慢性肾脏病血液透析患者中细小病毒 B19 感染的高患病率：一项多中心研究。

High prevalence of parvovirus B19 infection in patients with chronic kidney disease under hemodialysis: A multicenter study.

机构信息

Laboratório de Desenvolvimento Tecnológico em Virologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

出版信息

Int J Infect Dis. 2020 Nov;100:350-356. doi: 10.1016/j.ijid.2020.09.010. Epub 2020 Sep 11.

DOI:10.1016/j.ijid.2020.09.010

PMID:32927082

Abstract

OBJECTIVES

Parvovirus B19 (B19V) infection is commonly acute and self-limited, but in chronic kidney disease (CKD) patients under dialysis treatment, this infection could increase susceptibility to acute and chronic anemia. The aim of this study was to evaluate the frequency and risk of B19V infection among Brazilian CKD patients under dialysis.

METHODS

A study was conducted among 221 CKD patients and a control group of 142 blood donors. B19V infection was evaluated in serum samples by real-time PCR, and ELISA (anti-B19V IgM and IgG).

RESULTS

B19V DNA was detected in 65% (145/221) of CKD patients, which was significantly higher (p < 0.001) than in the blood donors (6.3%). Simultaneous detection of B19V IgG and viremia was shown in 40.3% of CKD patients, which was indicative of persistent B19V infection. CKD patients showed an increased risk of developing B19V infection (OR = 28.1, CI = 13.5-58.5, p = 0.001).

CONCLUSIONS

Despite an absence of clinical signs of B19V infection, these data highlight the importance of B19V infection in this high-risk population, since a persistent B19V infection could become clinically significant after renal transplant. Moreover, the persistent viremia should be considered as a potential risk, mainly because of the contamination of dialysis equipment.

摘要

目的

细小病毒 B19（B19V）感染通常是急性和自限性的，但在接受透析治疗的慢性肾脏病（CKD）患者中，这种感染可能会增加急性和慢性贫血的易感性。本研究旨在评估巴西 CKD 透析患者 B19V 感染的频率和风险。

方法

对 221 例 CKD 患者和 142 名献血者对照组进行了一项研究。通过实时 PCR 和 ELISA（抗 B19V IgM 和 IgG）检测血清样本中的 B19V 感染。

结果

在 221 例 CKD 患者中，有 65%（145/221）检测到 B19V DNA，明显高于献血者（6.3%）（p < 0.001）。40.3%的 CKD 患者同时检测到 B19V IgG 和病毒血症，表明存在持续性 B19V 感染。CKD 患者发生 B19V 感染的风险增加（OR = 28.1，CI = 13.5-58.5，p = 0.001）。