[马里镰状细胞贫血患者的人细小病毒B19感染:一项病例对照研究]

[Human parvovirus B19 infection in sickle cell anemia patient in Mali: a case-control study].

作者信息

Diallo D-A, Guindo A, Dorie A, Djibo N, Algiman E, Ouane O-D, Diakité A-A, Traoré F-F, Ag Baraika M, Dembélé A-K, Tchernia G

机构信息

Centre de recherche et de lutte contre la drépanocytose, 03, commune III, BP 186, Bamako 03, Mali.

出版信息

Arch Pediatr. 2011 Sep;18(9):962-5. doi: 10.1016/j.arcped.2011.06.019. Epub 2011 Jul 30.

Abstract

Human parvovirus B19 (HP-19) is the only Parvoviridae known to be pathogenic in human. Studies of HP-19 infection and its associated life-threatening complications in sickle cell anemia patients have been reported in Europe and the US. These results justify the development of HP-B19 prevention and strategies to reduce the incidence of severe and life-threatening complications associated with the infection in patients with sickle cell anemia, particularly in sub-Saharan Africa where the sickle cell anemia burden is high. In light of these considerations, we conducted a case-control study including 163 patients with sickle cell anemia and 163 controls. HP-B19 diagnosis was based on the detection of IgG and IgM antibodies specific for HP-B19 using commercially available enzyme immunoassays. Anti-human parvovirus B19 IgG antibodies were found in 105 of 193 (64.8%) patients vs 79 of 193 controls (48.4%). IgM antibodies were found at a higher frequency in sickle cell anemia patients than in controls. This higher frequency was found to be age-dependent. However, the reticulocyte count showed no significant decrease in Malian patients with sickle cell anemia. Further studies are needed to better characterize the implication of HP-B19 infection in sickle cell anemia mortality and morbidity and to develop preventive strategies and efficient management of the resulting complications.

摘要

人类细小病毒B19(HP - 19)是已知的唯一对人类致病的细小病毒科病毒。欧洲和美国已报道了关于镰状细胞贫血患者中HP - 19感染及其相关危及生命并发症的研究。这些结果证明了开发HP - B19预防措施以及降低镰状细胞贫血患者中与该感染相关的严重及危及生命并发症发生率的策略的合理性,特别是在撒哈拉以南非洲地区,那里镰状细胞贫血负担较重。鉴于这些考虑因素,我们开展了一项病例对照研究,纳入了163例镰状细胞贫血患者和163例对照。HP - B19诊断基于使用市售酶免疫测定法检测针对HP - B19的IgG和IgM抗体。193例患者中有105例(64.8%)检测到抗人类细小病毒B19 IgG抗体,而193例对照中有79例(48.4%)检测到。镰状细胞贫血患者中IgM抗体的检出频率高于对照。发现这种较高频率与年龄有关。然而,马里镰状细胞贫血患者的网织红细胞计数未显示出显著下降。需要进一步研究以更好地描述HP - B19感染在镰状细胞贫血死亡率和发病率中的影响,并制定预防策略和对由此产生的并发症进行有效管理。

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