title: Human parvovirus B19 infection in acute fulminant liver failure.
abstract: We previously reported detection of human parvovirus B19 DNA in livers from patients requiring transplantation for acute fulminant liver failure. In this study, we used immune adherence PCR (IA-PCR) to bind B19 virions in recipient native liver onto solid phase with specific monoclonal antibodies followed by PCR amplification of virion DNA. IA-PCR had sensitivity and specificity similar to conventional PCR. We examined liver tissue from 16 patients with non-A, non-B, non-C, non-E (NA-E) acute fulminant liver failure (AFLF) (6 of unknown etiology associated with aplastic anemia (AA), 4 of unknown etiology without AA; and 6 patients with AFLF of known etiology). IA-PCR detected B19 virions in 5 of 6 (83%) of livers from patients with idiopathic NA-E AFLF associated with AA and in 2 of 3 (75%) without AA, compared to 1 of 6 (17%) of livers from patients with AFLF of known etiology and to 6 of 34 (18%) of 34 control patients with chronic or neoplastic liver disease. Viral mRNA encoding the structural protein was detected in the liver tissue from three B19 IA-PCR positive patients with AFLF. Detection of B19 virions and mRNA for capsid proteins provided strong evidence for B19 infection during the course of NA-E AFLF and argues for involvement of B19 virus in liver injury.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, University of Iowa, Iowa City, USA.
authors.forename: Y V
authors.initials: YV
authors.lastname: Karetnyi
authors.forename: P R
authors.initials: PR
authors.lastname: Beck
authors.forename: R S
authors.initials: RS
authors.lastname: Markin
authors.forename: A N
authors.initials: AN
authors.lastname: Langnas
authors.forename: S J
authors.initials: SJ
authors.lastname: Naides
mesh_terms: D004261:DNA Replication; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000821:virology; D006801:Humans; D008099:Liver / Q000821:virology*; D017093:Liver Failure / Q000150:complications* / Q000821:virology; D010322:Parvoviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D016732:Parvovirus B19, Human / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis; D012680:Sensitivity and Specificity
chemical_list: D004279:DNA, Viral; D012333:RNA, Messenger; D012367:RNA, Viral