Barlinn Regine, Rollag Halvor, Trogstad Lill, Vainio Kirsti, Basset Coraline, Magnus Per, Dudman Susanne G
Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
Department of Medical Microbiology, Oslo University hospital, Norway.
J Clin Virol. 2017 Sep;94:57-62. doi: 10.1016/j.jcv.2017.07.010. Epub 2017 Jul 20.
Around 40% of pregnant women in Norway are parvovirus B19 (B19V) seronegative and thus at risk for B19 V infection. Studies on samples from women with symptomatic disease or known exposure have shown that nucleic acid amplification assays combined with serology increase the sensitivity and improves the diagnostic procedure.
The aim was to investigate the seroprevalence of B19V infection, the occurrence of new infections and vertical transmission in a population-based pregnancy cohort, with special emphasis on the diagnostic methods.
We randomly selected 1350 pregnant women from the Norwegian Mother and Child Cohort Study (MoBa), using an algorithm for the detection of B19V infection, including both serology and PCR.
Maternal infection was confirmed in 50 subjects (3.7% of 1349 women), of which 35(70%) were viremic. Of the initially seronegative 33(6.8%) seroconverted. The estimated average annual seroconversion rate was 15.5%, with the highest estimated annual seroconversion rate of 31.6%. The rates of yearly seroconversion followed the pattern found in reports from Norwegian microbiology laboratories. Among all women, 31 (2.3%) had an inconclusive serological profile and 17 (54.8%) had detectable virus. Of the 16 women with virus detectable at gestational week 17-18, seven were still seronegative with absent seroconversion in the second sample taken at birth. All together 10 children were vertically infected.
High incidence of viremic B19V infections and high estimated annual seroconversion rates were found. Lack of seroconversion despite longstanding viremia emphasizes the importance of including PCR when testing for B19V infection during pregnancy.
挪威约40%的孕妇细小病毒B19（B19V）血清学阴性，因此有感染B19V的风险。对有症状疾病或已知暴露的女性样本的研究表明，核酸扩增检测与血清学相结合可提高敏感性并改进诊断程序。
旨在调查基于人群的妊娠队列中B19V感染的血清流行率、新感染的发生率和垂直传播情况，特别强调诊断方法。
我们从挪威母婴队列研究（MoBa）中随机选取了1350名孕妇，使用一种检测B19V感染的算法，包括血清学和PCR。
在50名受试者中确诊为母体感染（1349名女性中的3.7%），其中35名（70%）为病毒血症患者。最初血清学阴性的33名受试者（6.8%）发生了血清转化。估计的年均血清转化率为15.5%，最高估计年均血清转化率为31.6%。年血清转化率的模式与挪威微生物学实验室报告中的模式一致。在所有女性中，31名（2.3%）血清学结果不确定，17名（54.8%）检测到病毒。在妊娠第17 - 18周检测到病毒的16名女性中，有7名在出生时采集的第二个样本中仍为血清学阴性且未发生血清转化。共有10名儿童发生垂直感染。
发现病毒血症性B19V感染的发生率较高，估计的年均血清转化率也较高。尽管长期存在病毒血症但未发生血清转化，这凸显了孕期检测B19V感染时采用PCR的重要性。
