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Transmission of human parvovirus B19 by coagulation factor concentrates
M D Williams1, B J Cohen, A C Beddall
1Haematology Department, Children's Hospital, Birmingham, UK.
Insights
Children with bleeding disorders receiving non-heat-treated factor concentrates had high rates of human parvovirus B19 antibody. Heat-treated factor VIII concentrate significantly reduced B19 virus transmission risk.
Area of Science:
- Virology
- Hematology
- Immunology
Background:
- Congenital bleeding disorders require regular treatment with blood-derived clotting factor concentrates.
- Human parvovirus B19 (B19V) is a potential pathogen transmitted through blood products.
- Assessing B19V exposure in vulnerable pediatric populations is crucial.
Purpose of the Study:
- To determine the prevalence of antibodies to human parvovirus B19 in children with congenital bleeding disorders.
- To evaluate the risk of B19V transmission associated with different factor concentrate treatments.
Main Methods:
- Serological testing for anti-B19 IgG antibodies in 86 children with bleeding disorders.
- Comparison of antibody prevalence between children receiving non-heat-treated factor VIII or prothrombin complex concentrates, cryoprecipitate, and age-matched controls.
- Investigation of acute B19V infection in children receiving specific factor VIII concentrate batches.
- Assessment of B19V acquisition in children treated with heat-treated factor VIII concentrate.
Main Results:
- A high prevalence (89%) of anti-B19 IgG was found in boys treated with non-heat-treated factor VIII or prothrombin complex concentrates.
- Children receiving non-heat-treated concentrates showed significantly higher B19V antibody rates compared to controls (38%) and cryoprecipitate recipients (48%).
- Two cases of acute B19V infection were linked to a specific batch of commercial factor VIII concentrate.
- Only 1 of 11 susceptible children acquired B19V after receiving heat-treated National Health Service factor VIII concentrate, indicating a reduced transmission risk.
Conclusions:
- Non-heat-treated factor concentrates pose a significant risk for transmitting human parvovirus B19 to children with bleeding disorders.
- Heat treatment of factor VIII concentrate substantially reduces the risk of B19V transmission.
- Heat treatment may also mitigate the transmission of other heat-labile viruses, including human immunodeficiency virus (HIV).
Abstract:
The prevalence of antibody to human parvovirus B19 was determined in 86 children with congenital bleeding disorders. Forty-seven of 53 boys (89%) receiving non-heat-treated factor VIII or prothrombin complex concentrates were anti-B19 IgG positive compared with 38% of their age-matched controls and 48% of children treated with cryoprecipitate. Acute B19 virus infection occurred in 2 boys 3-4 weeks after they had received the same batch of commercial factor VIII concentrate. Of 11 susceptible children who had only received heat-treated National Health Service factor VIII concentrate (8Y), 1 acquired anti-B19 IgG. This suggests that 8Y heat-treated concentrate has a much reduced risk of transmitting B19 virus and, by implication, other less heat-stable viruses such as human immunodeficiency virus.