Wermelinger Mônica Carvalho de Mesquita Werner, Oelemann Walter M R, Lima de Mendonça Marcos César, Naveca Felipe Gomes, von Hubinger Maria Genoveva
Departamento de Administração e Planejamento em Saúde, Escola National de Saúde Pública, Fundação Oswaldo Cruz, Manguinhos, Rio de Janeiro, Brazil.
J Clin Virol. 2002 Aug;25(2):223-30. doi: 10.1016/s1386-6532(02)00014-8.
Parvovirus B19 infections are associated with different clinical manifestations that vary from symptom-less to severe. The main clinical manifestations are erythema infectiosum or fifth disease, transient aplastic crisis in individuals with hemoglobinopathies, chronic anemia in the immunocompromised, acute polyarthralgia syndrome in adults, hydrops fetalis, spontaneous abortion and stillbirth. Although the classical features of B19 and rubella infections are distinct, uncommon presentations can lead to misdiagnosis.
The goal of this study was to assess the occurrence of parvovirus B19 (B19) infection in patients with clinical signs of toxoplasmosis or rubella, both of which were not confirmed by laboratorial techniques.
Serum samples from 214 patients were collected between January 1996 and December 1997 in the state of Rio de Janeiro, Brazil, B19 specific IgG and IgM were detected by using commercial enzyme-linked immunosorbent assays (ELISA), and viral nucleic acid was detected employing a nested polymerase chain reaction (PCR) protocol.
Combining the results obtained by IgM ELISA and PCR, 14.5% of the samples were positive in one or both tests, with a concordance of 92.5% between the two techniques.
Specimens collected in 16 out of 22 municipalities were positive in at least one out of the three tests employed, indicating that parvovirus B19 circulates in several regions of the state of Rio de Janeiro.
B19微小病毒感染与从无症状到严重的不同临床表现相关。主要临床表现为传染性红斑或第五病、血红蛋白病患者的短暂再生障碍危象、免疫功能低下者的慢性贫血、成人急性多关节痛综合征、胎儿水肿、自然流产和死产。尽管B19感染和风疹感染的典型特征不同，但不常见的表现可能导致误诊。
本研究的目的是评估有弓形虫病或风疹临床体征但实验室技术未确诊的患者中B19微小病毒（B19）感染的发生率。
1996年1月至1997年12月期间，在巴西里约热内卢州收集了214例患者的血清样本，使用商业酶联免疫吸附试验（ELISA）检测B19特异性IgG和IgM，并采用巢式聚合酶链反应（PCR）方案检测病毒核酸。
结合IgM ELISA和PCR获得的结果，14.5%的样本在一项或两项检测中呈阳性，两种技术的一致性为92.5%。
在22个城市中的16个城市收集的标本在采用的三项检测中至少有一项呈阳性，表明B19微小病毒在里约热内卢州的几个地区传播。
