Clinical and immune features of human parvovirus B19 infection in allogeneic stem cell transplantation recipients: A retrospective monocentric study.

Publisher: Munksgaard Country of Publication: Denmark NLM ID: 100883688 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3062 (Electronic) Linking ISSN: 13982273 NLM ISO Abbreviation: Transpl Infect Dis Subsets: MEDLINE

Original Publication: Copenhagen : Munksgaard, c1999-

Erythema Infectiosum*/complications ; Parvoviridae Infections* ; Parvovirus B19, Human*/genetics ; Hematopoietic Stem Cell Transplantation*/adverse effects; Humans ; Retrospective Studies ; DNA, Viral/analysis ; Stem Cell Transplantation

Background: Human parvovirus B19 (B19V) infection is associated with pure red cell aplasia (PRCA) in immunocompromised patients; however, the spectrum of manifestations associated with B19V in allogeneic hematopoietic stem cell transplantation recipients (alloHSCT) has rarely been reported.
Methods: In this study, we aimed to report clinical and immune features of B19V infection after alloHSCT. We retrospectively collected and analyzed clinical and microbiological data of all transplanted patients with B19V DNAmia or tissue infection detected by polymerase chain reaction (PCR) in our center from 2010 to 2021.
Results: We report 35 cases of B19V infections in 33 patients. Median time from transplant to B19V first PCR positivity was 6.9 months (interquartile range (IQR) [1.6-18.9]). No preferential immune profile, type of transplantation or conditioning was identified. Hematological impairment was the most frequent sign, followed by rash and fever. Unconventional clinical forms were also detected, such as acute myelitis and myositis. For some cases, the direct relationship between symptoms and B19V infection was difficult to prove but was suggested by targeted tissue PCR positivity. When hematological impairment was not at the forefront, reticulocytopenia helped to diagnose B19V infections. Treatment was mainly based on high dose intravenous immunoglobulin.
Conclusion: Although hematological impairment was the most frequent sign, B19V can affect multiple targets and lead to atypical manifestations. Because of its heterogeneous clinical presentation, B19V infection is likely under-diagnosed. Diagnosis of unusual B19V organ involvement needs combination of arguments which can include targeted tissue PCR.
(© 2023 Wiley Periodicals LLC.)

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Keywords: allogeneic stem cell transplantation; immune reconstitution; parvovirus B19

0 (DNA, Viral)

Date Created: 20230818 Date Completed: 20231023 Latest Revision: 20231023

20250114

10.1111/tid.14118

37594199