Article

Exposure of hematologic patients to parvovirus B19 as a contaminant of blood cell preparations and blood products

Universität Regensburg, Ratisbon, Bavaria, Germany
Transfusion (Impact Factor: 3.57). 12/2005; 45(11):1811-5. DOI: 10.1111/j.1537-2995.2005.00610.x
Source: PubMed

ABSTRACT Patients with hematologic malignancies often require blood products, and parvovirus B19 is known to be transmitted by this route. Primary infection with parvovirus B19 shows a wide variety of disease manifestation. In immunocompromised patients, symptoms are severe and viral clearance is delayed or missing.
A total of 2123 blood products given to all patients of a hematologic ward over a period of 6 months were retrospectively examined for the presence of parvovirus B19 DNA by an in-house real-time polymerase chain reaction (PCR; TaqMan). Patients who had received B19 DNA-positive blood products were further investigated serologically and by PCR for the presence of parvovirus B19 antibodies and DNA.
Twenty-one (1%) of 2123 blood products tested positive for the presence of B19 DNA (2% of pooled products, 0.7% of single-donor products, and 17.6% of allogeneic peripheral blood progenitor cells), the median viral load was 700 genome equivalents per mL. During the study period, 114 patients were treated on the ward, and 14 (12%) of them received B19 DNA-positive blood components. None of them developed symptoms of an acute B19 infection, although one had a short low-level viremia.
Although B19 DNA was detected in 1 percent of blood products given to hematologic patients, the exposure of 12 percent of patients did not result in symptomatic infections.

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    • "Although, this seems quite reassuring, these results cannot be generalized as they represent testing of only 3 batches and continuous monitoring is recommended. Other researchers from different countries have been able to detect parvovirus B19 DNA in 1 percent of all blood cell preparations and blood products applied to the patients on a hematologic ward, in 0.9 percent of standard blood components (in 2.0 percent of pooled plasma products and in 0.7 percent of single donor products) (Plentz et al, 2005), in 0.006 percent of blood donations, in 0.14 percent of single-donor blood products (Koppelman et al, 2004), in 0.16 percent of plasma samples (Thomas et al, 2003), in 0.6 to 1.3 percent of blood donors (Yoto et al, 1995; Candotti et al, 2004), in 12 percent of plasma pools with more than 10 4 geq per mL (Gallinella et al, 2002) in 43 percent of clotting factor concentrates (Schneider et al, 2004) and in 56 percent of "
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    ABSTRACT: Parvovirus B19 is known to cause a spectrum of diseases ranging from mild illness to life threatening disease. The icosahedral nonenveloped B19 virion is resistant to ordinary physicochemical factors, including solvent-detergent treatment. Because of its minute size, 20-25 nm, the pathogen is also relatively resistant to filtration. It can thus be transmitted through blood products to vulnerable recipients in which it causes severe disease. This study aimed at tracking the presence of parvovirus B19 in plasma products available in the local market in Saudi Arabia using nested PCR. Results showed the absence of detectable levels of parvovirus B19 DNA from the tested products. While this is reassuring, it should not entice the authorities to refrain from continuously monitoring blood products for the presence of this virus and thus avoid the possibility of transmission to at-risk individuals.
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    ABSTRACT: Little information is available on the immune response to parvovirus B19 after the administration of contaminated blood products. In the present study, we found that levels of B19 IgG in B19-seropositive recipients protect against reinfection and, after transfusion with pooled plasma containing B19 DNA (1.6 x 10(8) IU/mL), increase from 19-39 IU/mL to 50-100 IU/mL. We found that, in the presence of 1.6-2.2 x 10(8) IU of B19 DNA/mL in B19-seronegative recipients, a pooled-plasma B19 IgG level of 59.5 IU/mL is insufficient to prevent B19 transmission and subsequent seroconversion. These data should lead to improvements in the assessment of blood-product safety.
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