Persistent Anemia in an HIV Patient: The Role of Parvovirus B19

Parvovirus B19 (B19V) is a common single-stranded DNA virus that infects humans and is its only host. Although infection is often asymptomatic, B19V can cause significant hematologic disease due to its tropism for erythroid progenitor cells. Immunocompromised individuals, including those with human immunodeficiency virus (HIV), are susceptible to persistent infection and may develop pure red cell aplasia (PRCA) and chronic anemia. Since B19V infection is not routinely monitored in the United States, and its symptoms can overlap with other causes of anemia in HIV, diagnosis may be overlooked. Early identification is critical, as intravenous immunoglobulin (IVIG) can rapidly restore erythropoiesis and reverse transfusion dependence.