Clinical presentation of parvovirus B19 infection in HIV-infected patients with and without AIDS

Setúbal, Sérgio; Jorge-Pereira, Maria Cristina; Sant'Anna, Anadayr Leite Martins de; Oliveira, Solange Artimos de; Bazin, Anna Ricordi; Nascimento, Jussara Pereira do

doi:10.1590/s0037-86822003000200014

Cited by 11 publications

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“…From 1985 on, papers dealing with co-infection with HIV and erythrovirus B19 began to appear in the literature (Anderson et al 1985, Mitchell et al 1990, Chrystie et al 1990, Frickhofen et al 1990). In some of them erythrovirus B19 chronic anemia was indeed the initial manifestation of AIDS (Griffin et al 1991, Gottlieb & Deutsch 1992, Setúbal et al 2003. Erythrovirus B19 infection is one cause of anemia in AIDS patients, along with Mycobacterium tuberculosis, M. avium-intracellulare, cytomegalovirus, Histoplasma capsulatum, Toxoplasma gondii, lymphoma, vitamin deficiency, treatment with zidovudine and sulfa drugs, and the action of HIV itself on bone marrow accessory cells (Garcia 1996, Abkowitz et al 1997.…”

Section: Erythrovirus B19 Infects Erythrocytic Progenitors Transientmentioning

confidence: 99%

“…Immunoglobulin treatment can cure the infection and, sometimes and paradoxically, transiently worsen the clinical picture by triggering immune complex symptoms (Frickhofen et al 1990, Setúbal et al 2003, Young & Brown 2004). Since 1998 we have been studying erythrovirus B19 infection in our HIV infected patients in Hospital Universitário Antônio Pedro (HUAP), Niterói, Rio de Janeiro, Brazil (Aguiar et al 2001, Setúbal et al 2003. We have always considered co-infection infrequent and attributed this to the fact that most of our HIV infected patients were under anti-retroviral therapy.…”

Section: Erythrovirus B19 Infects Erythrocytic Progenitors Transientmentioning

confidence: 99%

“…Its resolution after immune reconstitution due to highly active anti-retroviral therapy (HAART) was described recently (Scapellato et al 2000, Chen et al 2001, Nolan et al 2003. Immunoglobulin treatment can cure the infection and, sometimes and paradoxically, transiently worsen the clinical picture by triggering immune complex symptoms (Frickhofen et al 1990, Setúbal et al 2003, Young & Brown 2004). Since 1998 we have been studying erythrovirus B19 infection in our HIV infected patients in Hospital Universitário Antônio Pedro (HUAP), Niterói, Rio de Janeiro, Brazil (Aguiar et al 2001, Setúbal et al 2003.…”

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confidence: 99%

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confidence: 99%

“…Since 1998 we have been studying erythrovirus B19 infection in our HIV infected patients in Hospital Universitário Antônio Pedro (HUAP), Niterói, Rio de Janeiro, Brazil (Aguiar et al 2001, Setúbal et al 2003. We have always considered co-infection infrequent and attributed this to the fact that most of our HIV infected patients were under anti-retroviral therapy.…”

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confidence: 99%

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Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Setúbal

Oliveira

Pires

et al. 2006

Mem. Inst. Oswaldo Cruz

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Erythrovirus B19 infects erythrocytic progenitors, transiently interrupting erythropoiesis. In AIDS patients it causes chronic anemia amenable to treatment. We looked for evidences of B19 infection in stored bone marrow material from patients with acquired immunodeficiency syndrome. Histological sections were made from stored paraffin blocks from 33 autopsies (39 blocks) and 35 biopsies (45 blocks, 30 patients) performed from 1988 to 2002. They were examined after hematoxylin-eosin (HE) staining, immunohistochemical (IHC), and in situ hybridization. HE revealed intra-nuclear inclusion bodies ("lantern cells") suggesting B19 infection in 19 sections corresponding to 19 of 63 patients examined with this test. Seven of 78 sections subjected to immunohistochemistry were positive, corresponding to 7 of 58 patients examined with this test. Fourteen sections corresponding to 13 of the 20 HE and/or IHC positive patients were subjected to in situ hybridization, with six positives results. Among the 13 patients subjected to the three techniques, only one gave unequivocal positive results in all and was considered a true positive. The frequency of B19 infection (1/63 patients) in the material examined can be deemed low.Key words: parvovirus B19-anemia -chronic-immunodeficiency Erythrovirus B19 infects human erythrocytic progenitor cells, leading to a transient interruption of erythropoiesis. In the immunocompetent host this viral infection is cleared within two weeks as a result of the appearance of serum specific antibodies, and the hematological manifestations are restricted to a slight and asymptomatic decline in the hemoglobin levels. When the antibodies appear there may be symptoms of immune complex disease like arthralgias and exanthema. This is what normally takes place during the common childhood exanthematic disease erythema infectiosum. The course can be quite different in certain kinds of host, like those with hereditary hemolytic anemias (e.g., sickle-cell anemia), in whom an acceptable hematocrit is maintained only through an intense and uninterrupted bone marrow activity. In this context erythrovirus B19 infection usually leads to the rapid onset of a life threatening acute anemia, the so called "transient aplastic crisis". The patient is transfusion-dependent until the appearance of specific antibodies spontaneously clears the infection. A similar situation can be found in the fetus, where normal erythron volume expansion also demands a high activity of the hematopoietic fetal tissues. The sudden interruption of hematopoiesis leads to fetal heart failure and anasarca (hydrops fetalis), which may result in fetal death. In immunocompromised individuals (e.g., HIV-infected patients) erythrovirus infection is not readily cleared and its long persistence leads to chronic anemia. In these patients, intravenous standard immunoglobulin infusions usually end viremia and restore hematopoiesis (de Mayolo & Temple 1990, Mitchell et al. 1990, Gottlieb & Deutsch 1992, Noronha et al. 2005.Erythrovirus B19 was discovered by...

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Section: Erythrovirus B19 Infects Erythrocytic Progenitors Transientmentioning

confidence: 99%

Section: Erythrovirus B19 Infects Erythrocytic Progenitors Transientmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Setúbal

Oliveira

Pires

et al. 2006

Mem. Inst. Oswaldo Cruz

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Frequency and genotype of human parvovirus B19 among Iranian patients infected with HIV

et al. 2015

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The human parvovirus B19 (B19) usually causes a subclinical infection in immunocompetent individuals. Whereas immunocompromised individuals such as patients infected with HIV are at risk of persistent anemia due to B19 infection. Only few studies have been carried out on distribution and molecular epidemiology of B19 in Iran. We aimed to determine the frequency and genotype of B19 among Iranian patients infected with HIV. We conducted a survey on 99 HIV patients and 64 healthy controls. IgG and IgM antibodies against B19 were detected by ELISA and B19 DNA was assessed by nested PCR. PCR products were subjected to direct sequencing and classified after phylogenetic analysis. The prevalence of B19 immunoglobulin was 11.1% for IgG and 1% for IgM. B19 DNA was detected in 13.1% of cases. The prevalence of B19 IgG, IgM, and DNA in control group was 25%, 1.6%, and 9.4%, respectively. B19 IgG was significantly lower in HIV group than in normal controls. There was no significant difference regarding anemia between cases and controls. All sequenced B19 isolates belonged to genotype 1A with low genetic diversity. Our findings indicated that in the HAART era, the importance of B19 infections in HIV patients may be limited whereas persistent B19 viremia in the circulation of healthy controls raises a potential concern in blood donations.

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A Meta-Analysis on the Seroprevalence of Parvovirus B19 among Patients with Sickle Cell Disease

Mohamed

Osman

et al. 2019

BioMed Research International

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Background Parvovirus B19 (B19 V) infection had been reported to be more frequent with serious clinical outcomes in patients with sickle cell disease (SCD) than in the general population. There is a wide variation in data among the existing literature regarding the seroprevalence of B19 V in patients with SCD. These data require further summary and analyses for better accuracy. This systematic review and meta-analysis was done to estimate the seroprevalence of B19 V in patients with SCD. Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, Virtual Health Library (VHL), ScienceDirect, Google Scholar, and OpenGrey were used for the systematic search. The random-effects model was used to estimate the pooled prevalence with the corresponding 95% confidence interval (CI) using OpenMeta Analyst software. Publication bias was estimated based on Begg's test, Egger's test, and examination of the funnel plot. Subgroup analyses and metaregression were used to explore the moderators of heterogeneity between studies. Results A total of 18 studies including 2890 patients were analyzed. The overall IgG seroprevalence of B19 V infection among patients with SCD was found to be 48.8% (95% CI 39.5%–58.0%). Evidence of publication bias was not detected. Evidence of acute viral infection detected by positive IgM antibodies among the screened SCD patients was found in 8.30% (95% CI 5.20%–11.4%) of them. There was a statistically signiﬁcant association between seroprevalence of B19 V and geographical areas. Conclusion There was a high prevalence of B19 V in patients with SCD. Healthcare providers need to be aware of the magnitude of B19 V infection in patients with SCD to ensure effective management. This review could provide a comprehensive view of B19 V prevalence in this susceptible population.

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Clinical presentation of parvovirus B19 infection in HIV-infected patients with and without AIDS

Cited by 11 publications

References 14 publications

Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Frequency and genotype of human parvovirus B19 among Iranian patients infected with HIV

A Meta-Analysis on the Seroprevalence of Parvovirus B19 among Patients with Sickle Cell Disease

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