet³

et al. 2010

J Virol

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“…Parvovirus B19 has been implicated as a causative agent in fulminant hepatitis even in healthy individuals 13 . Parvovirus B19 can be transmitted through respiratory secretions, transplacentally and by transfusion of blood or blood products 14,15 . The study also tried to explore the relationship between stillbirth, history of transfusion and Parvovirus B19 in the study population.…”

Section: Introductionmentioning

confidence: 99%

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

Bukar¹,

Abjah²

2013

AJSIR

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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).

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“…There are only 4 published clinical cases of B19V transmissions from blood component transfusion (3 from red cells and 1 from platelets). [14][15][16][17] An additional asymptomatic case has been reported from a recent prospective study of transfusion-transmitted viral infections. 18 In contrast, 2 studies have reported a small number of negative results when patients transfused with B19V DNA-positive components were evaluated for laboratory markers of B19V infection.…”

Section: Introductionmentioning

confidence: 99%

A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion

Kleinman

Glynn

Lee

et al. 2009

Blood

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Parvovirus B19V infection can be a serious infection for hematology patients with underlying hemolysis or compromised erythropoiesis syndromes. Although case reports of B19V transmission by blood component transfusion (as contrasted to manufactured plasma derivatives) are rare, no studies have systematically determined a rate of transmission to recipients transfused with B19V DNA-positive components. We used a linked donor and recipient repository and a sensitive, quantitative B19V DNA polymerase chain reaction (PCR) assay to assess such transmission in B19V-susceptible (ie, anti-B19V immunoglobulin G [IgG] negative) recipients. We assessed 112 B19V DNA-positive components from 105 donors (of 12 529 tested donations) transfused into a population of surgical patients with a pretransfusion B19V IgG seroprevalence of 78%. We found no transmission to 24 susceptible recipients from transfusion of components with B19V DNA at concentrations less than 10 6 IU/mL (upper 95% confidence interval, 11.7%). We found an anamnestic IgG response in one pretransfusion seropositive recipient transfused with a component containing greater than 10 10 IU/mL B19V DNA. These findings show either that transmission from components with less than 10 6 IU/mL does not occur, or, if it does, it is an uncommon event. These data do not support the need to routinely screen blood donations with a sensitive B19V DNA nucleic acid assay. (Blood. 2009;114:3677-3683) IntroductionThere have been multiple reports of parvovirus B19 (B19V) transmission by pooled plasma products, including factor VIII concentrate and solvent-detergent-treated pooled plasma, documented by recipient seroconversion in asymptomatic cases or, less frequently, by clinical diagnosis of B19V-related disease in association with positive B19V test results. [1][2][3][4][5] These cases, combined with the potential for very high B19V DNA concentrations (up to 10 12 IU/mL) in plasma donations 4 and the relative resistance of B19V to inactivation methods, 4,6 have led to B19V DNA testing of plasma donations to ensure that manufacturing plasma pools destined for plasma derivatives have a B19V DNA concentration less than or equal to 10 4 IU/mL, a limit proposed by the Food and Drug Administration (FDA). 7-9 The same limit for this so-called "in process testing" is a European regulatory requirement for anti-D immunoglobulin (Ig) preparations and plasma treated for virus inactivation. 10 To achieve this B19V DNA concentration in the final plasma pool, B19V DNA screening of the plasma donations used to make the pool is performed using assays (applied in minipool format) with the ability to detect approximately 10 6 IU/mL in an input unit of plasma. 8 To date, no B19V transmissions from pooled plasma products have been documented when less than 10 3 to 10 4 IU/mL B19V DNA is present in an infused product. 3,4,[11][12][13] The reason for this lack of infectivity is not completely understood. It may be due to an inadequate amount of infused infectious virions, a neutralization effect from B19V ...

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Transfusion‐transmitted human parvovirus B19 infection in a thalassemic patient

Abstract: This case documents the transmission of HPV B19 by the transfusion of 1 red cell unit and the occurrence of possible transient cardiac involvement in this infectious complication.

Cited by 73 publications

References 27 publications

Advances in Human B19 Erythrovirus Biology

Advances in Human B19 Erythrovirus Biology

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

A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion

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