Institute for Transfusion Medicine and Immunohematology, Johann Wolfgang Goethe University, German Red Cross, Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt, Germany.
Transfusion. 2011 Jan;51(1):129-36. doi: 10.1111/j.1537-2995.2010.02780.x.
Since 2000, blood donor screening for parvovirus B19 (B19) by nucleic acid testing (NAT) at the Ulm Institute has been conducted 6 to 8 weeks postdonation, that is, after transfusion of cellular blood products, whereas at the Frankfurt Institute all donations are screened before releasing any blood product. In this study, we evaluated the infectivity of B19-positive blood products in relation to the virus concentration in the transfused blood component.
Recipients were classified into two groups (A, transfused with blood products with B19 virus load less than 10(5) IU/mL; and B, transfused with blood products with B19 virus load greater than 10(5) IU/mL). Phylogenetic analyses were done for B19 DNA-positive donor and recipient pairs in the variant VP-1u genome region. All samples were investigated for immunoglobulin (Ig)M and IgG B19 antibodies.
B19 DNA was detected in 9 of 18 recipients of red blood cells (RBCs) from Group B, whereas none of the 16 recipients of RBCs from Group A were positive for B19 DNA (p=0.016). Phylogenetic analysis demonstrated identical genomic sequences between the donors and recipients. Because recipient B19 DNA and antibody results were not available before transfusion, we interpret our overall data to indicate equivocal evidence of B19 transmission by RBC transfusion.
B19 transmission by cellular blood products correlates with the virus concentration and the concentration of neutralizing antibodies. Thus, blood donor screening for B19 by minipool NAT should be done to supply at-risk patients (e.g., immunosuppressed patients) with B19-negative blood components.
自 2000 年以来，乌尔姆研究所一直采用核酸检测（NAT）在献血后 6 至 8 周进行微小病毒 B19（B19）筛查，即在输注细胞血液制品之后进行，而法兰克福研究所则在放行任何血液制品之前对所有献血进行筛查。在这项研究中，我们评估了与输注血液成分中病毒浓度相关的 B19 阳性血液制品的传染性。
将受血者分为两组（A 组，输注病毒载量小于 10^5 IU/mL 的 B19 血液制品；B 组，输注病毒载量大于 10^5 IU/mL 的 B19 血液制品）。对变异 VP-1u 基因组区域的 B19DNA 阳性供受者对进行了系统进化分析。所有样本均检测免疫球蛋白（Ig）M 和 IgG B19 抗体。
在 B 组的 18 名接受红细胞（RBC）的受血者中，有 9 名检测到 B19 DNA，而 A 组的 16 名接受 RBC 的受血者均未检测到 B19 DNA（p=0.016）。系统进化分析表明供者和受者之间存在相同的基因组序列。由于受血者 B19 DNA 和抗体结果在输血前不可用，因此我们将总体数据解释为表明通过 RBC 输血传播 B19 的证据存在疑问。
通过细胞血液制品传播 B19 与病毒浓度和中和抗体浓度相关。因此，应通过微小池 NAT 对献血者进行 B19 筛查，以为高危患者（例如，免疫抑制患者）提供 B19 阴性的血液成分。
