Kishore Janak, Srivastava Manisha, Choudhury Nabajyoti
Departments of Microbiology and Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Asian J Transfus Sci. 2011 Jul;5(2):140-3. doi: 10.4103/0973-6247.83239.
Human parvovirus B19 (B19) virus is a newly recognized agent for transfusion transmitted diseases. Beta-thalassemia major patients receive a hypertransfusion regimen, hence, are prone to acquire B19 infection; moreover, B19 escapes viral inactivation methods and donor units are not tested for B19, but there are just a couple of studies globally and none from the Asian continent. Hence, a study was designed to find the frequency of B19 infection and its transmission in multitransfused thalassemia patients.
Ninety multitransfused beta-thalassemia major (thalassemia) patients, 32 controls (age, sex matched) without any history of transfusion were enrolled. Besides the donor units were tested in B19 un-infected patients. B19 specific IgG and IgM antibodies in the sera were analyzed by ELISA (in-house), using B19 VPI and VP2 recombinant and purified antigens; additionally HBsAg and anti-HIV and anti-HCV antibodies were tested for coexisting infections.
Seventy-three (81%) thalassemia patients tested positive for anti-B19 IgG antibodies as compared to seven (21%) in the controls group (P < 0.01), while anti-B19 IgM antibodies were detected in 37 (41.1%) compared to two (6.2%) in the controls (P < 0.01). Mean age of the thalassemia patient was eight years (range 2 - 18 years) and B19 infection was highest in the six-to-ten year range. Seropositivity increased with the number of transfusions. Two of the four HBsAg positive and five of the seven anti-HCV IgM antibody-positive patients also had anti-B19 IgM. After a six-month follow-up, four (25%) of the 16 seronegative patients seroconverted and anti-B19 IgM antibodies were detected in their donor units.
Most of multitransfused thalassemics were B19 seropositive or had anti-B19 IgM; in the remaining uninfected group, B19 got transmitted through infected / IgM-positive donor units.
人类细小病毒B19（B19）是一种新发现的可通过输血传播的病原体。重型β地中海贫血患者接受强化输血方案，因此容易感染B19；此外，B19能逃避病毒灭活方法，且供血单位未进行B19检测，而全球仅有少数几项研究，亚洲大陆尚无相关研究。因此，设计了一项研究以确定多次输血的地中海贫血患者中B19感染的频率及其传播情况。
纳入90例多次输血的重型β地中海贫血（地中海贫血）患者和32例无输血史的对照者（年龄、性别匹配）。此外，对未感染B19的患者的供血单位进行检测。采用酶联免疫吸附测定法（实验室自制），使用B19病毒蛋白I（VPI）和病毒蛋白II（VP2）重组纯化抗原分析血清中的B19特异性IgG和IgM抗体；此外，检测乙肝表面抗原（HBsAg）、抗人类免疫缺陷病毒（HIV）抗体和抗丙型肝炎病毒（HCV）抗体以确定是否存在合并感染。
73例（81%）地中海贫血患者抗B19 IgG抗体检测呈阳性，而对照组为7例（21%）（P<0.01）；37例（41.1%）检测到抗B19 IgM抗体，对照组为2例（6.2%）（P<0.01）。地中海贫血患者的平均年龄为8岁（范围2至18岁），6至10岁年龄段的B19感染率最高。血清阳性率随输血次数增加而升高。4例HBsAg阳性患者中的2例以及7例抗HCV IgM抗体阳性患者中的5例也有抗B19 IgM。经过6个月的随访，16例血清阴性患者中有4例（25%）发生血清转化，且在其供血单位检测到抗B19 IgM抗体。
大多数多次输血地中海贫血患者B19血清学呈阳性或有抗B19 IgM；在其余未感染组中，B19通过感染/IgM阳性供血单位传播。
