Parvovirus B19 infection--persistence and genetic variation

Area of Science:

• Virology
• Immunology
• Rheumatology

Background:

• Human parvovirus B19 (B19) infection typically presents with acute symptoms such as rash, arthralgia, or aplastic crisis.
• The long-term sequelae and persistence of B19 infection in adults are not fully understood.
• Understanding persistent B19 infection is crucial for managing chronic symptoms and potential complications.

Purpose of the Study:

• To investigate the persistence of B19 infection in patients following acute symptomatic B19 illness.
• To identify clinical characteristics and outcomes associated with persistent B19 infection.
• To analyze viral DNA and serological markers in patients with prolonged B19 infection.

Main Methods:

• Prospective follow-up study of 53 patients with acute B19 infection.
• Assessment of persistent symptoms, serum B19 DNA, and anti-B19 antibodies at a mean follow-up of 57 months.
• Polymerase chain reaction (PCR) and single-stranded conformational polymorphism (SSCP) assays were used to analyze viral DNA.

Main Results:

• Seven out of 53 patients (13.2%) showed persistent B19 DNA in serum at follow-up, significantly higher than controls (p=0.016).
• All persistently infected individuals were women, with some experiencing chronic arthralgia, hemolytic anemia, or chronic fatigue syndrome.
• Analysis of viral DNA revealed evidence of viral evolution or dual infections in some persistently infected patients.

Conclusions:

• A subset of adults, predominantly women, can experience persistent B19 infection with prolonged or new-onset symptoms.
• Persistent B19 infection may be associated with chronic arthralgia, anemia, and fatigue, suggesting a need for long-term monitoring.
• Further research is warranted to elucidate the mechanisms and clinical implications of persistent B19 infection.