title: A linked donor-recipient study to evaluate parvovirus B19 transmission by blood component transfusion.
abstract: Parvovirus B19V infection can be a serious infection for hematology patients with underlying hemolysis or compromised erythropoiesis syndromes. Although case reports of B19V transmission by blood component transfusion (as contrasted to manufactured plasma derivatives) are rare, no studies have systematically determined a rate of transmission to recipients transfused with B19V DNA-positive components. We used a linked donor and recipient repository and a sensitive, quantitative B19V DNA polymerase chain reaction (PCR) assay to assess such transmission in B19V-susceptible (ie, anti-B19V immunoglobulin G [IgG] negative) recipients. We assessed 112 B19V DNA-positive components from 105 donors (of 12 529 tested donations) transfused into a population of surgical patients with a pretransfusion B19V IgG seroprevalence of 78%. We found no transmission to 24 susceptible recipients from transfusion of components with B19V DNA at concentrations less than 10(6) IU/mL (upper 95% confidence interval, 11.7%). We found an anamnestic IgG response in one pretransfusion seropositive recipient transfused with a component containing greater than 10(10) IU/mL B19V DNA. These findings show either that transmission from components with less than 10(6) IU/mL does not occur, or, if it does, it is an uncommon event. These data do not support the need to routinely screen blood donations with a sensitive B19V DNA nucleic acid assay.
authors.affiliation: Westat Inc, Rockville, MD, USA. skleinman@shaw.ca
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kleinman
authors.forename: Simone A
authors.initials: SA
authors.lastname: Glynn
authors.forename: Tzong-Hae
authors.initials: TH
authors.lastname: Lee
authors.forename: Leslie H
authors.initials: LH
authors.lastname: Tobler
authors.forename: Karen S
authors.initials: KS
authors.lastname: Schlumpf
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Todd
authors.forename: Hannah
authors.initials: H
authors.lastname: Qiao
authors.forename: Mei-Ying W
authors.initials: MY
authors.lastname: Yu
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
mesh_terms: D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001782:Blood Donors; D016022:Case-Control Studies; D004247:DNA / Q000032:analysis / Q000235:genetics; D004279:DNA, Viral / Q000097:blood*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000097:blood / Q000175:diagnosis* / Q000635:transmission*; D016732:Parvovirus B19, Human / Q000235:genetics*; D016133:Polymerase Chain Reaction; D014766:Viremia / Q000175:diagnosis*
chemical_list: D004279:DNA, Viral; D004247:DNA
references.citation: J Med Microbiol. 2004 Jun;53(Pt 6):459-475
references.pmid: 15150324
references.citation: Semin Hematol. 1988 Apr;25(2):159-72
references.pmid: 2838911
references.citation: Transfusion. 1997 Sep;37(9):947-52
references.pmid: 9308643
references.citation: Transfusion. 2001 Jan;41(1):130-5
references.pmid: 11161258
references.citation: N Engl J Med. 1994 Apr 28;330(17):1192-6
references.pmid: 8139629
references.citation: Vox Sang. 2002 Jan;82(1):18-23
references.pmid: 11856463
references.citation: Transfusion. 2007 Oct;47(10):1775-82
references.pmid: 17714425
references.citation: Transfusion. 2000 Oct;40(10):1203-6
references.pmid: 11061856
references.citation: Vox Sang. 1998;75(2):97-102
references.pmid: 9784661
references.citation: Transfusion. 2005 Jun;45(6):1003-10
references.pmid: 15935000
references.citation: Biologicals. 1997 Sep;25(3):283-8
references.pmid: 9324996
references.citation: Blood. 2005 Oct 15;106(8):2890-5
references.pmid: 15976179
references.citation: Transfusion. 2008 May;48(5):1036-7
references.pmid: 18454740
references.citation: Transfusion. 2005 Jul;45(7):1073-83
references.pmid: 15987350
references.citation: Vox Sang. 2003 May;84(4):300-7
references.pmid: 12757504
references.citation: Transfusion. 2007 Oct;47(10):1756-64
references.pmid: 17880600
references.citation: Transfusion. 1995 Sep;35(9):769-72
references.pmid: 7570939
references.citation: Transfus Med. 2007 Aug;17(4):263-78
references.pmid: 17680952
references.citation: J Virol. 2004 Nov;78(22):12169-78
references.pmid: 15507603
references.citation: Transfusion. 2002 Nov;42(11):1473-81
references.pmid: 12421221
references.citation: Transfusion. 1997 May;37(5):517-22
references.pmid: 9149778
references.citation: Am J Hematol. 1992 Mar;39(3):228-30
references.pmid: 1312304
references.citation: Transfusion. 2007 Oct;47(10):1745-50
references.pmid: 17880596
references.citation: Transfusion. 2007 May;47(5):883-9
references.pmid: 17465954
references.citation: Lancet. 1983 Aug 27;2(8348):482-4
references.pmid: 6136645
references.citation: Transfusion. 2006 Sep;46(9):1593-600
references.pmid: 16965589
references.citation: Transfusion. 2009 Nov;49(11):2454-89
references.pmid: 19682345
references.citation: J Infect Dis. 2006 Jul 15;194(2):154-8
references.pmid: 16779720
references.citation: Br J Haematol. 1995 Dec;91(4):1017-8
references.pmid: 8547113
references.citation: Transfusion. 2005 Nov;45(11):1811-5
references.pmid: 16271109