Parvovirus B19 infection and unresponsiveness to erythropoietin therapy in haemodialysis patients

Duranay, Murat; Bali, Musa; Sahin, Mustafa; Yakinci, G; Vurgun, Nureddin; Dilmen, Uğur

doi:10.1093/ndt/13.3.779

Cited by 9 publications

(9 citation statements)

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“…The immunosuppression state in dialysis patients due to underlying diseases and immunosuppressive treatment may prevent an effective antiviral immune response relating to persistent viral infection and chronic suppression of erythropoiesis with the development of chronic anemia or B19-related recurrent anemia [30,31]. Potentially life-threatening transient aplastic crisis due to B19 infection is also a major concern in some dialysis cases [11]. Finally, persistent B19 infection in patients on chronic dialysis can become clinically manifested after renal transplantation and the administration of immunosuppressive medications [13].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, dialysis patients reveal increased susceptibility to acute and chronic anemia after B19 infection. Moreover, B19 infection can induce aplastic crisis in dialysis patients similar to hemolytic anemia cases [11]. On the other hand, some authors believe that erythropoietin administration during B19 infection can facilitate viral replication [12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Frequency and Genotype of Human Parvovirus B19 among Iranian Hemodialysis and Peritoneal Dialysis Patients

Sharif

Aghakhani²,

Velayati³

et al. 2016

Intervirology

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Objectives: The aim of this study was to evaluate the frequency and genotype of human parvovirus B19 and its relation with anemia among Iranian patients under dialysis. Methods: Fifty hemodialysis (HD) and 33 peritoneal dialysis (PD) patients were enrolled. B19 IgG and IgM antibodies were assessed by ELISA, and the presence of B19 DNA was evaluated by nested PCR. PCR products were sequenced directly and phylogenetic analysis was performed. Results: In the HD group, the prevalence of B19 antibodies was 54% for IgG and 4% for IgM. B19 DNA was detected in 10% of the cases, and 10% showed B19 IgG and viremia simultaneously. In the PD group, the prevalence of B19 IgG and IgM was 57.6 and 0% respectively, whereas B19 DNA was found in 12.1% of the group. A total of 9.1% showed B19 IgG and viremia concurrently. There was no significant difference regarding anemia and B19 infection in either group. All B19 isolates were clustered in genotype 1A. Conclusion: Our findings indicate that B19 infection plays no role in leading chronic anemia in dialysis patients. However, persistent B19 viremia and the circulation of the same strains in dialysis patients may indicate a potential risk for the contamination of dialysis equipment and nosocomial spread of B19 infection within dialysis units.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frequency and Genotype of Human Parvovirus B19 among Iranian Hemodialysis and Peritoneal Dialysis Patients

Sharif

Aghakhani²,

Velayati³

et al. 2016

Intervirology

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“… 48–50 Generally, this viral infection has been associated with transient aplastic crisis and unresponsiveness to treatment with rHuEPO. 46,51 However, several studies have reported the occurrence of acquired pure red cell aplasia (PRCA) and severe transfusion-dependent anemia in kidney transplant patients infected by B19. 48,52–55 PRCA is a disorder characterized by anemia that leads to the almost complete absence of erythroid cells from precursors in the bone marrow but with normal production of granulocytes and megakaryocytes.…”

Section: Causes Of Resistance To Treatment With Recombinant Human Erymentioning

confidence: 99%

Resistance of dialyzed patients to erythropoietin

Alves

Vilaça

Carvalho

et al. 2015

Revista Brasileira de Hematologia e Hemoterapia

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Resistance to recombinant human erythropoietin is a common condition in dialyzed patients with chronic kidney disease and is associated with more hospitalizations, increased mortality and frequent blood transfusions. The main cause of hyporesponsiveness to recombinant human erythropoietin in these patients is iron deficiency. However, a high proportion of patients does not respond to treatment, even to the use of intravenous iron, which indicates the presence of other important causes of resistance. In addition to the iron deficiency, the most common causes of resistance include inflammation, infection, malnutrition, inadequate dialysis, and hyperparathyroidism, although other factors may be associated. In the presence of adequate iron stores, other causes should be investigated and treated appropriately.

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“…For most patients, erythropoiesis is maintained by erythropoiesis-stimulating agents, and red blood cells may have a shortened life span in the setting of uremia. This combination of factors may predispose these patients to potentially life-threatening transient aplastic crisis associated with parvovirus infection (72). Furthermore, some believe that administration of erythropoietin during B19 infection can facilitate viral replication by providing new target cells (73), thereby prolonging viremia and its associated complications.…”

Section: Parvovirus Infection In Dialysis Populationsmentioning

confidence: 99%