Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck/Kiel, Germany.
Vox Sang. 2014 Oct;107(3):226-32. doi: 10.1111/vox.12162. Epub 2014 Jun 11.
Parvovirus B19 (B19V) DNA seems to persist in the plasma of B19V-infected blood donors. The relevance of this for recipients of single-donor blood components is yet unclear.
We studied serial archive and follow-up samples from 75 B19V-infected blood donors to obtain more data about the duration and degree of viraemia and the presence of IgG and IgM anti-B19V. IgG antibodies were further characterized by Western blot analysis in 29 donors.
In 411 B19V DNA-positive samples collected, we found high concentrations (>10(6) IU B19V DNA/ml plasma) in five. B19V DNA persisted for a mean of 21·5 months (range: 2·3-52·4; 95% confidence interval, 19·1-23·9 months) in all donors. Only 15 such samples had either no or low-titre IgG anti-B19V. IgG antibodies were predominantly directed against epitopes on the minor capsid protein VP1, thus probably of neutralizing type with high avidity. IgM anti-B19V was detectable in 9/13 samples with high DNA concentrations.
The vast majority of single-donor blood components with detectable B19V DNA are probably not infectious for their recipients because DNA is at only low levels and the donors also have potentially neutralizing antibodies with high avidity. Anti-B19V IgM testing does not identify every donation with high B19V DNA concentrations, but, in addition to B19V NAT testing, donors with persistent IgG anti-B19V might be considered 'B19V-safe' for single-donor blood components.
细小病毒 B19(B19V)DNA 似乎在 B19V 感染的献血者血浆中持续存在。但对于接受单采血液成分的受血者来说,其相关性尚不清楚。
我们对 75 名 B19V 感染的献血者的连续存档和随访样本进行了研究,以获得更多关于病毒血症的持续时间和程度以及 IgG 和 IgM 抗-B19V 存在的数据。在 29 名供体中,进一步通过 Western blot 分析对 IgG 抗体进行了特征描述。
在收集的 411 份 B19V DNA 阳性样本中,我们发现有 5 份样本的浓度较高(血浆中>10^6 IU B19V DNA/ml)。所有供者的 B19V DNA 平均持续时间为 21.5 个月(范围:2.3-52.4;95%置信区间,19.1-23.9 个月)。仅有 15 份样本既无低滴度 IgG 抗-B19V,也无低滴度 IgG 抗-B19V。IgG 抗体主要针对次要衣壳蛋白 VP1 上的表位,因此可能具有高亲和力的中和型。在 9/13 份 DNA 浓度高的样本中可检测到 IgM 抗-B19V。
绝大多数可检测到 B19V DNA 的单采血液成分对受血者可能没有传染性,因为 DNA 水平较低,而且供者还具有高亲和力的潜在中和抗体。抗-B19V IgM 检测并不能识别每一份高 B19V DNA 浓度的献血,但除了 B19V NAT 检测外,持续存在 IgG 抗-B19V 的供者可能被认为是单采血液成分的“B19V 安全”。