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TREATMENT STRATEGIES AND OUTCOME OF PARVOVIRUS B19 INFECTION IN KIDNEY TRANSPLANT RECIPIENTS: A CASE SERIES AND LITERATURE REVIEW OF 128 PATIENTS.
Rev Invest Clin 2019; 71(4):265-274RI

Abstract

Background

There is no specific antiviral treatment for parvovirus B19 (PVB19) infection.

Objective

The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature.

Methods

We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature.

Results

In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases.

Conclusions

In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection.

Authors+Show Affiliations

Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31448778

Citation

Rosado-Canto, Rodrigo, et al. "TREATMENT STRATEGIES and OUTCOME of PARVOVIRUS B19 INFECTION in KIDNEY TRANSPLANT RECIPIENTS: a CASE SERIES and LITERATURE REVIEW of 128 PATIENTS." Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion, vol. 71, no. 4, 2019, pp. 265-274.
Rosado-Canto R, Carrillo-Pérez DL, Jiménez JV, et al. TREATMENT STRATEGIES AND OUTCOME OF PARVOVIRUS B19 INFECTION IN KIDNEY TRANSPLANT RECIPIENTS: A CASE SERIES AND LITERATURE REVIEW OF 128 PATIENTS. Rev Invest Clin. 2019;71(4):265-274.
Rosado-Canto, R., Carrillo-Pérez, D. L., Jiménez, J. V., Cuellar-Rodríguez, J., Parra-Avila, I., Alberú, J., & Morales-Buenrostro, L. E. (2019). TREATMENT STRATEGIES AND OUTCOME OF PARVOVIRUS B19 INFECTION IN KIDNEY TRANSPLANT RECIPIENTS: A CASE SERIES AND LITERATURE REVIEW OF 128 PATIENTS. Revista De Investigacion Clinica; Organo Del Hospital De Enfermedades De La Nutricion, 71(4), pp. 265-274. doi:10.24875/RIC.19002921.
Rosado-Canto R, et al. TREATMENT STRATEGIES and OUTCOME of PARVOVIRUS B19 INFECTION in KIDNEY TRANSPLANT RECIPIENTS: a CASE SERIES and LITERATURE REVIEW of 128 PATIENTS. Rev Invest Clin. 2019;71(4):265-274. PubMed PMID: 31448778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - TREATMENT STRATEGIES AND OUTCOME OF PARVOVIRUS B19 INFECTION IN KIDNEY TRANSPLANT RECIPIENTS: A CASE SERIES AND LITERATURE REVIEW OF 128 PATIENTS. AU - Rosado-Canto,Rodrigo, AU - Carrillo-Pérez,Diego L, AU - Jiménez,José V, AU - Cuellar-Rodríguez,Jennifer, AU - Parra-Avila,Idalia, AU - Alberú,Josefina, AU - Morales-Buenrostro,Luis E, PY - 2019/8/27/entrez KW - Conservative treatment KW - Human parvovirus B19 KW - Intravenous immunoglobulin KW - Kidney transplantation KW - Treatment outcome SP - 265 EP - 274 JF - Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion JO - Rev. Invest. Clin. VL - 71 IS - 4 N2 - Background: There is no specific antiviral treatment for parvovirus B19 (PVB19) infection. Objective: The objective of this study was to study the treatment and outcome of PVB19 infection in kidney transplant recipients (KTR) at our institution, and cases published in the medical literature. Methods: We conducted a retrospective review of PVB19 infection in KTR at an academic medical center over a 16-year period and summarized the data on its treatment and outcome in 120 KTR in the medical literature. Results: In our cohort of eight patients, the median time to the onset of PVB19 disease was 7.2 weeks after transplantation. All patients had severe aregenerative anemia (mean hemoglobin (Hb) of 6.2 ± 1.0 g/dl); all were treated with a reduction in their immunosuppressive regimen and the administration of single-dose intravenous immunoglobulin (IVIG) (mean total dosage of 0.87 ± 0.38 g/kg). The median time to anemia improvement (Hb >10 g/dl) was 3-week post-treatment. No recurrences were documented during follow-up (median 25 months). Among 128 patients (including our cohort of 8 and 120 reported in literature), therapeutic strategies included: 43% IVIG alone, 39% IVIG and reduced immunosuppression, 9% reduction of immunosuppression, and 9% conservative therapy. Clinical relapses were observed in 35% of 71 reported cases. Conclusions: In KTR, decreasing immunosuppression and the administration of low-dose immunoglobulin seem to be not worse than the standard dose in PVB19 infection. SN - 0034-8376 UR - https://www.unboundmedicine.com/medline/citation/31448778/TREATMENT_STRATEGIES_AND_OUTCOME_OF_PARVOVIRUS_B19_INFECTION_IN_KIDNEY_TRANSPLANT_RECIPIENTS:_A_CASE_SERIES_AND_LITERATURE_REVIEW_OF_128_PATIENTS L2 - http://clinicalandtranslationalinvestigation.com/frame_esp.php?id=225 DB - PRIME DP - Unbound Medicine ER -