Human parvovirus B19 and blood product safety. A tale of twenty years of improvements

Parvovirus B19 (B19V), long known to be the causative agent of erythema infectiosum (fifth disease), is not a newly emerging agent. The aim of this review is to analyse the role played by this virus in compromising safety in transfusion medicine and the progressive measures to reduce the risks associated with the virus

ヒトパルボウイルス B19 ニヨル キュウセイ シンフゼン ガ ウタガワレタ 5ショウレイ ノ リンショウテキ ケントウ

The clinical and laboratory findings of 5 adult patients with recent human parvovirus B19 infection in Anan city （from January to February 2005） were reported. They showed local and generalized edema and/or arthritis. Clinical examinations showed relative neutrophilia with lymphcytopenia, anemia, hypocomlementemia in all patients and proteinuria with hematuria in 2 cases （No 2, 3）. Erythema were recognized in only 2 younger cases （No 3, 5）. Mean weight increase due to edema was 2.2Kg. All 5 patients were positive for human parvovirus B19 IgM/IgG antibody. After treatment, CTR decreased 8.0% on an average, and elevated BNP levels markedly declined one month later in 3 cases （No 2, 3, 4）. %FS also reduced in these cases, and one case （No 4） observed slight degree of echo free space （probably pericardial effusion）. When human parvovirus B19 is prevalent, differential diagnosis of the symptoms such as anemia, dyspnea, oligouria and polyarthralgia are mandatory. If human parvovirus B19 infection is suspected, virus-related cardiomyopathy should be considered

Seroprevalence of Human Parvovirus B19 among Voluntary Blood Donors in Chennai: A Cross Sectional study

BACKGROUND : The transfusion transmitted emerging infectious agents has become a real threat to the transfusion safety. Human parvovirus B19 is one of the common viral infection worldwide with a potential threat of transfusion transmission through blood and its products particularly affecting the high risk groups. Introduction of screening test for detecting Human parvovirus B19 antibodies for blood donors needs further evaluation for its potential risk and cost effectiveness. AIM : To find out the seroprevalence of Human parvovirus B19 among voluntary blood donors in Chennai. MATERIALS AND METHODS : 106 blood samples from voluntary blood donors were collected in one year period from July 2015 to June 2016 and were subjected to IgM and IgG serological tests using NovaLisa Human parvovirus B19 ELISA kits. Data analysis was done using SPSS software and Chi-square test was used to find statistical significance. RESULTS : Among 106 voluntary blood donors, 44.3% of the donors were positive for anti-B19V IgG and none were positive for anti-B19V IgM. There was a statistically significant difference (p=0.018) in IgG positivity among different age group. Percentage of IgG B19V seropositivity gradually increases along with increase in age of the donors. Statistically significant difference (p=0.001) in IgG positivity in different socioeconomic groups affecting lower socioeconomic group more than the middle and higher groups. There was a statistically significant difference (p=0.019) in IgG positivity during different months in a year. Among 47 donors positive for IgG B19V, one was positive for HBsAg and two were positive for anti-HCV. CONCLUSION : The seroprevalence of anti-B19V IgG in blood donors is 44.3%. All donor samples in this study were seronegative for IgM. Further larger studies are needed to confirm the possibility of transfusion transmission of Human parvovirus B19, to estimate clinical impacts on recipients and to justify the introduction of donor screening for Human parvovirus B19. Till then it is imperative to screen blood components at least for high risk recipients

Parvovirus B19 infection in pediatric transplant patients

Evidence of recent parvovirus virus infection (as determined by the presence of a positive IgM antibody titer) without other identified causes of anemia was found in 5 of 26 pediatric solid-organ transplant recipients evaluated for moderate-to-severe anemia between June 1990 and July 1991. Anemia tended to be chronic (median duration of anemia at the time of diagnosis was 12 weeks) and was associated with normal red blood cell indices in the absence of reticulocytes. The median age of the children at the time of presentation with anemia due to parvovirus was 1.8 years at a median time of 8 months after transplantation. Four of the 5 children were treated with i.v. immunoglobulin because of persistance of anemia requiring blood transfusions. A response characterized by an increase in reticulocyte count and normalization of hemoglobin was seen in each of these patients 2-4 weeks after treatment. The remaining patient experienced a spontaneous recovery from her anemia. Parvovirus infection should be included in the differential diagnosis of solid-organ transplant recipients presenting with severe anemia associated with low or absent reticulocytes

Detecção de parvovírus humano B19 em casos de hydropsia fetal em São Paulo, Brasil

Human parvovirus B19 infection is known to be one of the causes of hydrops fetalis. The maternal infection caused by the virus may be symptomatic or asymptomatic. In this study, 40 pregnant women with gestational age of approximately 25 weeks, prenatal diagnosis of non immune hydrops fetalis and suspected of human parvovirus B19 infection were studied between January 1999 and December 2005. Serology results and detection of DNA in the maternal serum, foetal serum and amniotic fluid confirmed that 20 pregnant women had been infected by human parvovirus B19. The ultrasound examination demonstrated foetal hydrops, anaemia, hepatosplenomegaly, ascites, cardiopathy and amniotic fluid disorders. Among the positive cases, there were three fatal losses, one by miscarriage and two by intrauterine foetal death.A infecção por parvovírus humano B19 é um dos responsáveis pela hidropsia fetal. A infecção materna causada pelo vírus pode ser sintomática ou assintomática. Neste estudo 40 mulheres com idade gestacional de aproximadamente 25 semanas, diagnóstico pré-natal de hidropsia fetal e suspeita de infecção por parvovírus humano B19 foram avaliadas durante o período de janeiro de 1999 a dezembro de 2005. Os resultados de sorologia e detecção de DNA no soro materno, fetal e fluido amniótico confirmaram 20 mulheres grávidas com infecção por parvovírus humano B19. A análise de ultra-som demonstrou hidropsia fetal, anemia, hepatosplenomegalia, ascite, cardiopatia e desordens amnióticas. Entre os casos positivos, ocorreram três perdas fetais: uma por aborto e duas por morte fetal intra-uterina

Papular-purpuric gloves-and-socks syndrome. Presentation of a clinical case

Papular-Purpuric Glove-and-Sock Syndrome is a rare, infectious disease, of viral etiology, characterized by the presence of pruritus, edema and symmetrical erythema, very well defined at the wrists and ankles with a gloves-and-socks distribution. Other areas can be affected, with a moderate erythema appearing in cheeks, elbows, knees, armpits, abdomen, groin, external genitalia, internal face of the thighs and the buttocks. Erosions, small ulcers, enanthema and blisters can be observed in the oral cavity and lips, and less frequently in other mucous membranes. Complications are rare, although they can be severe, 50% of the published cases are related with the Parvovirus B19. Due to its oral involvement stomatologists should be aware of this syndrome in order to carry out a correct diagnosis of the disease.El Síndrome Papular Purpúrico en Guante y Calcetín es un síndrome raro, infeccioso, de etiología, viral que se caracteriza por la presencia de prurito, edema y eritema simétricos, muy bien delimitadas a nivel de las muñecas y de los tobillos con el aspecto en guante y calcetín. Pueden afectarse otras áreas apareciendo un eritema moderado en mejillas, codos, rodillas, axilas, abdomen, ingles, genitales externos, cara interna de muslos y glúteos. En la cavidad oral y labios y menos frecuentemente en otras membranas mucosas se pueden observar erosiones , pequeñas úlceras, enantema y vesículas. Las complicaciones son raras aunque pueden ser severas El 50% de los casos publicados están relacionados con el Parvovirus B19. La afectación oral en este síndrome hace que deba ser conocido por los estomatologos para realizar un correcto diagnostico de esta enfermedad

Relationship between Myelodysplastic Syndrome and Epstein-Barr Virus or Human Parvovirus Bl9 Infection

Background :The mechanisms responsible for the disturbed hematopoiesis in myelodysplastic syndrome (MDS) include the expansion of abnormal clones, defects in cellular differentiation and he perturbation in the production of hematopoietic regulatory factors. Recently, viral infection such as immunodeficiency virus is known to induce myelodysplasia. And viral infection evokes the production of several cytokines. Therefore, abnormal production of cyrokine may be a potential candidate for the pathogenesis of MDS after viral infections such as Epstein-Barr virus (EBV) and human parvovirus B19. Method :We investigated bone marrow aspiration slides from 17 patients with MDS referred for the bone marrow study, over a period from January, 1992 to April, 1996. To clarify the contribution of EBV and human parvovirus B19 infections to the pathogenesis of MDS, DNA-PCR for EBV and human parvovirus Bl9 was used. Result :The EBV and human parvovirus B19-PCR results were all negative in 17 patients with MDS. Conclusion :EBV and human parvovirus Bl9 infections may not be associated with the major pathogenesis of MDSope

Advances in the biology, diagnosis and host-pathogen interactions of parvovirus B19

Increased recognition of parvovirus B19(B19), an erythrovirus, as a significant human pathogen that causes fetal loss and severe disease in immunocompromised patients has resulted in intensive efforts to understand the pathogenesis of B19-related disease, to improve diagnostic strategy that is deployed to detect B19 infection and blood-product contamination and, finally, to elucidate the nature of the cellular immune response that is elicited by the virus in diverse patient cohorts. It is becoming clear that at least three related erythrovirus strains (B19, A6/K71 and V9) are circulating in the general population and that viral entry into target cells is mediated by an expanding range of cellular receptors, including P antigen and -integrins. Persistent infection by B19 is emerging as a contributory factor in autoimmune disease, a hypothesis that is constrained by the detection of B19 in the skin of apparently healthy individuals. B19 infection during pregnancy may account for thousands of incidences of fetal loss per annum in Europe, North America and beyond, yet there is currently only minimal screening of pregnant women to assess serological status, and thereby risk of infection, upon becoming pregnant. Whilst major advances in diagnosis of B19 infection have taken place, including standardization of serological and DNA-based detection methodologies, blood donations that are targeted at high-risk groups are only beginning to be screened for B19 IgG and DNAas a means of minimizing exposure of at-risk patients to the virus. It is now firmly established that a Th1-mediated cellular immune response is mounted in immunocompetent individuals, a finding that should contribute to the development of an effective vaccine to prevent B19 infection in selected high-risk groups, including sickle-cell anaemics

Parvovirus B19: Insights and implication for pathogenesis, prevention and therapy

Parvovirus B19 (B19V) is a small ssDNA non-enveloped virus, member of Parvoviridae family. The infection is widely diffused and is responsible for a broad range of clinical manifestations including fifth disease in children, transient aplastic crisis in patients with haematological disorders, non-immune hydrops fetalis in pregnant women, persistent anaemia in immunocompromised patients, arthropathy and inflammation of various other tissues. B19V infects and replicates in erythroid progenitor cells (EPCs) in the bone marrow. The depletion of infected EPCs represents the pathogenetic mechanisms of some haematological B19V-associate diseases. Following a primary infection, the virus can establish lifelong persistence in several tissues. Currently, the pathological potential of persistent virus on the cellular signalling pathways remains unclear. In non-erythroid tissues, the infection is usually, abortive, and the virus seems to exert its pathological role through indirect mechanisms, such as induction of inflammatory and autoimmune processes, or through virus-induced apoptosis mediated by viral proteins. In addition to the diseases for which the etiological role of B19V has been fully demonstrated, there are several clinical conditions, including autoimmune diseases, that are presumably, but not certainly, associated with B19V infection. In this review, we describe recent findings that may give us new insight into the pathogenic role of B19V in systemic sclerosis, an autoimmune disease of unknown multifactorial aetiology. Furthermore, we describe the latest findings on the intrauterine B19V infections. Moreover, since there are some ongoing interesting studies focused on vaccine development and antiviral drug discovery for the prevention and treatment of parvovirus B19 infection we described some advances in this field of research

Functional annotation of human parvovirus b19 proteome and Molecular docking of VP1 protein with Teniposide

Parvovirus B19 is a common source of infection with a seroprevalence of 60-70% in the adult population. Human parvovirus causes several distinct clinical syndromes such as erythema, polyarthritis resembling rheumatoid arthritis, vasculitis, hydrops fetalis, myocarditis etc. Recent years have witnessed manifest increase in clinical knowledge of parvovirus B19-associated complications, diagnosis and treatment. Traditional immunosuppressive therapy being unsuccessful, anti-viral therapy might be worthy of consideration. Functional annotation of human parvoviral proteome may provide insights into role of viral proteome in its survival and pathogenic mechanisms. Availability of whole proteome in the open source aided functional annotation of protein using SVMprot. Protein functions common to both structural and non-structural proteins are metal -binding, lipid-binding, copper-binding, calcium-binding, zinc-binding, magnesium-binding, DNA-binding, RNA-binding, transmembrane and outer membrane group of proteins. VP1 protein of human parvovirus b19 being quiet important for its structural integrity and being non homologous to human proteome, was identified as an attractive molecular target for structure based drug discovery. 3D structure of target protein VP1protein is predicted based on VP2 protein from human parvovirus b19 using MODELLER9V6. The modeled structure is validated using PROCHECK. Binding sites were predicted in Discovery studio 2.0 and Teniposide was found to be best docked lead molecule among selected ligands those docked to the functionally important site 1 using LigandFit protocol. The docking complex shows teniposide forming strong hydrogen bond with serine 580 of modeled VP1 protein. The strong hydrogen bonding, hydrophobic interaction, Vander wall interaction marked by teniposide would affect the structural integrity of parvovirus B19 significantly. The detailed insight of structural, functional and interactive aspect of the protein is being studied would enable us delineate it as potential drug target. Also different docking poses generated through docking studies may be considered as a model for identifying drug candidate against parvovirus