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在巴西里约热内卢尼泰罗伊人类细小病毒B19活动频繁的季节,通过快速筛查方法发现病毒血症献血者。

Viremic blood donor found by a rapid screening method in a season of high human parvovirus B19 activity in Niterói, Rio de Janeiro, Brazil.

作者信息

Setúbal Sérgio, Cárdias Cláudia Alessandra da Silva, de Oliveira Solange Artimos, do Nascimento Jussara Pereira

机构信息

Departamento de Medicina Clínica, Universidade Federal Fluminense, Niterói, RJ, 24033-900, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2004 Feb;99(1):95-9. doi: 10.1590/s0074-02762004000100017. Epub 2004 Mar 31.

Abstract

Erythrovirus B19 infection is usually benign but may have serious consequences in patients with hemolytic anemia (transient aplastic crisis), immunodeficiency (in whom persistent infection can lead to chronic bone marrow failure with anemia), or who are in the first or second trimester of gestation (spontaneous abortion, hydrops fetalis, and fetal death). Being non-enveloped, B19 resists most inactivation methods and can be transmitted by transfusion. B19 is difficult to cultivate and native virus is usually obtained from viremic blood. As specific antibodies may be absent, and there is no reliable immunological method for antigen detection, hybridization or polymerase chain reaction are needed for detecting viremia. A rapid method, gel hemagglutination (Diamed ID-Parvovirus B19 Antigen Test), can disclose highly viremic donations, whose elimination lessens the viral burden in pooled blood products and may even render them non-infectious. In order to obtain native antigen and to determine the frequency of viremic donors, we applied this test to blood donors in a period of high viral activity in our community. Positive or indeterminate results were re-tested by dot-blot hybridization. We tested 472 donors in 1998 and 831 ones in 1999. One viremic donor was found in 1999. We suggest that in periods of high community viral activity the gel hemagglutination test may be useful in avoiding highly viremic blood being added to plasma pools or directly transfused to patients under risk.

摘要

细小病毒B19感染通常是良性的,但对于患有溶血性贫血(暂时性再生障碍危象)、免疫缺陷(持续性感染可导致慢性骨髓衰竭伴贫血)的患者,或处于妊娠头三个月或第二个三个月的孕妇(自然流产、胎儿水肿和胎儿死亡),可能会产生严重后果。由于B19无包膜,它能抵抗大多数灭活方法,可通过输血传播。B19难以培养,天然病毒通常从病毒血症血液中获得。由于可能不存在特异性抗体,且没有可靠的抗原检测免疫方法,因此需要采用杂交或聚合酶链反应来检测病毒血症。一种快速方法,即凝胶血凝试验(达美ID - 细小病毒B19抗原检测),可以检测出病毒血症水平高的献血者,去除这些献血者可减轻混合血液制品中的病毒负荷,甚至可能使其不具传染性。为了获得天然抗原并确定病毒血症献血者的频率,我们在社区病毒活动高发期对献血者应用了该检测方法。阳性或不确定结果通过斑点杂交进行重新检测。我们在1998年检测了472名献血者,在1999年检测了831名献血者。1999年发现了一名病毒血症献血者。我们建议,在社区病毒活动高发期,凝胶血凝试验可能有助于避免将病毒血症水平高的血液加入血浆库或直接输给有风险的患者。

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