Schneider Beate, Becker Maria, Brackmann Hans-Hermann, Eis-Hübinger Anna Maria
Institute of Medical Microbiology and Immunology, University of Bonn, Germany.
Thromb Haemost. 2004 Oct;92(4):838-45. doi: 10.1160/TH04-04-0229.
Human parvovirus B19 (B19) DNA has frequently been detected in plasma-derived coagulation factor concentrates. Furthermore, transmission of B19 infection was observed, indicating presence of the infectious virus despite routine viral inactivation/removal procedures during the manufacturing process. Recently, human parvovirus DNA isolates, variant from B19, have been identified resulting in classification of B19 virus into three distinct genotypes, with all viruses previously classified as B19 belonging to genotype 1. So far, there is no information available on contamination of clotting factor concentrates with genotype 2. Therefore, we analysed 202 different factor concentrate lots for genotype 1 and 2 DNA by PCR. Analysis of one hundred eighty-one lots representing 13 different products, administered over the last three years, was compared to 21 lots (8 products) used until the early 1980s which had not been treated by viral inactivation procedures. Genotype 1 DNA was detected in 77/181 (42.5%) currently administered lots, and 17/21 (81%) previously used lots. The level of genotype 1 DNA contamination was similar in currently and previously administered concentrates. Genotype 2 DNA was found in 5/202 (2.5%) lots, all of which were co-contaminated with genotype 1 DNA. DNA sequence analysis showed that the PCR-double positive concentrates contained typical genotype 1 and genotype 2 DNA. Because genotype 2 appears to cause a similar spectrum of diseases as genotype 1, simultaneous detection of genotype 2 by nucleic acid amplification testing (NAT), now widely applied to plasma pools for genotype 1, would give an added level of safety to blood products.
人细小病毒B19(B19)DNA在血浆源性凝血因子浓缩物中经常被检测到。此外,还观察到B19感染的传播,这表明尽管在制造过程中有常规的病毒灭活/去除程序,但仍存在传染性病毒。最近,已鉴定出与人细小病毒DNA分离株不同的B19变异体,导致B19病毒被分为三种不同的基因型,所有先前被归类为B19的病毒都属于基因型1。到目前为止,尚无关于凝血因子浓缩物被基因型2污染的信息。因此,我们通过PCR分析了202个不同批次的因子浓缩物中的基因型1和2 DNA。将过去三年中使用的代表13种不同产品的181个批次与20世纪80年代初使用的21个批次(8种产品)进行了比较,后者未经过病毒灭活程序处理。在目前使用的181个批次中有77个(42.5%)检测到基因型1 DNA,在先前使用的21个批次中有17个(81%)检测到。目前和先前使用的浓缩物中基因型1 DNA的污染水平相似。在202个批次中有5个(2.5%)检测到基因型2 DNA,所有这些批次都同时被基因型1 DNA污染。DNA序列分析表明,PCR双阳性浓缩物中含有典型的基因型1和基因型2 DNA。由于基因型2似乎与基因型1引起相似的疾病谱,因此通过核酸扩增检测(NAT)同时检测基因型2(目前广泛应用于血浆库以检测基因型1)将为血液制品提供更高的安全性。