Parvovirus B19 infection--persistence and genetic variation.
53 patients with acute B19 infection were studied; symptoms at acute infection were rash and arthralgia (n = 26), rash (n = 7), arthralgia (n = 16), aplastic crisis (n = 3), and intrauterine fetal death (n = 1). These patients were followed for 26-85 months (mean 57 months) and re-assessed for persistent symptoms, anti-B19 antibodies, and B19 DNA. At follow-up, 7 individuals were positive for serum B19 DNA, compared with none of the controls (2-tailed p value = 0.016). All 7 of those persistently infected were women, 3 of whom had symptoms; 1 had a chronic haemolytic anaemia (initial presentation was aplastic crisis); 1 had persistent arthralgia in both knees (initial presentation was bilateral knee arthralgia); and 1 had arthralgia in one knee and chronic fatigue syndrome (initial presentation was bilateral arthralgia in knees and shoulders). For the 7 persistently infected patients, serum from the time of diagnosis of acute B19 infection was available for 4, all of which contained B19 DNA. With single-stranded conformational polymorphism (SSCP) assay of these 11 PCR products, identical SSCP types were demonstrated in 5 of 7 follow-up isolates. In 2 of the 4 cases for which both acute and follow-up PCR product was available, the SSCP type of the follow-up product was different from that of the acute product. Two B19 virus types were demonstrated in one patient (with persistent arthralgia and chronic fatigue syndrome) at follow-up assessment.
Kerr
J R
JR
Department of Bacteriology, Belfast City Hospital, Northern Ireland.
Curran
M D
MD
Moore
J E
JE
Murphy
P G
PG
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis*; D016731:Erythema Infectiosum / Q000453:epidemiology / Q000235:genetics* / Q000276:immunology*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007075:Immunoglobulin M / Q000032:analysis; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016732:Parvovirus B19, Human / Q000235:genetics / Q000276:immunology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011863:Radioimmunoassay
D000914:Antibodies, Viral; D004279:DNA, Viral; D007075:Immunoglobulin M