Distinctive Inflammatory Traits of Parvovirus B19 Infection Associated with Persisting Autoimmunity

Area of Science:

• Immunology
• Virology
• Rheumatology

Background:

• Adult parvovirus B19 (B19V) infection presents with cyclic outbreaks.
• B19V infection can manifest with inflammatory symptoms that mimic or precede systemic autoimmune diseases.
• Clinical features distinguishing transient from persistent B19V-related manifestations are not well understood.

Purpose of the Study:

• To investigate the epidemiology and clinical phenotypes of B19V infection in patients with immune-mediated manifestations.
• To identify clinical traits differentiating B19V infection outcomes in patients with and without autoimmunity.
• To analyze the presentation and management of B19V infection in a tertiary care setting.

Main Methods:

• Retrospective, multicentre, observational study design.
• Data collected from the 2024 B19V infection outbreak.
• Inclusion of patients with B19V infection, immune-mediated manifestations, and pre-existing autoimmunity.

Main Results:

• 39 B19V infections identified with an annual incidence of 1.78 cases/1000 patients.
• Arthritis was significantly more frequent in new-onset autoimmunity (89%) compared to pre-existing (14%) or no autoimmunity (19%).
• New-onset B19V autoimmunity occurred in 1/6 cases, presenting distinct features and requiring immunosuppression.

Conclusions:

• B19V infection is a potential trigger for new-onset autoimmune diseases in adults.
• Distinct clinical phenotypes are associated with B19V-triggered autoimmunity.
• Management of B19V-associated autoimmunity may necessitate significant immunosuppressive therapy.