Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, 12203 Berlin, Germany.
Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany.
Viruses. 2022 Feb 21;14(2):444. doi: 10.3390/v14020444.
Human parvovirus B19 (B19V) is the predominant virus currently detected in endomyocardial biopsies (EMBs). Recent findings indicate that, specifically, transcriptionally active B19V with detectable viral RNA is of prognostic relevance in inflammatory viral cardiomyopathy. We aimed to evaluate B19V replicative status (viral RNA) and beneficial effects in a sub-collective of the prospective randomized placebo-controlled phase II multi-center BICC-Trial (Betaferon In Chronic Viral Cardiomyopathy) after interferon beta-1b (IFN-β) treatment. EMBs of = 64 patients with B19V mono-infected tissue were retrospectively analyzed. Viral RNA could be detected in = 18/64 (28.1%) of B19V DNA positive samples (mean age 51.7 years, 12 male), of whom = 13 had been treated with IFN-ß. Five patients had received placebo. PCR analysis confirmed in follow-up that EMBs significantly reduced viral RNA loads in = 11/13 (84.6%) of IFN-ß treated patients ( = 0.001), independently from the IFN-ß dose, in contrast to the placebo group, where viral RNA load was not affected or even increased. Consequently, a significant improvement of left ventricular ejection fraction (LVEF) after treatment with IFN-ß was observed (LVEF mean baseline 51.6 ± 14.1% vs. follow-up 61.0 ± 17.5%, = 0.03). In contrast, in the placebo group, worsening of LVEF was evaluated in = 4/5 (80.0%) of patients. We could show for the first-time the beneficial effects from treatment with IFN-ß, suppressing B19V viral RNA and improving the hemodynamic course. Our results need further verification in a larger prospective randomized controlled trial.
人细小病毒 B19（B19V）是目前在心肌活检（EMB）中检测到的主要病毒。最近的研究结果表明，在炎症性病毒性心肌病中，具有可检测到病毒 RNA 的转录活性的 B19V 具有预后相关性。我们旨在评估干扰素-β-1b（IFN-β）治疗后，在前瞻性随机安慰剂对照 II 期多中心 BICC-Trial（慢性病毒性心肌病中的 Betaferon）的亚组中 B19V 的复制状态（病毒 RNA）和有益作用。回顾性分析了 64 例 B19V 单一感染组织的 EMB。在 18/64（28.1%）的 B19V DNA 阳性样本中可以检测到病毒 RNA（平均年龄 51.7 岁，12 名男性），其中 13 名接受了 IFN-β 治疗。5 名患者接受了安慰剂。PCR 分析在随访中证实，与安慰剂组相比，13 名接受 IFN-β 治疗的患者中有 11 名（84.6%）（ = 0.001）的 EMB 显著降低了病毒 RNA 负荷，而 IFN-β 剂量则没有影响或甚至增加。因此，观察到 IFN-β 治疗后左心室射血分数（LVEF）的显著改善（LVEF 平均基线 51.6 ± 14.1%vs. 随访 61.0 ± 17.5%， = 0.03）。相反，在安慰剂组中，5 名患者中有 4 名（80.0%）评估 LVEF 恶化。我们首次证明了 IFN-β 治疗的有益作用，抑制 B19V 病毒 RNA 并改善血液动力学过程。我们的结果需要在更大的前瞻性随机对照试验中进一步验证。
