Epidemiology of Parvovirus B19 and Anemia Among Kidney Transplant Recipients

Abstract

Purpose: Persistent anemia has been described in kidney transplant (KTX) recipients with Parvovirus B19 virus infection. However, epidemiology of Parvovirus B19 and Parvovirus B19-related anemia after KTx remains unclear. The study\u27s aims were 1) to investigate the frequency of Parvovirus B19 infection and 2) to assess the incidence of Parvovirus B19-related anemia in KTx recipients. Methods: Aliterature search for studies that reported the occurrence rate of Parvo-virus B19 infection and/or seroprevalence of Parvovirus B19 inKTx recipientswas conducted using Medline, Embase, and Cochrane Database from inception through October 2018. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. Results: 15 observational studies with a total of 1, 757 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of Parvovirus B19 IgG was 87. 4% (950/oCI: 64. 4°/\u3c, 96. 4%). The pooled estimated occurrence rate of positive Parvovirus B19 DNA in the first year after KTx was 9. 7% (95%CI: 4. 7°/\u3c, 18. 9%). Sensitivity analysis excluding a study (that solely included KTx patients with anemia) was performed, and showed the pooled estimated occurrence rate of positive Parvovirus B19DNAafterKTxof8. 6%(95%CI: 4. 0%-17. 6%). Meta-regression analysis demonstrated no significant correlations between the year of study and occurrence rate of positive Parvovirus B19 DNA (P = 0. 93). Among KTx recipients with positive Parvovirus B19 DNA, the pooled estimated incidence rates of anemia and severe anemiawere37. 6o/o(95o/oCL25. 8o/o-51. 1o/o)and22. 3o/o(7. 1o/\u3c, 51. 9o/o), respectively. Egger\u27s regression asymmetry test was perforated and showed no publication bias in all analyses. Conclusions: Parvovirus B19 infection occurs mostly within the first year post-transplant. The overall estimated occurrence of positive Parvovirus Bl 9 DNA after KTX is 9. 70/0. The estimated incidence of anemia among KTx recipients with positive Parvovirus B19 DNA is 21. 6%. Parvovirus B 19 should be ruled out in cases of persistent anemia after transplant. [Figure Presented]

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