Institute for Medical Microbiology and Hygiene, University of Regensburg, Franz-Josef-Strauß Allee 11, Regensburg, Germany.
Vox Sang. 2011 May;100(4):351-8. doi: 10.1111/j.1423-0410.2010.01445.x. Epub 2010 Dec 7.
Due to their high resistance to inactivation procedures, nonenveloped viruses such as parvovirus B19, human bocavirus (HBoV), human parvovirus 4 (PARV4), hepatitis A (HAV) and hepatitis E virus (HEV) pose a particular threat to blood products. Virus transmission to patients treated with blood products presents an additional burden to disease. We determined the frequency and the amount of nucleic acid specific for nonenveloped viruses in recently manufactured preparations of commercial coagulation factor concentrates.
At least three different batches of each of 13 different plasma-derived and recombinant coagulation factor products were tested for the presence and the amount of nucleic acid for parvovirus B19, HBoV, human parvovirus 4, hepatitis A virus and HEV by using quantitative polymerase chain reaction.
Whereas none of the recombinant products tested positive for any of these viruses, parvovirus B19 DNA with amounts ranging between 2×10(1) and 1.3×10(3) genome equivalents/ml was detected in five plasma-derived products. In addition to parvovirus B19 genotype 1, genotypes 2 and 3 were observed in two batches of a factor VIII/von-Willebrand factor product. In two products (one factor VIII concentrate and one activated prothrombin complex concentrate), a combination of both genotypes 1 and 2 of parvovirus B19 was detected.
The data show that nucleic acids from several relevant nonenveloped viruses are not found at detectable levels in coagulation factor concentrates. In some cases, parvovirus B19 DNA was detectable at low levels. Testing of the plasma pools for the full range of parvovirus genotypes is advocated for ensuring product safety.
由于无包膜病毒(如细小病毒 B19、人博卡病毒、人细小病毒 4 型、甲型肝炎病毒和戊型肝炎病毒)对失活处理具有很强的抵抗力,因此它们对血液制品构成了特殊威胁。经血液制品传播给患者的病毒会给疾病带来额外负担。我们确定了最近生产的商业凝血因子浓缩物中常见的非包膜病毒的核酸频率和数量。
通过使用定量聚合酶链反应,对 13 种不同的血浆源性和重组凝血因子产品的至少三个不同批次进行了针对细小病毒 B19、人博卡病毒、人细小病毒 4 型、甲型肝炎病毒和戊型肝炎病毒的核酸存在和数量的检测。
虽然没有一种重组产品对这些病毒中的任何一种呈阳性,但在五种血浆源性产品中检测到了数量在 2×10(1)到 1.3×10(3)基因组当量/ml 之间的细小病毒 B19 DNA。除了细小病毒 B19 基因型 1 之外,还在两种因子 VIII/血管性血友病因子产品的两个批次中观察到了基因型 2 和 3。在两种产品(一种因子 VIII 浓缩物和一种激活的凝血酶原复合物浓缩物)中,检测到了细小病毒 B19 基因型 1 和 2 的组合。
这些数据表明,在凝血因子浓缩物中,无法以可检测的水平发现几种相关的非包膜病毒的核酸。在某些情况下,可以检测到低水平的细小病毒 B19 DNA。建议对血浆池进行全面的细小病毒基因型检测,以确保产品安全。