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Subclinical parvovirus B19 infection in children with sickle cell anemia
Sherri A Zimmerman1, Jacqueline S Davis, William H Schultz
1Division of Hematology/Oncology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA. Zimme008@mc.duke.edu
Insights
Most children with sickle cell anemia (SCA) are exposed to parvovirus B19 by their teenage years. However, many infections are subclinical, as evidenced by the low rate of documented transient aplastic crisis.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Viral Pathogenesis
Background:
- Sickle cell anemia (SCA) is a genetic blood disorder.
- Parvovirus B19 infection can cause transient aplastic crisis in SCA patients.
- Understanding parvovirus B19 prevalence is crucial for managing SCA complications.
Purpose of the Study:
- To determine the prevalence of parvovirus B19 exposure in pediatric SCA patients.
- To assess the clinical consequences of parvovirus B19 exposure in this cohort.
Main Methods:
- Prospective serologic testing for parvovirus B19 antibodies in steady-state pediatric SCA patients.
- Retrospective chart review for documented transient aplastic crisis.
Main Results:
- 53% of 102 SCA patients showed evidence of past parvovirus B19 infection.
- Prevalence increased with age, from 44% (5-9 years) to 71% (17-21 years).
- Only 27% had a documented transient aplastic crisis.
Conclusions:
- The majority of pediatric SCA patients have been exposed to parvovirus B19 by adolescence.
- Subclinical parvovirus B19 infections are common in children with SCA.
- Lack of documented crisis does not rule out prior infection.
Purpose:
To investigate the prevalence and clinical consequences of previous parvovirus B19 exposure in a large cohort of pediatric patients with sickle cell anemia (SCA).
Methods:
Prospective serologic testing for previous parvovirus B19 exposure was performed in steady-state pediatric patients with SCA, either prior to starting hydroxyurea therapy or in preparation for transition to the adult service. A retrospective chart review was performed to ascertain whether patients had a documented history of a transient aplastic crisis.
Results:
The prevalence of serologic evidence of previous parvovirus infection increased with age. The overall prevalence in 102 children with SCA was 53%, ranging from 44% between 5 and 9 years of age to 71% between 17 and 21 years of age. Only 27% of patients had a previous clinically recognized transient aplastic crisis.
Conclusions:
By the teenage years, most pediatric patients with SCA have serologic evidence of previous parvovirus B19 exposure. However, subclinical parvovirus infection appears to be common in children with SCA, since most patients have no documented previous transient aplastic crisis.