Institute of Medical Microbiology and Hygiene, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
J Clin Virol. 2013 Oct;58(2):443-8. doi: 10.1016/j.jcv.2013.07.007. Epub 2013 Jul 31.
After acute parvovirus B19 (B19V) infection of immunocompetent individuals, viral genomes persist lifelong in various tissues. In immunocompromized patients, acute B19V infection may be associated with severe anaemia. It is unclear whether reactivation of latent B19V DNA may contribute to persistent viraemia and anaemia in transplant recipients.
We retrospectively analysed the impact of B19V infection in 371 adult transplant recipients (kidney, liver, heart, bone marrow). The patients' pre-transplantation serostatus was determined. 1431 sera or plasmas obtained in monthly intervals during six months following transplantation were analysed for the presence of B19V DNA by quantitative PCR which allows discrimination between B19V genotypes 1-3.
Overall, 82% of the patients were seropositive. B19V DNA (<600-1100 geq/ml) was detected in 4.0% of patients and classified as genotype 1 in 12, genotype 2 in one and genotype 3 in two patients. Whereas 5.5%, 6.7% and 5.7% of liver, heart and bone marrow recipients displayed DNAemia, viral genomes were detected only in 1.4% of kidney recipients. Haemoglobin levels and reticulocyte counts showed no differences between DNAemic and non-DNAemic patients. In a control group of 120 healthy subjects, 78% were seropositive and 2.5% displayed DNAemia.
Prevalence and level of B19V DNAemia in adult transplant recipients was comparable to that observed in healthy individuals, but with a distinct accumulation within the first weeks post-transplantation. The presence of low-level DNAemia in transplant recipients was not associated with anaemia.
在免疫功能正常的个体感染急性细小病毒 B19（B19V）后，病毒基因组会在各种组织中终身存在。在免疫功能低下的患者中，急性 B19V 感染可能与严重贫血有关。目前尚不清楚潜伏的 B19V DNA 是否会重新激活，从而导致移植受者持续病毒血症和贫血。
我们回顾性分析了 371 例成年移植受者（肾、肝、心脏、骨髓）的 B19V 感染的影响。检测了患者移植前的血清学状态。在移植后 6 个月内每月采集 1431 份血清或血浆，通过定量 PCR 分析 B19V DNA 的存在情况，定量 PCR 可以区分 B19V 基因型 1-3。
总体而言，82%的患者血清学阳性。4.0%的患者检测到 B19V DNA（<600-1100 geq/ml），其中 12 例为基因型 1，1 例为基因型 2，2 例为基因型 3。肝、心脏和骨髓移植受者中，有 5.5%、6.7%和 5.7%的患者发生 DNA 血症，但仅在 1.4%的肾移植受者中检测到病毒基因组。DNA 血症患者和非 DNA 血症患者的血红蛋白水平和网织红细胞计数无差异。在 120 例健康对照者的对照组中，78%的患者血清学阳性，2.5%的患者发生 DNA 血症。
成人移植受者的 B19V 病毒血症的流行率和水平与健康个体相似，但在移植后前几周明显积累。移植受者低水平 DNA 血症的存在与贫血无关。
