Adland, Emily

Goulder, Philip

Jooste, Pieter

Klenerman, Paul

Malik, Amna

Matthews, Philippa

Sharp, Colin

Simmonds, Peter

BMC Infectious Diseases

PubMed

Philippa Matthews

Colin Sharp

Amna Malik

Emily Adland

Pieter Jooste

Philip Goulder

Peter Simmonds

Paul Klenerman

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Paediatric PARV4 infection in South Africa:
relationship to age, maternal PARV4 status, and
HIV infection
Philippa Matthews1,2*, Colin Sharp3, Amna Malik4, Emily Adland4, Pieter Jooste5, Philip Goulder4, Peter Simmonds3,
Paul Klenerman1,2,6
From International Symposium HIV and Emerging Infectious Diseases 2014
Marseille, France. 21-23 May 2013
Introduction
First identified in 2005, PARV4 is best characterized in
Western cohorts where it is strongly associated with
other blood borne viruses and occurs only in individuals
with risk factors for parenteral infection (in particular,
injecting drug users). However, studies in Africa have
shown evidence of PARV4 in subjects with no clear risk
factors for acquisition of blood borne viruses. The clini-
cal significance of PARV4 remains uncertain, but there
is growing interest in the role of coinfecting pathogens
in shaping outcomes of HIV, and in chronic viral infec-
tions as determinants of immunological development in
childhood.
Materials and methods
We studied a cohort of HIV-infected mothers (n=32)
and children (n=40; median age 28 months), and HIV-
negative pediatric controls (n=24, median age 86
months) in Kimberley, South Africa. PARV4 serostatus
was determined by ELISA for IgG to the PARV4 VP2
protein. HIV viral load was determined using the Abbott
m2000 assay, and CD4 T cell count by flow cytometry.
Results
In this cohort, 45/96 individuals (46.9%) were positive for
PARV4 IgG, including 19/32 adults (59.4%) and 26/64
children (40.6%). The seroprevalence of PARV4 IgG
increased with age, demonstrating acquisition throughout
childhood, plateauing by age 6-10 years (Fig. 1; R2=0.75 by
logistic regression). There was strong concordance
between maternal and child infection, with the mother’s
PARV4 status being a clear predictor of IgG in her off-
spring (p=0.006). HIV-negative individuals were more
likely than HIV-positive subjects to be PARV4 IgG posi-
tive (p=0.03), although this relationship may be con-
founded by age. There was no relationship between
PARV4 status and HIV viral load or CD4 T cell count in
HIV-infected adults or children.
Conclusions
The epidemiology of PARV4 in this cohort contrasts strik-
ingly with that in Western countries: the prevalence of
PARV4 IgG approached 50%, with evidence for ongoing
transmission throughout the early years of life. The
observed concordance within families is suggestive of
maternal to child transmission. Future studies are planned,
to investigate further the relationship between PARV4 sta-
tus and outcomes of HIV infection.
Authors’ details
1Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK.
2Department of Infectious Diseases and Microbiology, Oxford University
Hospitals, John Radcliffe Hospital, Oxford, OX3 9DU, UK. 3Roslin Institute,
University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK. 4Department
of Pediatrics, University of Oxford, Oxford, OX1 3SY, UK. 5Paediatric
Department, University of Free State, Kimberley Hospital, Kimberley, Northern
Cape, South Africa. 6NIHR Biomedical Research Center, John Radcliffe
Hospital, Oxford OX3 9DU, UK.
Published: 23 May 2014
doi:10.1186/1471-2334-14-S2-P92
Cite this article as: Matthews et al.: Paediatric PARV4 infection in South
Africa: relationship to age, maternal PARV4 status, and HIV infection.
BMC Infectious Diseases 2014 14(Suppl 2):P92.
1Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
Full list of author information is available at the end of the article
Matthews et al. BMC Infectious Diseases 2014, 14(Suppl 2):P92
http://www.biomedcentral.com/1471-2334/14/S2/P92
© 2014 Matthews et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.


Paediatric PARV4 infection in South Africa: relationship to age, maternal PARV4 status, and HIV infection

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     Edinburgh Research Explorer                                      Paediatric PARV4 infection in South Africa: relationship to age,maternal PARV4 status, and HIV infectionCitation for published version:Matthews, P, Sharp, C, Malik, A, Adland, E, Jooste, P, Goulder, P, Simmonds, P & Klenerman, P 2014,'Paediatric PARV4 infection in South Africa: relationship to age, maternal PARV4 status, and HIV infection'pp. P92. DOI: 10.1186/1471-2334-14-S2-P92Digital Object Identifier (DOI):10.1186/1471-2334-14-S2-P92Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher's PDF, also known as Version of recordPublisher Rights Statement:© 2014 Matthews et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited. The Creative Commons Public Domain Dedicationwaiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,unless otherwise stated.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 05. Apr. 2019POSTER PRESENTATION Open AccessPaediatric PARV4 infection in South Africa:relationship to age, maternal PARV4 status, andHIV infectionPhilippa Matthews1,2*, Colin Sharp3, Amna Malik4, Emily Adland4, Pieter Jooste5, Philip Goulder4, Peter Simmonds3,Paul Klenerman1,2,6From International Symposium HIV and Emerging Infectious Diseases 2014Marseille, France. 21-23 May 2013IntroductionFirst identified in 2005, PARV4 is best characterized inWestern cohorts where it is strongly associated withother blood borne viruses and occurs only in individualswith risk factors for parenteral infection (in particular,injecting drug users). However, studies in Africa haveshown evidence of PARV4 in subjects with no clear riskfactors for acquisition of blood borne viruses. The clini-cal significance of PARV4 remains uncertain, but thereis growing interest in the role of coinfecting pathogensin shaping outcomes of HIV, and in chronic viral infec-tions as determinants of immunological development inchildhood.Materials and methodsWe studied a cohort of HIV-infected mothers (n=32)and children (n=40; median age 28 months), and HIV-negative pediatric controls (n=24, median age 86months) in Kimberley, South Africa. PARV4 serostatuswas determined by ELISA for IgG to the PARV4 VP2protein. HIV viral load was determined using the Abbottm2000 assay, and CD4 T cell count by flow cytometry.ResultsIn this cohort, 45/96 individuals (46.9%) were positive forPARV4 IgG, including 19/32 adults (59.4%) and 26/64children (40.6%). The seroprevalence of PARV4 IgGincreased with age, demonstrating acquisition throughoutchildhood, plateauing by age 6-10 years (Fig. 1; R2=0.75 bylogistic regression). There was strong concordancebetween maternal and child infection, with the mother’sPARV4 status being a clear predictor of IgG in her off-spring (p=0.006). HIV-negative individuals were morelikely than HIV-positive subjects to be PARV4 IgG posi-tive (p=0.03), although this relationship may be con-founded by age. There was no relationship betweenPARV4 status and HIV viral load or CD4 T cell count inHIV-infected adults or children.ConclusionsThe epidemiology of PARV4 in this cohort contrasts strik-ingly with that in Western countries: the prevalence ofPARV4 IgG approached 50%, with evidence for ongoingtransmission throughout the early years of life. Theobserved concordance within families is suggestive ofmaternal to child transmission. Future studies are planned,to investigate further the relationship between PARV4 sta-tus and outcomes of HIV infection.Authors’ details1Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK.2Department of Infectious Diseases and Microbiology, Oxford UniversityHospitals, John Radcliffe Hospital, Oxford, OX3 9DU, UK. 3Roslin Institute,University of Edinburgh, Easter Bush, Edinburgh, EH25 9RG, UK. 4Departmentof Pediatrics, University of Oxford, Oxford, OX1 3SY, UK. 5PaediatricDepartment, University of Free State, Kimberley Hospital, Kimberley, NorthernCape, South Africa. 6NIHR Biomedical Research Center, John RadcliffeHospital, Oxford OX3 9DU, UK.Published: 23 May 2014doi:10.1186/1471-2334-14-S2-P92Cite this article as: Matthews et al.: Paediatric PARV4 infection in SouthAfrica: relationship to age, maternal PARV4 status, and HIV infection.BMC Infectious Diseases 2014 14(Suppl 2):P92.1Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UKFull list of author information is available at the end of the articleMatthews et al. BMC Infectious Diseases 2014, 14(Suppl 2):P92http://www.biomedcentral.com/1471-2334/14/S2/P92© 2014 Matthews et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

http://dx.doi.org/10.1186/1471-2334-14-S2-P92

Paediatric PARV4 infection in South Africa: relationship to age, maternal PARV4 status, and HIV infection

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