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Kumari S, Thomas RK, R K, Barani R, Srikanth P. Ensuring Transfusion Safety: Screening Blood Donors for Human Parvovirus B19. Cureus 2024; 16:e67359. [PMID: 39310657 PMCID: PMC11413613 DOI: 10.7759/cureus.67359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
Ensuring the safety of blood and blood products is a vital aspect of healthcare. The potential for transmission of pathogens through blood and blood products makes transfusion safety a significant concern. Despite advancements in testing methodologies, donated blood products still pose a risk for infection transmission. Human parvovirus B19 (B19V) is a small, single-stranded, non-enveloped DNA virus transmissible parenterally by blood transfusion. B19V causes a wide range of clinical manifestations, which is generally harmless in healthy individuals. B19V infection may cause severe complications, such as aplastic crises, as it affects erythrocyte progenitor cells in individuals with increased erythrocyte turnover. Additionally, B19V can be transmitted from pregnant women to their foetus, potentially causing hydrops fetalis and foetal death. The potential for transmission through blood and blood products makes B19V a significant concern for transfusion safety. In response to the growing recognition of B19V's impact on transfusion safety, various international health organisations have introduced guidelines to minimise its transmission through blood and plasma products. However, the implementation of these guidelines varies globally, with some regions, such as India, still lacking formal protocols for B19V monitoring. This review article explores the existing methodologies for screening blood donors for B19V, assesses the associated transfusion risks, and considers the implications for public health and clinical practice. By emphasising advancements in diagnostic techniques and the challenges of their implementation, this article provides a comprehensive overview of efforts to reduce the transmission of B19V through blood transfusions, thereby ensuring safer blood supplies and improved patient outcomes.
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Affiliation(s)
- Swati Kumari
- Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | | | - Krishanamoorthy R
- Transfusion Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Ramya Barani
- Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Padma Srikanth
- Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Nordholm AC, Trier Møller F, Fischer Ravn S, Flink Sørensen L, Moltke-Prehn A, Elskær Mollerup J, Funk T, Sperling L, Jeyaratnam U, Træholt Franck K, Hjort-Pedersen K, Hjørnet Kamper C, Thoft Nielsen R, Jokelainen P, Wessman M. Epidemic of parvovirus B19 and disease severity in pregnant people, Denmark, January to March 2024. Euro Surveill 2024; 29. [PMID: 38873795 DOI: 10.2807/1560-7917.es.2024.29.24.2400299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
We report an epidemic of parvovirus B19 infections in Denmark during the first quarter of 2024, with a peak incidence 3.5 times higher than during the most recent epidemic in 2017. In total, 20.1% (130/648) of laboratory-confirmed cases were pregnant. Severe adverse outcomes were observed among 12.3% (16/130) of pregnant people and included foetal anaemia, foetal hydrops and miscarriage. Parvovirus B19 infection is not systematically monitored, but a national laboratory-based surveillance system is currently being established in Denmark.
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Affiliation(s)
- Anne Christine Nordholm
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Frederik Trier Møller
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Signe Fischer Ravn
- Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
| | - Lotte Flink Sørensen
- Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
| | - Anja Moltke-Prehn
- Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
| | - Jacob Elskær Mollerup
- Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
| | - Tjede Funk
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Lene Sperling
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Ulisa Jeyaratnam
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Kristina Træholt Franck
- Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Copenhagen, Denmark
| | - Karina Hjort-Pedersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | | | - Rikke Thoft Nielsen
- Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen, Denmark
| | - Pikka Jokelainen
- Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Maria Wessman
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Boissiere J, Watkins V, Kuller JA, Dotters-Katz SK. Parvovirus B19 in Pregnancy. Obstet Gynecol Surv 2024; 79:281-289. [PMID: 38764205 DOI: 10.1097/ogx.0000000000001263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Importance Although the risk of parvovirus B19 infection during pregnancy and subsequent risk of adverse fetal outcome are low, understanding management practices is essential for proper treatment of fetuses with nonimmune hydrops fetalis. In addition, continued investigation into delivery management, breastfeeding recommendations, and congenital abnormalities associated with pregnancies complicated by parvovirus B19 infection is needed. Objective This review describes the risks associated with parvovirus B19 infection during pregnancy and the management strategies for fetuses with vertically transmitted infections. Evidence Acquisition Original articles were obtained from literature search in PubMed, Medline, and OVID; pertinent articles were reviewed. Results Parvovirus B19 is a viral infection associated with negative pregnancy outcomes. Up to 50% of people of reproductive age are susceptible to the virus. The incidence of B19 in pregnancy is between 0.61% and 1.24%, and, overall, there is 30% risk of vertical transmission when infection is acquired during pregnancy. Although most pregnancies progress without negative outcomes, viral infection of the fetus may result in severe anemia, congestive heart failure, and hydrops fetalis. In addition, vertical transmission carries a 5% to 10% chance of fetal loss. In pregnancies affected by fetal B19 infection, Doppler examination of the middle cerebral artery peak systolic velocity should be initiated to surveil for fetal anemia. In the case of severe fetal anemia, standard fetal therapy involves an intrauterine transfusion of red blood cells with the goal of raising hematocrit levels to approximately 40% to 50% of total blood volume. One transfusion is usually sufficient, although continued surveillance may indicate the need for subsequent transfusions. There are fewer epidemiologic data concerning neonatal risks of congenital parvovirus, although case reports have shown that fetuses with severe anemia in utero may have persistent anemia, thrombocytopenia, and edema in the neonatal period. Conclusions and Relevance Parvovirus B19 is a common virus; seropositivity in the geriatric population reportedly reaches 85%. Within the pregnant population, up to 50% of patients have not previously been exposed to the virus and consequently lack protective immunity. Concern for parvovirus B19 infection in pregnancy largely surrounds the consequences of vertical transmission of the virus to the fetus. Should vertical transmission occur, the overall risk of fetal loss is between 5% and 10%. Thus, understanding the incidence, risks, and management strategies of pregnancies complicated by parvovirus B19 is essential to optimizing care and outcomes. Further, there is currently a gap in evidence regarding delivery management, breastfeeding recommendations, and the risks of congenital abnormalities in pregnancies complicated by parvovirus B19. Additional investigations into optimal delivery management, feeding plans, and recommended neonatal surveillance are needed in this cohort of patients.
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Affiliation(s)
- Jaye Boissiere
- Medical Student, Duke University Medical School, Durham, NC
| | - Virginia Watkins
- Fellow, Department of Obstetrics and Gynecology, Duke University, Durham, NC
| | - Jeffrey A Kuller
- Professor, Department of Obstetrics and Gynecology, Duke University, Durham, NC
| | - Sarah K Dotters-Katz
- Associate Professor, Department of Obstetrics and Gynecology, Duke University, Durham, NC
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Dittmer FP, Guimarães CDM, Peixoto AB, Pontes KFM, Bonasoni MP, Tonni G, Araujo Júnior E. Parvovirus B19 Infection and Pregnancy: Review of the Current Knowledge. J Pers Med 2024; 14:139. [PMID: 38392573 PMCID: PMC10890458 DOI: 10.3390/jpm14020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Parvovirus B19, a member of the Parvoviridae family, is a human pathogenic virus. It can be transmitted by respiratory secretions, hand-to-mouth contact, blood transfusion, or transplacental transmission. Most patients are asymptomatic or present with mild symptoms such as erythema infectiosum, especially in children. In rare cases, moderate-to-severe symptoms may occur, affecting blood cells and other systems, resulting in anemia, thrombocytopenia, and neutropenia. Non-immune pregnant women are at risk for fetal infection by parvovirus B19, with greater complications if transmission occurs in the first or second trimester. Infected fetuses may not show any abnormalities in most cases, but in more severe cases, there may be severe fetal anemia, hydrops, and even pregnancy loss. Maternal diagnosis of intrauterine parvovirus B19 infection includes IgG and IgM antibody testing. For fetal diagnosis, PCR is performed through amniocentesis. In addition to diagnosing the infection, it is important to monitor the peak of systolic velocity of the middle cerebral artery (PVS-MCA) Doppler to assess the presence of fetal anemia. There is no vaccine for parvovirus B19, and fetal management focuses on detecting moderate/severe anemia by fetal PVS-MCA Doppler, which, if diagnosed, should be treated with intrauterine transfusion by cordocentesis. Prevention focuses on reducing exposure in high-risk populations, particularly pregnant women.
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Affiliation(s)
- Fernanda Parciasepe Dittmer
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil
| | - Clara de Moura Guimarães
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil
| | - Alberto Borges Peixoto
- Gynecology and Obstetrics Service, Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba 38050-501, MG, Brazil
- Department of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (UFTM), Uberaba 38025-440, MG, Brazil
| | - Karina Felippe Monezi Pontes
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil
- Service of Gynecology and Obstetrics, Ipiranga Hospital, São Paulo 04262-000, SP, Brazil
| | - Maria Paola Bonasoni
- Department of Pathology, Santa Maria Nuova Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 50122 Reggio Emilia, Italy
| | - Gabriele Tonni
- Department of Obstetrics and Neonatology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil
- Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul 09521-160, SP, Brazil
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STOKES CALEB, J. MELVIN ANN. Viral Infections of the Fetus and Newborn. AVERY'S DISEASES OF THE NEWBORN 2024:450-486.e24. [DOI: 10.1016/b978-0-323-82823-9.00034-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Lino JF, Diniz LMO, Rezende LG, Costa VFT, Romanelli RMC. Diagnosis of congenital infections in premature, low-birthweight newborns with intrauterine growth restriction caused by cytomegalovirus (CMV), herpes simplex virus (HSV), Parvo-B 19, and Zika virus: a systematic review. J Perinat Med 2022; 50:993-1000. [PMID: 35427445 DOI: 10.1515/jpm-2021-0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To identify the prevalence of viral congenital infections in newborns classified as premature, low-birthweight, small for gestational age or intrauterine growth restriction. METHODS The definition considered for selecting papers were: P as newborns younger than 28 days; V as low-birthweight, prematurity and intrauterine growth restriction; O as frequency of congenital infections with Cytomegalovirus, Parvovirus B19, Herpes Simplex, and Zika virus. The research was performed using EMBASE, LILACS, SCOPUS and MEDLINE databases, with no limitations on date and language. RESULTS Eight studies were included. Manuscripts including Herpes Simplex, Zika virus or Parvovirus B19 did not fulfill the defined criteria. A wide variation in the frequency of CMV congenital infection (0-4.8%) was found, which might be attributed to regional and methodological differences between investigations. CONCLUSIONS Newborn characteristics associated with CMV congenital infections may direct investigations towards these patients with a higher probability of infection. However, as data are controversial, studies concerning screening of infection are important to define recommendations of diagnosis.
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Affiliation(s)
- Janaina F Lino
- Pediatrics Department of Federal University of Minas Gerais School Medicine, Belo Horizonte, Brazil
| | - Lilian M O Diniz
- Pediatrics Department of Federal University of Minas Gerais School Medicine, Belo Horizonte, Brazil
| | - Larissa G Rezende
- Federal University of Minas Gerais School Medicine, Belo Horizonte, Brazil
| | - Victoria F T Costa
- Federal University of Minas Gerais School Medicine, Belo Horizonte, Brazil
| | - Roberta M C Romanelli
- Pediatrics Department of Federal University of Minas Gerais School Medicine, Belo Horizonte, Brazil
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Ultrasound Findings of Fetal Infections: Current Knowledge. REPRODUCTIVE MEDICINE 2022. [DOI: 10.3390/reprodmed3030016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Infectious diseases during pregnancy are still a major cause of fetal mortality and morbidity worldwide. The most common teratogenic pathogens are cytomegalovirus (CMV), varicella-zoster virus (VZV), rubeovirus, parvovirus B19, herpes simplex virus (HSV), Toxoplasma gondii, Treponema pallidum and the emergent Zika virus (ZIKV). Ultrasound findings include cerebral anomalies, orbital defects, micrognathia, cardiac defects, hepatosplenomegaly, liver calcifications, abdominal anomalies, skin and limb anomalies, edema, placental and amniotic fluid anomalies and altered Doppler analyses. The classification of ultrasound markers of congenital infections by anatomical region is reported to guide differential diagnosis and prenatal care.
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Maranto M, Cigna V, Orlandi E, Cucinella G, Lo Verso C, Duca V, Picciotto F. Non-immune hydrops fetalis: Two case reports. World J Clin Cases 2021; 9:6531-6537. [PMID: 34435022 PMCID: PMC8362581 DOI: 10.12998/wjcc.v9.i22.6531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fetal hydrops is a serious condition difficult to manage, often with a poor prognosis, and it is characterized by the collection of fluid in the extravascular compartments. Before 1968, the most frequent cause was the maternal-fetal Rh incompatibility. Today, 90% of the cases are non-immune hydrops fetalis. Multiple fetal anatomic and functional disorders can cause non-immune hydrops fetalis and the pathogenesis is incompletely understood. Etiology varies from viral infections to heart disease, chromosomal abnormalities, hematological and autoimmune causes.
CASE SUMMARY A 38-year-old pregnant woman has neck lymphoadenomegaly, fever, cough, tonsillar plaques at 14 wk of amenorrhea and a rash with widespread itching. At 27.5 wk a fetal ultrasound shows signs of severe anemia and hydrops. Cordocentesis is performed with confirmation of severe fetal anemia and subsequent fetal transfusion. The karyotype is 46, XX, array-comparative genome hybridization (CGH) negative, and infectious tests are not conclusive. In the following days there is a progressive improvement of the indirect signs of fetal anemia. At 33.6 wk, for relapse of severe fetal anemia, further fetal transfusions are necessary and an urgent cesarean section is performed. On the day 12 of life, for the detection of anemia, the newborn is subjected to transfusion of concentrated red blood cells and begins treatment with erythropoietin. Later there is a normalization of blood chemistry values and the baby does not need new transfusions. A 29-year-old pregnant woman, with Sjogren's syndrome and positive Anti-Ro/SSA antibodies, is subjected to serial fetal ecocardio for branch block. At 26.5 wk there is a finding of fetal ascites. Infectious disease tests on amniotic fluid are negative as well as quantitative fluorescent polymerase chain reaction, Array CGH. At cordocentesis Hb is 1.3 mmol/L, consequently fetal transfusion is performed. Also in this case, due to continuous episodes of relapse of fetal anemia with consequent transfusions, at 29.4 wk a cesarean section is performed. On day 9 of life, a treatment with erythropoietin is started in the newborn, but the baby needs three blood transfusions. The search for autoantibodies in the baby found SS-A Ro60 positive, SSA-Ro52 positive and SS-B negative. The hemoglobin values normalized after the disappearance of maternal autoantibodies.
CONCLUSION An attempt to determine the etiology of hydrops should be made at the time of diagnosis because the goal is to treat underlying cause, whenever possible. Even if the infectious examinations are not conclusive, but the pregnancy history is strongly suggestive of infection as in the first case, the infectious etiology must not be excluded. In the second case, instead, transplacental passage of maternal autoantibodies caused hydrops fetalis and severe anemia. Finally, obstetric management must be aimed at fetal support up to an optimal timing for delivery by evaluating risks and benefits to increase the chances of survival without sequelae.
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Affiliation(s)
- Marianna Maranto
- Fetal Medicine and Prenatal Diagnosis Unit, Villa Sofia Cervello Hospitals, Palermo 90146, Italy
| | - Valentina Cigna
- Fetal Medicine and Prenatal Diagnosis Unit, Villa Sofia Cervello Hospitals, Palermo 90146, Italy
| | - Emanuela Orlandi
- Fetal Medicine and Prenatal Diagnosis Unit, Villa Sofia Cervello Hospitals, Palermo 90146, Italy
| | - Gaspare Cucinella
- Health Promotion, Maternal and Infant Care Unit, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Palermo 90100, Italy
| | - Clelia Lo Verso
- Neonatology and Neonatal Intensive Care Unit, Civico Di Cristina Benfratelli Hospital, Palermo 90100, Italy
| | - Vincenzo Duca
- Neonatology and Neonatal Intensive Care Unit, Ingrassia Hospital, Palermo 90100, Italy
| | - Francesco Picciotto
- Fetal Medicine and Prenatal Diagnosis Unit, Villa Sofia Cervello Hospitals, Palermo 90146, Italy
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Cruz-Martínez R, Sosa Sosa C, Martínez-Rodríguez M, Gámez-Varela A, Villalobos-Gómez R, López-Briones H, Luna-García J, Chávez-González E, Juárez-Martínez I. Single Uterine Access for Bilateral Pleuroamniotic Shunting in Fetuses with Severe Hydrothorax by an Internal Rotational Maneuver: Feasibility and Outcomes between Successful and Failed Procedures. Fetal Diagn Ther 2021; 48:209-216. [PMID: 33677452 DOI: 10.1159/000513748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/13/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to describe the feasibility of single percutaneous uterine access for bilateral pleuroamniotic shunting (PAS) in fetuses with severe hydrothorax by using an internal rotational maneuver and to compare perinatal outcomes between successful and failed procedures. METHODS A prospective cohort of 25 fetuses with isolated bilateral hydrothorax and hydrops were referred to our fetal surgery center in Queretaro, Mexico during an 8-year period. Bilateral PAS was first attempted through a percutaneous single uterine access by internal rotation of the fetus, which was achieved by using the blunt tip of the same cannula, and in case of a failed procedure, a second uterine port was used to place the second shunt. The perinatal outcomes between successful (single uterine port) and failed (2 uterine ports) fetal procedures were compared. RESULTS Placing of bilateral shunts through a percutaneous single uterine access was feasible in 15/25 (60%) cases. Overall, median GA at delivery was 35.2 weeks with a survival rate of 64.0% (16/25). Three cases were excluded due to shunt dislodgement, leaving a final population of 22 fetuses; 13/22 (59.1%) and 9/22 (40.9%) managed using 1 and 2 uterine ports, respectively. The group with bilateral PAS placement through a successful single uterine port showed a significantly higher GA at birth (36.5 vs. 32.8 weeks, p = 0.001), lower surgical time (11.0 vs. 19.0 min, p = 0.01), longer interval between fetal intervention and delivery (5.7 vs. 2.7 weeks, p = 0.01), lower risk of preterm delivery (46.2 vs. 100%, p < 0.01), and lower rate of perinatal death (15.4 vs. 55.6%, p < 0.05) than the failed procedures requiring 2 uterine ports. CONCLUSION In fetuses with severe bilateral hydrothorax and hydrops, bilateral pleuroamniotic shunting through a successful single percutaneous uterine access is feasible in up to 60% of cases and is associated with better perinatal outcomes.
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Affiliation(s)
- Rogelio Cruz-Martínez
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico, .,Instituto de Ciencias de la Salud (ICSa), Universidad Autónoma del Estado de Hidalgo (UAEH), Hidalgo, Mexico, .,Department of Fetal Surgery, Hospital de Especialidades del Niño y la Mujer "Dr. Felipe Núñez-Lara,", Queretaro, Mexico,
| | - Cristian Sosa Sosa
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Miguel Martínez-Rodríguez
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico.,Department of Fetal Surgery, Hospital de Especialidades del Niño y la Mujer "Dr. Felipe Núñez-Lara,", Queretaro, Mexico
| | - Alma Gámez-Varela
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Rosa Villalobos-Gómez
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Hugo López-Briones
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Jonahtan Luna-García
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Eréndira Chávez-González
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
| | - Israel Juárez-Martínez
- Prenatal Diagnosis and Fetal Surgery Center, Fetal Medicine Mexico and Fetal Medicine Foundation of Mexico, Queretaro, Mexico
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10
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Attwood LO, Holmes NE, Hui L. Identification and management of congenital parvovirus B19 infection. Prenat Diagn 2020; 40:1722-1731. [PMID: 32860469 DOI: 10.1002/pd.5819] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022]
Abstract
Parvovirus B19 (B19V) infection is well known for its mild, self-limiting clinical presentations in children, such as erythema infectiosum. Approximately 40% of women of childbearing age are susceptible to B19V infection. While maternal B19V infection usually has a good prognosis, B19V can cause severe fetal anaemia and pregnancy loss due to its ability to suppress erythroid progenitor cells. Non-invasive ultrasound monitoring for fetal anaemia is usually performed if maternal seroconversion occurs in the first 20 weeks of gestation, with amniocentesis for fetal infection reserved for those who first present with fetal anaemia or hydrops of unknown cause. Intrauterine transfusion is the standard treatment for severe fetal anaemia and is associated with a significant improvement in survival. However, survivors of hydrops fetalis may have a higher rate of long-term neurodevelopmental complications compared with non-hydropic survivors. This review aims to synthesise published data on the diagnosis, surveillance and outcomes of congenital parvovirus infection to assist clinicians in diagnosing and managing this important condition.
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Affiliation(s)
- Lucy O Attwood
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
| | - Natasha E Holmes
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.,Department of Perinatal Medicine, Mercy Hospital for Women, Melbourne, Victoria, Australia.,Department of Medicine and Radiology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Hui
- Department of Perinatal Medicine, Mercy Hospital for Women, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.,Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, Northern Health, Melbourne, Victoria, Australia
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Bua G, Tedesco D, Conti I, Reggiani A, Bartolini M, Gallinella G. No G-Quadruplex Structures in the DNA of Parvovirus B19: Experimental Evidence versus Bioinformatic Predictions. Viruses 2020; 12:E935. [PMID: 32854437 PMCID: PMC7552014 DOI: 10.3390/v12090935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022] Open
Abstract
Parvovirus B19 (B19V), an ssDNA virus in the family Parvoviridae, is a human pathogenic virus, responsible for a wide range of clinical manifestations, still in need of effective and specific antivirals. DNA structures, including G-quadruplex (G4), have been recognised as relevant functional features in viral genomes, and small-molecule ligands binding to these structures are promising antiviral compounds. Bioinformatic tools predict the presence of potential G4 forming sequences (PQSs) in the genome of B19V, raising interest as targets for antiviral strategies. Predictions locate PQSs in the genomic terminal regions, in proximity to replicative origins. The actual propensity of these PQSs to form G4 structures was investigated by circular dichroism spectroscopic analysis on synthetic oligonucleotides of corresponding sequences. No signature of G4 structures was detected, and the interaction with the G4 ligand BRACO-19 (N,N'-(9-{[4-(dimethylamino)phenyl]amino}acridine-3,6-diyl)bis(3-pyrrolidin-1-ylpropanamide) did not appear consistent with the stabilisation of G4 structures. Any potential role of PQSs in the viral lifecycle was then assessed in an in vitro infection model system, by evaluating any variation in replication or expression of B19V in the presence of the G4 ligands BRACO-19 and pyridostatin. Neither showed a significant inhibitory activity on B19V replication or expression. Experimental challenge did not support bioinformatic predictions. The terminal regions of B19V are characterised by relevant sequence and symmetry constraints, which are functional to viral replication. Our experiments suggest that these impose a stringent requirement prevailing over the propensity of forming actual G4 structures.
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Khalil A, Sotiriadis A, Chaoui R, da Silva Costa F, D'Antonio F, Heath PT, Jones C, Malinger G, Odibo A, Prefumo F, Salomon LJ, Wood S, Ville Y. ISUOG Practice Guidelines: role of ultrasound in congenital infection. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:128-151. [PMID: 32400006 DOI: 10.1002/uog.21991] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - A Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - F da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - F D'Antonio
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
| | - P T Heath
- Paediatric Infectious Diseases Research Group and Vaccine Institute, St George's University of London and St George's University Hospitals NHS Trust, London, UK
| | - C Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G Malinger
- Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Odibo
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - F Prefumo
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - L J Salomon
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
| | | | - Y Ville
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
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Li X, Lin Z, Liu J, Tang Y, Yuan X, Li N, Lin Z, Chen Y, Liu A. Overall prevalence of human parvovirus B19 among blood donors in mainland China: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2020; 99:e19832. [PMID: 32332630 PMCID: PMC7220778 DOI: 10.1097/md.0000000000019832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Human parvovirus B19 (B19V) infection exhibits a broad range of clinical outcomes. Blood transfusion is a common route of B19V transmission. However, information about the overall prevalence of B19V infection and B19V genotypes among blood donors in mainland China is lacking. METHODS This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search for studies reporting the B19V prevalence among blood donors in mainland China from 2000 to 2018 was performed. The prevalence of B19V was estimated through a meta-analysis of the relevant literature. A comprehensive meta-analysis program was used for data processing and statistical analysis. RESULTS Twenty-one eligible articles were included, involving 48,923 participants assessed for B19V-DNA, 12,948 participants assessed for anti-B19V immunoglobulin M (IgM), and 8244 participants assessed for anti-B19V immunoglobulin G (IgG). The analysis revealed the pooled estimates of the prevalence rates of B19V-DNA, anti-B19V IgM, and anti-B19V IgG among blood donors to be 0.7% (95% confidence interval [CI] 0.2-2.4%), 2.7% (95% CI 1.7-4.3%), and 33.6% (95% CI 28.2-39.4%), respectively. Moreover, phylogenetic analyses indicated that 142 of 169 (84.0%) B19V isolates belonged to Genotype 1. CONCLUSIONS The overall prevalence of B19V among blood donors is not high in mainland China, and most isolates belong to Genotype 1.
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Affiliation(s)
- Xin Li
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
- Department of Blood Transfusion Medicine, School of Medical Technology and Engineering
| | - Zheng Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health
| | - Jiayan Liu
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
| | - Yuanyuan Tang
- Department of Rheumatology, Weifang Yidu Central Hospital, Weifang, Shandong Province
| | - Xiaohong Yuan
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
| | - Nainong Li
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
| | - Zhenxing Lin
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
| | - Yuanzhong Chen
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
| | - Ailin Liu
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital
- Department of Pharmaceutical Analysis, Faculty of Pharmacy, Fujian Medical University, Fuzhou, Fujian Province, China
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Tomlinson JE, Jager M, Struzyna A, Laverack M, Fortier LA, Dubovi E, Foil LD, Burbelo PD, Divers TJ, Van de Walle GR. Tropism, pathology, and transmission of equine parvovirus-hepatitis. Emerg Microbes Infect 2020; 9:651-663. [PMID: 32192415 PMCID: PMC7144241 DOI: 10.1080/22221751.2020.1741326] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Equine parvovirus-hepatitis (EqPV-H) has recently been associated with cases of Theiler's disease, a form of fulminant hepatic necrosis in horses. To assess whether EqPV-H is the cause of Theiler's disease, we first demonstrated hepatotropism by PCR on tissues from acutely infected horses. We then experimentally inoculated horses with EqPV-H and 8 of 10 horses developed hepatitis. One horse showed clinical signs of liver failure. The onset of hepatitis was temporally associated with seroconversion and a decline in viremia. Liver histology and in situ hybridization showed lymphocytic infiltrates and necrotic EqPV-H-infected hepatocytes. We next investigated potential modes of transmission. Iatrogenic transmission via allogeneic stem cell therapy for orthopedic injuries was previously suggested in a case series of Theiler's disease, and was demonstrated here for the first time. Vertical transmission and mechanical vectoring by horse fly bites could not be demonstrated in this study, potentially due to limited sample size. We found EqPV-H shedding in oral and nasal secretions, and in feces. Importantly, we could demonstrate EqPV-H transmission via oral inoculation with viremic serum. Together, our findings provide additional information that EqPV-H is the likely cause of Theiler's disease and that transmission of EqPV-H occurs via both iatrogenic and natural routes.
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Affiliation(s)
- Joy Ellen Tomlinson
- Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Mason Jager
- Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | | | - Melissa Laverack
- New York State Animal Health Diagnostic Center, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Lisa Ann Fortier
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Edward Dubovi
- New York State Animal Health Diagnostic Center, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Lane D Foil
- Entomology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Peter D Burbelo
- Dental Clinical Research Core, National Institute of Dental and Craniofacial Research, National Institute of Health, Bethesda, MD, USA
| | - Thomas J Divers
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
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15
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Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev 2019; 33:33/1/e00130-18. [PMID: 31826871 DOI: 10.1128/cmr.00130-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.
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16
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Salbetti MB, Pedranti MS, Barbero P, Molisani P, Lazzari M, Olivera N, Isa MB, Bertoldi A, Moreno L, Adamo MP. Molecular screening of the human parvoviruses B19 and bocavirus 1 in the study of congenital diseases as applied to symptomatic pregnant women and children. Access Microbiol 2019; 1:e000037. [PMID: 32974527 PMCID: PMC7470285 DOI: 10.1099/acmi.0.000037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction B19 virus (B19V) and bocavirus 1 (HBoV1) are human pathogenic parvoviruses that are prevalent worldwide and are responsible for a diverse and not yet fully established spectrum of clinical manifestations. Objective To screen B19V and HBoV1 in patients with clinical manifestations associated with acquisition of the infection during gestation. Methods A retrospective, observational study was performed that included serum samples from patients without a previous known aetiology. B19V and HBoV1 were determined by end-point PCR. Positive samples were genotyped. Results A total of 106 serum samples were analysed, 61 from pregnant women and 45 from neonates and paediatric patients. None were positive for HBoV1, while B19V was detected in 37/106 [34.9 %, 95 % confidence interval (CI): 26.5–44.4] of the samples studied. In the group of pregnant women, 28/61 (45.9 %, 95 % CI: 34.0–58.3) were B19V-positive, and 2 of them had foetal anaemia followed by hydrops and foetal death, 3 were associated with a history of recurrent pregnancy loss and there was 1 case of spontaneous abortion. B19V was also detected in cases of maternal febrile exanthema, polyhydramnios, oligohydramnios and foetal ascites. In the group of children, 9/45 (20.0 %, 95 % CI: 10.9–33.8) neonatal patients were B19V-positive, and this was associated with foetal hydrops, TORCH syndrome and cardiac alterations. The nucleotide sequences analysed confirmed the identity of B19V genotype 1. Conclusions We found no evidence to indicate the presence of HBoV1 in maternal blood or in the newborns/paediatric patients (hence providing no support for the supposed vertical transmission). On the other hand, the high frequency of B19V in the pathologies studied indicates the importance of molecular diagnosis in both the mother and the child. Future efforts should contribute to early detection and characterization of infections.
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Affiliation(s)
- Maria Belen Salbetti
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
| | - Mauro Sebastian Pedranti
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
| | - Paula Barbero
- Área de Epidemiología, Ministerio de Salud de la Provincia de Córdoba, Av. Vélez Sarsfield 2311, Córdoba, Argentina
| | - Paula Molisani
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
| | - Martina Lazzari
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
| | - Nicolas Olivera
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
| | - Maria Beatriz Isa
- Clínica Universitaria Reina Fabiola, Córdoba, Oncativo 1248, Córdoba, Argentina
| | - Ariel Bertoldi
- Clínica Universitaria Reina Fabiola, Córdoba, Oncativo 1248, Córdoba, Argentina
| | - Laura Moreno
- Cátedra de Clínica Pediátrica, Hospital Universitario de Maternidad y Neonatología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Rodríguez Peña 285, Córdoba, Argentina
| | - Maria Pilar Adamo
- Laboratorio de Rubéola y Parvovirus, Instituto de Virología “Dr J. M. Vanella”, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Enf. Gordillo Gómez s/n, Ciudad Universitaria, Córdoba, Argentina
- *Correspondence: Maria Pilar Adamo,
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17
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Xiong YQ, Tan J, Liu YM, He Q, Li L, Zou K, Sun X. The risk of maternal parvovirus B19 infection during pregnancy on fetal loss and fetal hydrops: A systematic review and meta-analysis. J Clin Virol 2019; 114:12-20. [PMID: 30897374 DOI: 10.1016/j.jcv.2019.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/11/2019] [Accepted: 03/07/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Human parvovirus B19 (B19) is widespread infection in humans, yet the impact on adverse pregnancy outcomes is controversial. OBJECTIVE to evaluate the impact of B19 infection during pregnancy on adverse pregnancy outcome, and investigated the incidence of fetal loss and fetal hydrops after maternal B19 infection during pregnancy. STUDY DESIGN A systematic literature search was performed using Embase, Medline, PubMed, Web of science, and the Cochrane Library database for relevant publications up to 10th August 2018. Cohort studies and case-control studies were included in analyses. RESULTS In total, 36 eligible studies were included. Of these, 18 studies reported the risk of maternal B19 infection during pregnancy on fetal loss and 20 studies reported the incidence of fetal loss or fetal hydrops after maternal B19 infection. Collectively, the results indicated that maternal B19 infection increased the risk of fetal loss, spontaneous abortion, and stillbirth with ORs of 2.68 (95% CI: 2.02-3.55), 2.42 (95% CI: 1.76-3.33), and 3.53 (95% CI: 1.91-6.54), respectively, when compared with uninfected pregnant women. In addition, the incidence of fetal loss and fetal hydrops in B19 infected pregnant women was 7.6% (95% CI: 5.5-9.5) and 9.3% (95% CI: 5.6-13.0), respectively. CONCLUSIONS maternal parvovirus B19 infection during pregnancy increased the risk of fetal loss, spontaneous abortion, and stillbirth. A high incidence of fetal loss and fetal hydrops was observed in pregnant women with parvovirus B19 infection.
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Affiliation(s)
- Yi-Quan Xiong
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jing Tan
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yan-Mei Liu
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qiao He
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ling Li
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Kang Zou
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xin Sun
- Chinese Evidence-based Medicine Centre and CREAT Group, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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18
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Bascietto F, Liberati M, Murgano D, Buca D, Iacovelli A, Flacco ME, Manzoli L, Familiari A, Scambia G, D'Antonio F. Outcome of fetuses with congenital parvovirus B19 infection: systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:569-576. [PMID: 29785793 DOI: 10.1002/uog.19092] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/26/2018] [Accepted: 05/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the outcome of fetuses affected by congenital parvovirus B19 (PB19) infection, with or without signs of hydrops on ultrasound. METHODS PubMed, EMBASE and CINAHL databases were searched for studies reporting on prenatal diagnosis and outcome of fetal PB19 infection. The outcomes explored were miscarriage, perinatal death (PND), intrauterine death, neonatal death, spontaneous resolution of hydrops or fetal anemia, need for intrauterine transfusion (IUT), resolution of hydrops or anemia after transfusion, fetal loss following transfusion, abnormal brain scan after birth and abnormal neurodevelopmental outcome. Outcomes were reported according to the presence or absence of signs of hydrops on ultrasound. A subgroup analysis was performed including hydropic and non-hydropic fetuses diagnosed at < 20 weeks and ≥ 20 weeks of gestation. Meta-analyses of proportions and meta-analyses using individual-data random-effects logistic regression were performed to analyze the data. RESULTS Thirty-five observational studies were included, involving 611 fetuses affected by PB19 infection. The risks of miscarriage (odds ratio (OR), 11.5; 95% CI, 2.7-49.7) and PND (OR, 4.2; 95% CI, 1.6-11.0) were higher in fetuses with PB19 infection presenting, compared with those not presenting, signs of hydrops on ultrasound. In fetuses affected by hydrops, spontaneous resolution of the infection, defined as disappearance of hydrops without need for IUT, occurred in 5.2% (95% CI, 2.5-8.8%) of cases whereas, in the group of fetuses not affected by hydrops, infection resolved in 49.6% (95% CI, 20.7-78.6%) of cases. IUT was performed in 78.7% (95% CI, 66.4-88.8%) of hydropic and in 29.6% (95% CI, 6.0-61.6%) of non-hydropic fetuses affected by congenital PB19 infection and resolution of the infection after IUT occurred in 55.1% (95% CI, 34.0-75.3%) and in 100% (95% CI, 57.3-100%) of cases, respectively. The risk of fetal loss after IUT was higher in fetuses affected compared with those not affected by hydrops (OR, 9.8; 95% CI, 2.8-34.6). The prevalence of abnormal brain imaging was 9.8% (95% CI, 2.5-21.0%) in fetuses affected and 0.0% (95% CI, 0.0-7.0%) in those not affected by hydrops, whilst the corresponding figures for abnormal neurodevelopmental outcome were 9.5% (95% CI, 2.6-20.2) and 0.0% (95% CI, 0.0-7.5), respectively; however, statistical power to assess these outcomes was inadequate due to the small number of included cases. CONCLUSIONS Hydrops is the main determinant of mortality and adverse perinatal outcome in fetuses with PB19 infection. Perinatal outcome in non-hydropic fetuses is generally favorable. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Bascietto
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - M Liberati
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - D Murgano
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - D Buca
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - A Iacovelli
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - M E Flacco
- Local Health Unit of Pescara, Pescara, Italy
| | - L Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - A Familiari
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - G Scambia
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - F D'Antonio
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
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Chirambo-Kalolekesha M, Kaile T, Mwaba F, Daka V, Simakando M, Kowa S. Seroprevalence of parvovirus B19 in blood donors: the risks and challenges of blood transfusion in Zambia in the era of HIV/AIDS at the Kitwe Central Hospital, blood bank. Afr Health Sci 2018; 18:496-502. [PMID: 30602980 PMCID: PMC6307010 DOI: 10.4314/ahs.v18i3.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Human Parvovirus (B19V) is a small, single-stranded, non-enveloped DNA virus which is pathogenic to humans causing a wide array of clinical complications which include erythema infectiosum, aplastic crisis and hydrops foetalis. It is generally harmless in healthy individuals but may be life threatening in immunocompromised individuals such as patients with sickle cell disease, cancer, HIV and pregnant women. It has been shown to be transmissible by blood transfusion but donor screening for the virus is not yet mandatory in most sub-Saharan African countries including Zambia. MATERIALS AND METHODS This was a cross-sectional study undertaken at the Kitwe Central Hospital, blood bank and Tropical Diseases Research Centre at Ndola Central Hospital. A total of 192 blood samples were screened for Ig M antibodies against parvovirus B19 by ELISA. OBJECTIVES The general objective of the study was to determine the seroprevalence of parvovirus B19 infections among healthy blood donors at the Kitwe Central Hospital blood bank. Specific Objectives were to detect parvovirus B19 Ig M antibodies in donor blood using serology and to analyse the age and sex distribution of parvovirus among blood donors. RESULTS The prevalence of parvovirus B19 Ig M in this study was 15.6%. The majority of the positive cases were in the age group 15-22 years (17.8%) but there was no statistical significance between occurrence of parvovirus and age ( p value=0.703). Prevalence in males was higher than in females that is 16.4% and 13.8%, respectively. The relationship between gender and parvovirus B19 occurrence was however not significant either (p value=0.516). CONCLUSION This study showed a 15.6% prevalence rate of acute Parvovirus B19 infections in blood donors at the Kitwe Central Hospital, blood bank. Studies with larger sample sizes are needed to validate these results.
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Affiliation(s)
| | - Trevor Kaile
- University of Zambia, School of Medicine, Department of Pathology and Microbiology
| | - Florence Mwaba
- University of Zambia, School of Medicine, Department of Pathology and Microbiology
| | - Victor Daka
- University of Zambia, School of Medicine, Department of Pathology and Microbiology
| | - Marah Simakando
- University of Zambia, School of Medicine, Department of Pathology and Microbiology
| | - Sumbukeni Kowa
- University of Zambia, School of Medicine, Department of Pathology and Microbiology
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20
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Affiliation(s)
- Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
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21
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Bonvicini F, Bua G, Gallinella G. Parvovirus B19 infection in pregnancy-awareness and opportunities. Curr Opin Virol 2017; 27:8-14. [PMID: 29096233 DOI: 10.1016/j.coviro.2017.10.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/26/2017] [Accepted: 10/11/2017] [Indexed: 12/31/2022]
Abstract
Parvovirus B19 (B19V) is a human pathogenic virus associated with a wide range of clinical conditions. In pregnancy, B19V poses a potential hazard to the fetus as crossing the placental barrier and infecting erythroid progenitor cells in bone marrow and liver, it blocks fetal erythropoiesis leading to profound anemia, hydrops and/or fetal death. The virus is not regarded as a teratogen, however more scientific awareness is emerging on mechanisms and consequences of intrauterine infection and possible sequelae in the neonatal development. Reliable diagnostic procedures and fetal management strategies, including intrauterine transfusion, are established. In spite of being a recognized fetotropic agent possibly leading to fetal loss, testing for B19V is not routinely included in preconception or antenatal screenings, possibly delaying the management of B19V-complicated pregnancies. Continuous advances in B19V research will provide for better diagnostic methods and algorithms, as well as for the development of effective prophylactic interventions and novel therapeutic options.
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Affiliation(s)
- Francesca Bonvicini
- Department of Pharmacy and Biotechnology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
| | - Gloria Bua
- Department of Pharmacy and Biotechnology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; S.Orsola-Malpighi Hospital - Microbiology, Via Massarenti 9, 40138 Bologna, Italy
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Cui J, Biernacka K, Fan J, Gerber PF, Stadejek T, Opriessnig T. Circulation of Porcine Parvovirus Types 1 through 6 in Serum Samples Obtained from Six Commercial Polish Pig Farms. Transbound Emerg Dis 2016; 64:1945-1952. [PMID: 27882679 DOI: 10.1111/tbed.12593] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Indexed: 01/10/2023]
Abstract
Porcine parvoviruses are small non-enveloped DNA viruses, very resistant to inactivation, and ubiquitous in the global pig population. Porcine parvovirus type 1 (PPV1) has been known since the 1960s and is a major causative agent of reproductive failure in breeding herds. During the last decade, several new parvoviruses have been identified in pigs by molecular methods and have been consecutively designated as PPV2 through PPV6. Epidemiology data for these viruses are limited, and the impact of these newly recognized parvoviruses on pigs is largely unknown. To further generate knowledge on the distribution of PPVs in pigs, a total of 247 serum samples were collected from six commercial Polish pig farms during 2013-2015 and tested by PCR assays and ELISAs. The pigs ranged from two to 18 weeks of age at sample collection. Breeding herds supplying the investigated farms were routinely vaccinated against PPV1. While all growing pig samples were negative for PPV1 DNA, young pigs were frequently negative for PPV1 antibodies and seroconversion to PPV1 was commonly seen at 9-10 weeks of age. The PPV2 antibody detection was highest in young pigs (2-6-week-old) and decreased in older pigs indicating passively acquired antibodies. The DNA prevalence rates in the serum samples analysed were 19% for PPV2, 7.7% for PPV3, 2.4% for PPV4, 4.0% for PPV5 and 6.1% for PPV6. Most PPV DNA-positive samples were identified in 9- to 18-week-old pigs with no obvious association with disease on the farm. All recently emerging PPV genotypes were detected in Polish farms. Similar to previous reports in other pig populations, PPV2 was the most frequent PPV genotype circulating in Poland.
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Affiliation(s)
- J Cui
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - K Biernacka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - J Fan
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK.,College of Veterinary Medicine, Agricultural University of Hebei, Baoding, China
| | - P F Gerber
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - T Stadejek
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - T Opriessnig
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK.,Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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23
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Bonvicini F, Bua G, Manaresi E, Gallinella G. Enhanced inhibition of parvovirus B19 replication by cidofovir in extendedly exposed erythroid progenitor cells. Virus Res 2016; 220:47-51. [DOI: 10.1016/j.virusres.2016.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/30/2016] [Accepted: 04/01/2016] [Indexed: 12/22/2022]
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24
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Gilarranz R, Chamizo F, Hernández-Febles M, Valle L, Pena-Lopez MJ. Parvovirus B19 congenital infection. Infect Dis (Lond) 2016; 48:566-8. [DOI: 10.3109/23744235.2016.1163731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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25
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Parvovirus B19 Replication and Expression in Differentiating Erythroid Progenitor Cells. PLoS One 2016; 11:e0148547. [PMID: 26845771 PMCID: PMC4742074 DOI: 10.1371/journal.pone.0148547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/20/2016] [Indexed: 01/30/2023] Open
Abstract
The pathogenic Parvovirus B19 (B19V) is characterized by a strict adaptation to erythroid progenitor cells (EPCs), a heterogeneous population of differentiating cells with diverse phenotypic and functional properties. In our work, we studied the dynamics of B19V infection in EPCs in dependence on the cell differentiation stage, in terms of distribution of infected cells, synthesis of viral nucleic acids and production of infectious virus. EPCs at early differentiation stage led to an abortive infection, without viral genome replication and a very low transcriptional activity. EPCs at later stages were permissive, with highest levels of viral replicative activity at day 9 (+3.0 Log from 2 to 48 hpi) and lower levels at day 18 (+1.5 Log from 2 to 48 hpi). B19V DNA increment was in accordance with the percentage of cells positive to flow-FISH assay (41.4% at day 9, 1.1% at day 18). Quantitation of total RNA indicated a close association of genome replication and transcription with viral RNA accumulation within infected cells related to viral DNA increase during the course of infection. Analysis of the different classes of mRNAs revealed two distinct pattern of genome expression profile with a fine regulation in the frequency utilization of RNA processing signals: an early phase, when cleavage at the proximal site leading to a higher relative production of mRNA for NS protein, and a late phase, when cleavage at the distal site was more frequent leading to higher relative abundance of mRNA for VP and 11 kDA proteins. Infectious virus was released from cells at day 6–15, but not at day 18. Our results, providing a detailed description of B19V replication and expression profile in differentiating EPCs, highlight the very tight adaptation of B19V to a specific cellular target defined both by its erythroid lineage and its differentiation stage.
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26
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Habibagahi M, Habibagahi Z, Saidmardani SM, Sadeghian F. No Definite Association between Human Parvovirus B19 Infection and Behçet Disease. IRANIAN JOURNAL OF MEDICAL SCIENCES 2015; 40:493-500. [PMID: 26538777 PMCID: PMC4628139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND The etiology of the Behçet disease (BD) has remained obscured. There have been studies to show the association of BD to infections like herpes simplex, hepatitis, and parvovirus B19 however, the findings are rather controversial. MATERIALS AND METHODS We selected 55 patients with the best matched symptoms of BD and measured the loads of B19 DNA in their plasma by quantitative real time PCR and verified their seropositivity by ELISA. All findings were compared to the results from 42 healthy persons. RESULTS Patients showed a wide spectrum of BD symptoms. Serologic studies showed high prevalence of B19 IgG among the tested patients which was not statistically different with the healthy population (72.7% vs. 85.7%, respectively). Similarly, the prevalence of B19 IgM between patients and controls was not different (18% vs. 11.9%, respectively). No correlation was found between the presence of anti-B19 antibodies and the clinical observations. Only one person from the patient and control groups had detectable levels of B19 DNA without any difference or correlation with the disease symptoms. CONCLUSION Our data could not establish an association between B19 parvovirus infection and Behçet disease, although there have been reports of such correlation. Nevertheless, there might be indirect relation in genetically susceptible individuals after viral infections. More studies on designed animal models and surveys on patients should be done to resolve this controversy.
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Affiliation(s)
- Mojtaba Habibagahi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Mojtaba Habibagahi, PhD; Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Zand Blvd, Shiraz, Iran Tel/Fax: +98 71 32351575
| | - Zahra Habibagahi
- Department of Rheumatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Said-Mostafa Saidmardani
- Department of Rheumatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faezeh Sadeghian
- Department of Rheumatology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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27
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Marano G, Vaglio S, Pupella S, Facco G, Calizzani G, Candura F, Liumbruno GM, Grazzini G. Human Parvovirus B19 and blood product safety: a tale of twenty years of improvements. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:184-96. [PMID: 25849894 PMCID: PMC4385066 DOI: 10.2450/2014.0174.14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/09/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Giuseppe Marano
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Stefania Vaglio
- Italian National Blood Centre, National Institute of Health, Rome, Italy
- Faculty of Medicine and Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Simonetta Pupella
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Giuseppina Facco
- Italian National Blood Centre, National Institute of Health, Rome, Italy
- Immunohaemathology and Transfusion Medicine Unit, Joint Hospital-University Institution “Città della Salute e della Scienza”, Turin, Italy
| | - Gabriele Calizzani
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | - Fabio Candura
- Italian National Blood Centre, National Institute of Health, Rome, Italy
| | | | - Giuliano Grazzini
- Italian National Blood Centre, National Institute of Health, Rome, Italy
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28
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Duedu KO, Sagoe KWC, Ayeh-Kumi PF, Affrim RB, Adiku T. The effects of co-infection with human parvovirus B19 and Plasmodium falciparum on type and degree of anaemia in Ghanaian children. Asian Pac J Trop Biomed 2015; 3:129-39. [PMID: 23593592 DOI: 10.1016/s2221-1691(13)60037-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 12/12/2012] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To determin the extent to which parvovirus B19 (B19V) and co-infection of B19V and malaria contribute to risk of anaemia in children. METHODS B19V DNA and malaria parasites were screened for 234 children at the PML Children's Hospital in Accra. The role of B19V and co-infection with B19V and malaria in anaemia was evaluated by analysing full blood cell counts, malaria and B19V DNA results from these children. RESULTS The prevalence of B19V, malaria and co-infection with B19V and malaria was 4.7%, 41.9% and 2.6%, respectively. Malaria posed a greater risk in the development of mild anaemia compared to severe anaemia (OR=5.28 vrs 3.15) whereas B19V posed a higher risk in the development of severe anaemia compared to mild anaemia (OR=4.07 vrs 1.00) from a non-anaemic child. Persons with co-infection with B19V and malaria had 2.23 times the risk (95% CI=0.40-12.54) of developing severe anaemia should they already have a mild anaemia. The degree of anaemia was about three times affected by co-infection (Pillai's trace=0.551, P=0.001) as was affected by malaria alone (Pillai's trace=0.185, P=0.001). B19V alone did not significantly affect the development of anaemia in a non-anaemic child. Microcytic anaemia was associated with B19V and co-infection with B19V and malaria more than normocytic normochromic anaemia. CONCLUSIONS B19V was associated with malaria in cases of severe anaemia. The association posed a significant risk for exacerbation of anaemia in mild anaemic children. B19V and co-infection with B19V and malaria may be associated with microcytic anaemia rather than normocytic normochromic anaemia as seen in cases of B19V infection among persons with red cell abnormalities.
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Affiliation(s)
- Kwabena Obeng Duedu
- Department of Microbiology, University of Ghana Medical School, Korle-Bu, Accra, Ghana ; Institute of Cell Biology, School of Biological Sciences, University of Edinburgh, Scotland, UK
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Abstract
SUMMARYParvovirus B19 (B19V) infection during pregnancy may have serious consequences like fetal anaemia, hydrops fetalis, and fetal loss. Since epidemiological data on B19V infection are generally lacking in Sudan, the current study aimed to determine the seroprevalence of B19V in Sudanese pregnant women. Five hundred women, attending antenatal clinics in Khartoum state between November 2008 and March 2009, were enrolled and screened for B19V IgG and IgM antibodies by enzyme immunoassays. The study revealed a B19V IgG seroprevalence of 61·4%, with one subject positive for IgM. B19V DNA was not detected by PCR in any of the tested individuals. B19V IgG seroprevalence was significantly correlated with multigravidity (P = 0·046). Our data showed that B19V infection is prevalent in Sudan and we recommend further studies in Sudanese women, particularly in those with complications and adverse outcomes of pregnancy.
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30
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Karabulut A, Gök S, Koçyiğit A. Non-immune hydrops fetalis without anemia due to parvovirus B19. Int J Gynaecol Obstet 2013; 124:82. [PMID: 24140219 DOI: 10.1016/j.ijgo.2013.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 07/14/2013] [Accepted: 09/27/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Aysun Karabulut
- Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey.
| | - Soner Gök
- Department of Obstetrics and Gynecology, Pamukkale University Medical School, Denizli, Turkey
| | - Ali Koçyiğit
- Department of Radiology, Pamukkale University Medical School, Denizli, Turkey
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Abstract
Parvovirus B19 is a widespread human pathogenic virus, member of the Erythrovirus genus in the Parvoviridae family. Infection can be associated with an ample range of pathologies and clinical manifestations, whose characteristics and outcomes depend on the interplay between the pathogenetic potential of the virus, its adaptation to different cellular environments, and the physiological and immune status of the infected individuals. The scope of this review is the advances in knowledge on the biological characteristics of the virus and of virus-host relationships; in particular, the interactions of the virus with different cellular environments in terms of tropism and ability to achieve a productive replicative cycle, or, on the contrary, to establish persistence; the consequences of infection in terms of interference with the cell physiology; the process of recognition of the virus by the innate or adaptive immune system, hence the role of the immune system in controlling the infection or in the development of clinical manifestations. Linked to these issues is the continuous effort to develop better diagnostic algorithms and methods and the need for development of prophylactic and therapeutic options for B19V infections.
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Affiliation(s)
- Giorgio Gallinella
- Department of Pharmacy and Biotechnology, University of Bologna, and Microbiology, S.Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy
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