Lui S L, Luk W K, Cheung C Y, Chan T M, Lai K N, Peiris J S
Department of Medicine, Queen Mary Hospital and The University of Hong Kong, Pokfulam, SAR, China.
Transplantation. 2001 Jan 15;71(1):59-64. doi: 10.1097/00007890-200101150-00010.
Parvovirus B19 (B19) infection is known to cause chronic infection leading to anemia in immunocompromised patients. Although nosocomial B19 infections in immunocompetent patients have been documented, no outbreaks in immunocompromised patients have been previously reported. Whether transmission can occur from a patient with chronic infection is also unknown.
An outbreak of B19 infection in a renal transplant unit was investigated by molecular analysis of the virus strains and a case-control study.
Three patients had genetically identical virus strains suggesting the occurrence of nosocomial transmission. The index case transmitted infection many weeks after the onset of her clinical symptoms. Other patients at risk of acquiring infection were those most intensively immunosuppressed. Viral load in the serum correlated with the hematological response. A rebound in the viral load was associated with clinical relapse and the failure of i.v. immunoglobulin therapy.
Nosocomial transmission of B19 can occur from immunocompromised patients even when they are in the chronic stage of the infection. The clinical and virological response to i.v. immunoglobulin therapy is variable and depends on the overall level of immunosuppression of the patient.
已知细小病毒B19（B19）感染可导致慢性感染，进而使免疫功能低下的患者出现贫血。虽然已有免疫功能正常患者发生医院内B19感染的记录，但此前尚无免疫功能低下患者发生感染暴发的报道。慢性感染患者是否会发生病毒传播也尚不清楚。
通过对病毒株进行分子分析和病例对照研究，对一家肾移植病房发生的B19感染暴发进行了调查。
三名患者的病毒株基因相同，提示发生了医院内传播。首例病例在临床症状出现数周后传播了感染。其他有感染风险的患者是免疫抑制最严重的患者。血清中的病毒载量与血液学反应相关。病毒载量的反弹与临床复发及静脉注射免疫球蛋白治疗失败有关。
即使处于感染慢性期，免疫功能低下的患者也可能发生B19的医院内传播。静脉注射免疫球蛋白治疗的临床和病毒学反应存在差异，且取决于患者的整体免疫抑制水平。
