High Frequencies of Exposure to the Novel Human Parvovirus PARV4 in Hemophiliacs and Injection Drug Users, as Detected by a Serological Assay for PARV4 Antibodies
High Frequencies of Exposure to the Novel Human Parvovirus PARV4 in Hemophiliacs and Injection Drug Users, as Detected by a Serological Assay for PARV4 Antibodies
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DOI：
10.1086/605646
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发表时间：
2009-10-01
影响因子：
6.4
通讯作者：
Simmonds, Peter
中科院分区：
文献类型：
--
作者：
Sharp, Colin P.;Lail, Alice;Simmonds, Peter
背景。 PARV4 是一种人类细小病毒，首先在患有人类免疫缺陷病毒 (HIV) 血清转化样疾病的个体中检测到并克隆，随后在淋巴组织和骨髓中持续存在。与人类细小病毒 B19 感染相反，PARV4 感染最常见于注射吸毒者 (IDU)，特别是同时感染 1 型 HIV (HIV-1) 的人。为了研究 PARV4 的传播途径并确定是否通过血浆来源的血液制品获得感染，我们开发了一种新型抗 PARV4 酶联免疫吸附测定 (ELISA)，以确定其在肠胃外暴露受试者中的血清阳性率。方法。表达 PARV4 病毒蛋白 2 (VP2)，并在间接 ELISA 中用作抗原，以检测抗 PARV4 免疫球蛋白 G。结果。所有 50 名非肠胃外暴露于 PARV4 的成年对照受试者均为抗 PARV4 阴性，而感染 HIV 和未感染 HIV 的注射吸毒者的抗体频率分别为 67% 和 33%。在接受非病毒灭活因子 VIII/因子 IX 治疗的 HIV 合并感染者和未感染 HIV 的血友病患者（分别为 20 人中的 11 人和 15 人中的 4 人）中，发现感染频率相似，证实了主要是肠外传播，而这些兄弟姐妹的 35 名非血友病兄弟姐妹中，除 1 人外，其余所有人均发现血清阴性（尽管有密切的家庭接触）。结论。本研究提供了令人信服的证据，证明 PARV4 主要通过胃肠外传播。使用非病毒灭活凝血因子治疗的血友病患者广泛感染的证据给血浆衍生的血液制品带来了新的安全问题，特别是因为细小病毒对病毒灭活相对具有抵抗力。
Background. PARV4 is a human parvovirus that was first detected in and cloned from an individual with a human immunodeficiency virus (HIV) seroconversion- like illness and that subsequently persisted in the lymphoid tissue and bone marrow. In contrast to human parvovirus B19 infections, PARV4 infections are most frequently detected in injection drug users (IDUs), particularly those who are coinfected with HIV type 1 (HIV-1). To investigate the routes of transmission of PARV4 and to ascertain whether infections are acquired through plasma-derived blood products, we developed a novel anti-PARV4 enzyme-linked immunosorbent assay (ELISA) to determine its seroprevalence in subjects with parenteral exposure.Methods. PARV4 viral protein 2 (VP2) was expressed and used as antigen in an indirect ELISA, to detect anti-PARV4 immunoglobulin G.Results. All 50 adult control subjects who were nonparenterally exposed to PARV4 were anti-PARV4 negative, in contrast to HIV-infected and HIV-uninfected IDUs, who had antibody frequencies of 67% and 33%, respectively. Predominantly parenteral transmission was confirmed by the finding of similar frequencies of infection among HIV-coinfected and HIV-uninfected hemophiliacs (11 of 20 individuals and 4 of 15 individuals, respectively) who were treated with nonvirally inactivated factor VIII/factor IX, whereas all but 1 of the 35 nonhemophiliac siblings of these siblings were found to be seronegative (despite having close household contact).Conclusions. The present study provides convincing evidence that PARV4 is primarily transmitted parenterally. Evidence for widespread infection of hemophiliacs treated with nonvirally inactivated clotting factor creates fresh safety concerns for plasma-derived blood products, particularly because parvoviruses are relatively resistant to virus inactivation.