Identification and Characterization of Acute Infection With Parvovirus B19 Genotype 2 in Immunocompromised Patients in Poland
Identification and Characterization of Acute Infection With Parvovirus B19 Genotype 2 in Immunocompromised Patients in Poland
复制标题
DOI：
10.1002/jmv.21947
复制
发表时间：
2011-01-01
影响因子：
12.7
通讯作者：
Brojer, Ewa
中科院分区：
文献类型：
--
作者：
Grabarczyk, Piotr;Kalinska, Aleksandra;Brojer, Ewa
细小病毒B19 （B19V）分为三种基因型。基因2型和3型可能导致诊断困难，其流行病学尚未得到很好的了解。在本研究中，评估了波兰症状性感染患者中B19V基因型的患病率，并描述了感染非基因型1株患者的感染过程。实时聚合酶链反应（Real-time PCR）能够检测B19V的所有三种基因型，用于筛查患者血浆样本。2004年至2008年，在血液学和产科/妇科病房的患者中发现了69例，主要是急性期B19V DNA阳性病例。对30例患者进行了更详细的研究，并通过分析NS1/VP1u区域进行了基因分型。大多数样本为基因1型。然而，两株（6.6%）被鉴定为基因型2，与高病毒血症相关，并在一名患有贫血的肾移植受体和一名化疗后全细胞减少的白血病患者中被鉴定出来。前者改变免疫抑制治疗，后者改变静脉注射免疫球蛋白治疗，导致临床参数正常化，虽然病毒载量下降，但仍可检测到B19V DNA。肾移植受者随后怀孕，虽然持续感染B19V基因2型，但没有临床并发症。这是东欧第一次对基因2型B19V感染症状病例的描述，表明急性感染，特别是在这些病毒株免疫功能低下的患者中，可能比想象的更为普遍。中华医学杂志，23(3):391 - 391,2011。(C) 2010 Wiley-Liss, Inc。
Parvovirus B19 (B19V) is divided into three genotypes. Genotypes 2 and 3 may cause diagnostic difficulties and their epidemiology is not well understood. In the present study the prevalence of B19V genotypes in patients with symptomatic infection in Poland was evaluated and the course of infection in patients infected with non-genotype 1 strains is described. Real-time PCR, able to detect all three genotypes of B19V was used to screen patient plasma samples. Sixty-nine, mainly acute-phase B19V DNA positive cases were identified in patients from hematological and obstetric/gynecological wards between 2004 and 2008. Thirty patients were studied in greater detail and genotyping was performed by analysis of the NS1/VP1u region. The majority of samples were genotype 1. However two (6.6%) strains were identified as genotype 2, associated with high viremia and identified in a kidney transplant recipient with anemia and a leukemia patient, following chemotherapy, with pancytopenia. A change of immunosuppression treatment in the former and treatment with intravenous immunoglobulin in latter, resulted in normalization of clinical parameters, and whilst viral loads fell, B19V DNA was still detectable. The kidney transplant recipient subsequently became pregnant with no clinical complications, although persistently infected with B19V genotype 2. This is the first description of symptomatic cases of genotype 2 B19V infection in Eastern Europe suggesting that acute infection, particularly among immunocompromised patients with these virus strains may be more prevalent than thought. J. Med. Virol. 83:142-149, 2011. (C) 2010 Wiley-Liss, Inc.