title: Human parvovirus B19 in young male patients with hemophilia A: associations with treatment product exposure and joint range-of-motion limitation.
abstract: BACKGROUND
  To evaluate the risk of human parvovirus B19 (B19) transmission in recombinant antihemophilic factor, the seroprevalence among 798 two- to seven-year-old boys with hemophilia was compared. Also, data collected on joints were used to assess relations between B19 serostatus and joint range-of-motion (ROM) limitation.
  
  
  METHODS
  Staff at US hemophilia treatment centers collected data on product exposures and ROM of 10 joints and provided blood specimens as part of blood safety surveillance. Blood was tested for immunoglobulin G anti-B19. Associations between B19 seropositivity and treatment products and joint ROM limitations were examined in multivariate analyses.
  
  
  RESULTS
  Compared to children who received no product, the odds of B19 seropositivity were 0.8 (p = 0.5), 1.9 (p = 0.05), and 7.6 (p < 0.001) for those children who received recombinant antihemophilic factor only, both recombinant antihemophilic factor and plasma-derived factor, and plasma-derived factor only, respectively. Children who were anti-B19 positive had an average 8 degrees less overall ROM (p = 0.002) than those who were B19 antibody negative after adjustment for other risk factors.
  
  
  CONCLUSIONS
  The risk of B19 transmission by recombinant antihemophilic factor is low. Previous B19 infection is associated with ROM limitations in very young male patients with hemophilia. Virus inactivation techniques effective against B19 and other nonenveloped viruses are needed.
authors.affiliation: Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30303, USA. msoucie@cdc.gov
authors.forename: J Michael
authors.initials: JM
authors.lastname: Soucie
authors.forename: Edward B
authors.initials: EB
authors.lastname: Siwak
authors.forename: W Craig
authors.initials: WC
authors.lastname: Hooper
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Evatt
authors.forename: F Blaine
authors.initials: FB
authors.lastname: Hollinger
mesh_terms: D000367:Age Factors; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004340:Drug Contamination; D005169:Factor VIII / Q000009:adverse effects*; D006467:Hemophilia A / Q000628:therapy* / Q000821:virology; D006801:Humans; D008297:Male; D010322:Parvoviridae Infections / Q000635:transmission*; D016732:Parvovirus B19, Human / Q000276:immunology / Q000302:isolation & purification*; D016059:Range of Motion, Articular; D011994:Recombinant Proteins / Q000009:adverse effects
chemical_list: D000914:Antibodies, Viral; D011994:Recombinant Proteins; D005169:Factor VIII