Erdman D D, Usher M J, Tsou C, Caul E O, Gary G W, Kajigaya S, Young N S, Anderson L J
Respiratory and Enterovirus Branch, Centers for Disease Control, Atlanta, Georgia 30333.
J Med Virol. 1991 Oct;35(2):110-5. doi: 10.1002/jmv.1890350207.
To determine the diagnostic use of different markers of acute parvovirus B19 infection, serum specimens obtained from 128 persons with erythema infectiosum were tested for specific immunoglobulin G (IgG), IgA, and IgM antibodies by capture enzyme immunoassay (EIA) using Chinese hamster ovary (CHO) cell-expressed B19 antigen, and tested for circulating B19 DNA by polymerase chain reaction (PCR). A significant rise in specific IgG and IgA antibodies was detected in 87% and 77%, respectively, of persons from whom acute- and convalescent-phase serum specimens were available. Specific IgA antibodies were detected in single serum specimens from 90% of cases and were present in 22 (18%) of 120 persons from a control group without a history of recent exposure to B19. Specific IgM antibodies were detected in 97% of cases and one person (1%) from the control group. B19 DNA was detected in 94% of cases and was absent in 20 persons from the control group positive for both IgG and IgA antibodies. Serum specimens obtained between 4 and 6 months after onset of illness from six additional persons were also tested. All had specific IgG antibodies, four (67%) had IgA, five (83%) had IgM, and none had detectable B19 DNA. Our data indicate that 1) specific IgA antibodies are too persistent to be a useful indicator of recent B19 infection; 2) specific IgM antibodies are the most sensitive indicator of acute B19 infection in immunologically normal persons but can persist up to 6 months; and 3) B19 DNA can often be detected up to 2 months after onset of illness even in immunologically normal hosts and might be a useful adjunct test for diagnosis of acute B19 infection.
为确定急性B19细小病毒感染不同标志物的诊断用途，采用中国仓鼠卵巢（CHO）细胞表达的B19抗原，通过捕获酶免疫测定（EIA）对128例传染性红斑患者的血清标本检测特异性免疫球蛋白G（IgG）、IgA和IgM抗体，并通过聚合酶链反应（PCR）检测循环B19 DNA。在可获得急性期和恢复期血清标本的患者中，分别有87%和77%检测到特异性IgG和IgA抗体显著升高。90%的病例单份血清标本中检测到特异性IgA抗体，在无近期B19暴露史的120名对照组人员中有22人（18%）存在该抗体。97%的病例检测到特异性IgM抗体，对照组中有1人（1%）检测到该抗体。94%的病例检测到B19 DNA，在IgG和IgA抗体均为阳性的20名对照组人员中未检测到。还对另外6例患者发病后4至6个月采集的血清标本进行检测。所有患者均有特异性IgG抗体，4例（67%）有IgA抗体，5例（83%）有IgM抗体，均未检测到B19 DNA。我们的数据表明：1）特异性IgA抗体持续存在时间过长，无法作为近期B19感染的有用指标；2）特异性IgM抗体是免疫功能正常者急性B19感染最敏感的指标，但可持续长达6个月；3）即使在免疫功能正常的宿主中，发病后2个月内通常也能检测到B19 DNA，其可能是诊断急性B19感染的有用辅助检测方法。
