Parvovirus B19. Stellungnahmen des Arbeitskreises Blut des Bundesministeriums für Gesundheit

Parvovirus B19 Passive Transmission by Transfusion of Intercept® Blood System-Treated Platelet Concentrate

“…Interestingly nearly 40% of the B19V-positive samples harboured high B19V burdens (26 donations, >1.00 × 10 10 IU/ml, 0.003% donations tested), similar to the donation implicated in case 1 (4.87 × 10 10 IU/ml). Such very high B19V DNA-positive blood levels occur during the short highly viraemic phase after primary infection before the B19V IgM and IgG immune response starts around 10 days after infection [2,7]. In both cases described, the plasma of the B19V-contaminated donation was devoid of both B19V-specific IgM and IgG antibodies.…”

“…The majority of these are asymptomatic or mild childhood infections. However, other clinical outcomes may occur, e.g., erythema infectiosum in children, transient aplastic crisis, chronic pure red blood cell (RBC) aplasia, prolonged joint pain in elderly individuals, pregnancy complications (foetal hydrops or spontaneous abortion) as well as severe prolonged anaemia in immunocompromised haematological patients [1,2]. …”

“…Apart from the common asymptomatic course of the disease and the fact that the infection is often not well recognised by many physicians, the most probable reason for the relatively few B19V TTIs is the presence of neutralising anti-B19V antibodies stemming either from the donation itself or being already present in the recipient [4]. The relatively common B19V contamination of plasma derivatives led to widespread adoption of B19V nucleic acid testing (NAT) screening of source and recovered plasma donations to detect high-titre viraemic units before pooling and fractionation in the pharmaceutical industry [2,11,12,13]. …”

“…As in many European countries, NAT of blood donors for B19V is not mandatory for the release of labile blood products in Switzerland but is routinely performed by the manufacturer of fractionation plasma [2]. Since 2007, all donations at the Interregional Blood Transfusion SRC Ltd (formerly Blood Transfusion Service (BTS) SRC Berne) were tested for B19V by NAT with a sensitivity limit of 10 6 IU/ml in the individual donation.…”

“…B19V is also a transfusion-transmitted agent because of the incomplete clearance of the virus after an acute infection, an extremely high viraemia in acutely infected individuals and the well-known resistance of the virus to many inactivation processes used during the manufacturing of blood-derived plasma derivatives and labile blood products [2,3,4,5,6]. B19V viraemia occurs approximately 1 week after primary infection and persists at high titres of up to 10 14 viral particles/ml in plasma for approximately 5 days [2,7]. …”