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Recurrent high level parvovirus B19/genotype 2 viremia in a renal transplant recipient analyzed by real-time PCR for simultaneous detection of genotypes 1 to 3.
J Med Virol. 2005 Jan; 75(1):161-9.JM

Abstract

Organ transplant recipients infected with parvovirus B19 frequently develop persistent viremia associated with chronic anemia and pure red cell aplasia. In this study, a male renal transplant recipient who had been infected with parvovirus B19/genotype 2 after renal transplantation at the age of 34 years is described. The patient was repeatedly treated with high dose intravenous immunoglobulin (IVIG) that resulted in the resolvement of symptoms but not in virus eradication. During an observation period of 33 months after transplantation three phases associated with high parvovirus B19 viremia were observed. Both the first and the second viremic phases were combined with severe anemia. Parvovirus B19 specific IgM-antibodies were initially detected at the beginning of the second phase in continually rising concentrations. Initially eradication of the virus by immunoglobulin therapy was reported after the first viremic phase [Liefeldt et al. (2002): Nephrol Dial Transplant 17:1840-1842]. Retrospectively this statement has to be corrected. It was based on the use of a qualitative PCR assay specific for parvovirus B19 genotype 1 associated with reduced sensitivity for detection of genotype 2. After sequence analysis of the viral DNA and adjustment of a real-time PCR assay (TaqMan) for quantitative detection of all three B19 virus genotypes analysis of consecutive serum samples allowed the demonstration of long lasting phases with reduced viral loads following IVIG-treatment. These results demonstrate that IVIG treatment of parvovirus B19-triggered anemia in transplant recipients offers an opportunity to resolve symptoms, but does not guarantee eradication of the virus. Since reactivation of parvovirus B19 infection can result in high virus load associated with the recurrence of symptoms repeated screening for viral DNA is recommended using the TaqMan system established for quantitative detection of all three genotypes of parvovirus B19.

Authors+Show Affiliations

Department of Nephrology, School of Medicine, Charité, Schumannstr, Berlin, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15543575

Citation

Liefeldt, Lutz, et al. "Recurrent High Level Parvovirus B19/genotype 2 Viremia in a Renal Transplant Recipient Analyzed By Real-time PCR for Simultaneous Detection of Genotypes 1 to 3." Journal of Medical Virology, vol. 75, no. 1, 2005, pp. 161-9.
Liefeldt L, Plentz A, Klempa B, et al. Recurrent high level parvovirus B19/genotype 2 viremia in a renal transplant recipient analyzed by real-time PCR for simultaneous detection of genotypes 1 to 3. J Med Virol. 2005;75(1):161-9.
Liefeldt, L., Plentz, A., Klempa, B., Kershaw, O., Endres, A. S., Raab, U., Neumayer, H. H., Meisel, H., & Modrow, S. (2005). Recurrent high level parvovirus B19/genotype 2 viremia in a renal transplant recipient analyzed by real-time PCR for simultaneous detection of genotypes 1 to 3. Journal of Medical Virology, 75(1), 161-9.
Liefeldt L, et al. Recurrent High Level Parvovirus B19/genotype 2 Viremia in a Renal Transplant Recipient Analyzed By Real-time PCR for Simultaneous Detection of Genotypes 1 to 3. J Med Virol. 2005;75(1):161-9. PubMed PMID: 15543575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrent high level parvovirus B19/genotype 2 viremia in a renal transplant recipient analyzed by real-time PCR for simultaneous detection of genotypes 1 to 3. AU - Liefeldt,Lutz, AU - Plentz,Annelie, AU - Klempa,Boris, AU - Kershaw,Olivia, AU - Endres,Anne-Sophie, AU - Raab,Ulla, AU - Neumayer,Hans-H, AU - Meisel,Helga, AU - Modrow,Susanne, PY - 2004/11/16/pubmed PY - 2005/3/4/medline PY - 2004/11/16/entrez SP - 161 EP - 9 JF - Journal of medical virology JO - J Med Virol VL - 75 IS - 1 N2 - Organ transplant recipients infected with parvovirus B19 frequently develop persistent viremia associated with chronic anemia and pure red cell aplasia. In this study, a male renal transplant recipient who had been infected with parvovirus B19/genotype 2 after renal transplantation at the age of 34 years is described. The patient was repeatedly treated with high dose intravenous immunoglobulin (IVIG) that resulted in the resolvement of symptoms but not in virus eradication. During an observation period of 33 months after transplantation three phases associated with high parvovirus B19 viremia were observed. Both the first and the second viremic phases were combined with severe anemia. Parvovirus B19 specific IgM-antibodies were initially detected at the beginning of the second phase in continually rising concentrations. Initially eradication of the virus by immunoglobulin therapy was reported after the first viremic phase [Liefeldt et al. (2002): Nephrol Dial Transplant 17:1840-1842]. Retrospectively this statement has to be corrected. It was based on the use of a qualitative PCR assay specific for parvovirus B19 genotype 1 associated with reduced sensitivity for detection of genotype 2. After sequence analysis of the viral DNA and adjustment of a real-time PCR assay (TaqMan) for quantitative detection of all three B19 virus genotypes analysis of consecutive serum samples allowed the demonstration of long lasting phases with reduced viral loads following IVIG-treatment. These results demonstrate that IVIG treatment of parvovirus B19-triggered anemia in transplant recipients offers an opportunity to resolve symptoms, but does not guarantee eradication of the virus. Since reactivation of parvovirus B19 infection can result in high virus load associated with the recurrence of symptoms repeated screening for viral DNA is recommended using the TaqMan system established for quantitative detection of all three genotypes of parvovirus B19. SN - 0146-6615 UR - https://www.unboundmedicine.com/medline/citation/15543575/Recurrent_high_level_parvovirus_B19/genotype_2_viremia_in_a_renal_transplant_recipient_analyzed_by_real_time_PCR_for_simultaneous_detection_of_genotypes_1_to_3_ L2 - https://doi.org/10.1002/jmv.20251 DB - PRIME DP - Unbound Medicine ER -