Exposure of hematologic patients to parvovirus B19 as a contaminant of blood cell preparations and blood products

Plentz, Annelie; Hahn, J.; Knöll, Antje; Holler, Ernst; Jilg, Wolfgang; Modrow, Susanne

doi:10.1111/j.1537-2995.2005.00610.x

Cited by 45 publications

(45 citation statements)

References 44 publications

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“…Although, this seems quite reassuring, these results cannot be generalized as they represent testing of small batches and continuous monitoring is recommended. Other researchers from different countries have been able to detect parvovirus B19 DNA in 1 percent of all blood cell preparations and blood products applied to the patients on a haematologic ward, in 0.9 percent of standard blood components (in 2.0 percent of pooled plasma products and in 0.7 percent of single donor products), 18 in 0.006 percent of blood donations, in 0.14 percent of single-donor blood products, 19 in 0.16 percent of plasma samples, 15 in 0.6e1.3 percent of blood donors. 13 Given these data, it is apt that screening of blood donors for parvovirus B19 is now in prospect.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of human parvovirus B19 in healthy blood donors

Kumar

Gupta²,

Sen³

et al. 2013

Medical Journal Armed Forces India

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a b s t r a c tBackground: Human parvovirus B19 is an emerging transfusion transmitted infection.Although parvovirus B19 infection is connected with severe complications in some recipients, donor screening is not yet mandatory. To reduce the risk of contamination, plasma-pool screening and exclusion of highly viraemic donations are recommended. In this study the prevalence of parvovirus B19 in healthy blood donors was detected by ELISA.Methods: A total of 1633 samples were screened for IgM and IgG antibodies against parvovirus B19 by ELISA. The initial 540 samples were screened for both IgM and IgG class antibodies and remaining 1093 samples were screened for only IgM class antibodies by ELISA.Results: Net prevalence of IgM antibodies to human parvovirus B19 in our study was 7.53% and prevalence of IgG antibodies was 27.96%. Dual positivity (IgG and IgM) was 2.40%. Conclusion:The seroprevalence of human parvovirus B19 among blood donor population in our study is high, and poses an adverse transfusion risk especially in high-risk group of patients who have no detectable antibodies to B19. Studies with large sample size are needed to validate these results.ª 2012, Armed Forces Medical Services (AFMS). All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of human parvovirus B19 in healthy blood donors

Kumar

Gupta²,

Sen³

et al. 2013

Medical Journal Armed Forces India

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“…18 In contrast, 2 studies have reported a small number of negative results when patients transfused with B19V DNA-positive components were evaluated for laboratory markers of B19V infection. 19,20 Nevertheless, given the tropism for 21 and potential pathophysiologic effects of B19V infection on erythroid precursor cells, 22 concern remains for potential deleterious outcomes in frequently transfused hematology patients with underlying hemolysis or compromised erythropoiesis syndromes. 13 Because the sensitivity of B19V DNA assays has improved, B19V DNA prevalence in blood donors has been shown to be An Inside Blood analysis of this article appears at the front of this issue.…”

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confidence: 99%

“…In a study conducted in an adult hematology service, 6 adult recipients with hematologic malignancies (5 of whom underwent stem cell transplantation) were identified as transfused with blood components that were retrospectively found to contain B19V DNA at less than 10 6 geq/ mL; in 4 of 5 evaluated cases, the DNA-positive component also contained B19V IgG. Each recipient was B19V DNA negative when tested 3 to 18 days after transfusion, 19 and none showed clinical symptoms of B19V infection on retrospective chart review. 19 The mechanism to explain lack of transmission to susceptible recipients by B19V DNA-containing units is unknown but could be related to the lack of a large enough inoculating dose of B19 virions to establish infection.…”

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confidence: 99%

“…Each recipient was B19V DNA negative when tested 3 to 18 days after transfusion, 19 and none showed clinical symptoms of B19V infection on retrospective chart review. 19 The mechanism to explain lack of transmission to susceptible recipients by B19V DNA-containing units is unknown but could be related to the lack of a large enough inoculating dose of B19 virions to establish infection. This could be due to the ratio between infectious dose and virion number (which is not known), the low levels of transfused intact and/or replication competent virions in units with low DNA concentrations, or neutralization of otherwise infectious virions either by antibody in the transfused unit or by passively transfused antibody from other units.…”

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confidence: 99%

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A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion

Kleinman

Glynn

Lee

et al. 2009

Blood

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Parvovirus B19V infection can be a serious infection for hematology patients with underlying hemolysis or compromised erythropoiesis syndromes. Although case reports of B19V transmission by blood component transfusion (as contrasted to manufactured plasma derivatives) are rare, no studies have systematically determined a rate of transmission to recipients transfused with B19V DNA-positive components. We used a linked donor and recipient repository and a sensitive, quantitative B19V DNA polymerase chain reaction (PCR) assay to assess such transmission in B19V-susceptible (ie, anti-B19V immunoglobulin G [IgG] negative) recipients. We assessed 112 B19V DNA-positive components from 105 donors (of 12 529 tested donations) transfused into a population of surgical patients with a pretransfusion B19V IgG seroprevalence of 78%. We found no transmission to 24 susceptible recipients from transfusion of components with B19V DNA at concentrations less than 10 6 IU/mL (upper 95% confidence interval, 11.7%). We found an anamnestic IgG response in one pretransfusion seropositive recipient transfused with a component containing greater than 10 10 IU/mL B19V DNA. These findings show either that transmission from components with less than 10 6 IU/mL does not occur, or, if it does, it is an uncommon event. These data do not support the need to routinely screen blood donations with a sensitive B19V DNA nucleic acid assay. (Blood. 2009;114:3677-3683) IntroductionThere have been multiple reports of parvovirus B19 (B19V) transmission by pooled plasma products, including factor VIII concentrate and solvent-detergent-treated pooled plasma, documented by recipient seroconversion in asymptomatic cases or, less frequently, by clinical diagnosis of B19V-related disease in association with positive B19V test results. [1][2][3][4][5] These cases, combined with the potential for very high B19V DNA concentrations (up to 10 12 IU/mL) in plasma donations 4 and the relative resistance of B19V to inactivation methods, 4,6 have led to B19V DNA testing of plasma donations to ensure that manufacturing plasma pools destined for plasma derivatives have a B19V DNA concentration less than or equal to 10 4 IU/mL, a limit proposed by the Food and Drug Administration (FDA). 7-9 The same limit for this so-called "in process testing" is a European regulatory requirement for anti-D immunoglobulin (Ig) preparations and plasma treated for virus inactivation. 10 To achieve this B19V DNA concentration in the final plasma pool, B19V DNA screening of the plasma donations used to make the pool is performed using assays (applied in minipool format) with the ability to detect approximately 10 6 IU/mL in an input unit of plasma. 8 To date, no B19V transmissions from pooled plasma products have been documented when less than 10 3 to 10 4 IU/mL B19V DNA is present in an infused product. 3,4,[11][12][13] The reason for this lack of infectivity is not completely understood. It may be due to an inadequate amount of infused infectious virions, a neutralization effect from B19V ...

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“…There is evidence for parvovirus B19 transmission via blood products, PBSC or bone marrow. 4,5 Patients required erythrocyte infusions during conditioning before trans-plantation. Parvovirus B19 is known to be a frequent contaminant of blood products, 6 but as parvovirus B19 screening is not part of the routine control of blood products in Germany it was not analysed, and so infection via this route cannot be excluded.…”

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Human parvovirus B19 infection with GvHD-like erythema in two allogeneic stem cell transplant recipients

Muetherig

Christopeit

Müller

et al. 2007

Bone Marrow Transplant

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Exposure of hematologic patients to parvovirus B19 as a contaminant of blood cell preparations and blood products

Abstract: Although B19 DNA was detected in 1 percent of blood products given to hematologic patients, the exposure of 12 percent of patients did not result in symptomatic infections.

Cited by 45 publications

References 44 publications

Seroprevalence of human parvovirus B19 in healthy blood donors

Seroprevalence of human parvovirus B19 in healthy blood donors

A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion

Human parvovirus B19 infection with GvHD-like erythema in two allogeneic stem cell transplant recipients

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