人细小病毒B19感染与过敏性紫癜

目的：探讨过敏性紫癜与人细胞小病毒B19感染的关系及免疫状况，方法：采用ELISA法对42例过敏性紫癜患儿血清进行B19病毒抗体IgM检测，同时采用流式细胞仪检测42例过敏性紫癜患儿的T细胞亚群、自然杀伤细胞（NK）细胞活性。结果：（1）42例过敏性紫癜患儿血清B19抗体IgM阳性13例（30．95％），28例对照组阳性1例，两组差异有非常显著性意义（P＜0．01）；（2）过敏性紫癜患儿存在T细胞亚群异常，NK细胞活性降低，结论：（1）福建省过敏性紫癜人群有较高B19病毒感染。（2）过敏性紫癜与B19病毒感染有较密切相关。（3）过敏性紫癜患儿存在T细胞功能紊乱。NK细胞活性降低，B19相关性过敏性紫癜患儿NK细胞活性降低更为显著。     

临沂市献血人员人细小病毒B19感染情况的调查

目的 调查山东临沂市区部分献血员中人细小病毒B19 （human parvovirus B19,HPVB19）的感染状况.方法 采用实时荧光定量PCR检测方法,对临沂市632份无偿献血者的血清HPVB19进行检测.结果 632名献血员HPVB19检测阳性42例,阳性率为6.64%.其中男26例（阳性率为6.28%）,女16例（阳性率为7.33%）.两组比较（χ2＝0.14,P＞0.05）,无统计学意义.各年龄段中,18～25岁年龄组阳性率最低,为3.85% 36～45岁年龄组阳性率最高,达到15.69%.36～45岁年龄组明显高于18～25岁组、26～35岁组和46～55岁,与其他年龄组比较（χ2=17.16,P〈0.01）,具有统计学意义.结论 对临沂市献血人员血液中HPVB19的感染状况进行了初步血清流行病学调查,为输血安全和血液制品安全管理政策的制订提供了理论依据.     

妊娠期细小病毒B19感染

检查了不明原因的死胎，Ｂ超检查发现水肿和／或胸、腹水的胎儿，畸形儿及死亡的新生儿共１１例，采取母血、羊水和脐血标本，应用ＰＣＲ技术进行检测。结果：母血标本８例，４例Ｂ１９阳性，羊水和脐血标本１１例，４例阳性，胎儿感染率为３６３６％。１１例中有４例胎儿水肿，３例Ｂ１９阳性，Ｂ１９阴性的１例经检查证实为母儿Ｒｈ血型不合，抗人球蛋白实验阳性，系免疫性水肿。Ｂ１９检查的病例中有２例是双胎妊娠，其４个胎儿均受感染。此外，Ｂ１９阳性的病例中有２例胎儿伴短肢畸形，是巧合还是感染所致，尚不能作出定论     

精液细小病毒B19感染情况初探

目的 :探讨人细小病毒 (HPVB19)在男性精液中的感染情况。方法 :用HPVB19 PCR法对 46例健康已婚男性和 15例健康未婚男性精液进行检测。结果 :46例健康已婚男性精液HPVB19阳性率为 19 5 % ( 9/46 ) ,而未婚男性对照组阳性率仅为 6 6 % ( 1/15 ) ,但两组比较差异无显著意义 ( χ2 =0 378,P >0 0 5 )。结论 :精液中HPVB19感染是否可通过垂直传播方式引起孕妇胎儿宫内感染 ,仍有待进一步研究证实 ,应引起男性学专家的足够重视。     

广东地区育龄妇女人细小病毒B19感染筛查结果分析

目的 通过对广东地区育龄妇女人细小病毒B19(human parvovirus B19,B19)感染筛查结果进行分析,了解广东地区育龄妇女人细小病毒B19感染情况. 方法 采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测广东地区育龄妇女血清中人细小病毒B19特异性IgM和IgG抗体,并对检测结果进行分析. 结果 广东地区育龄妇女血清中人细小病毒B19特异性IgM和IgG抗体阳性率分别为1.40％(700/50 086)、16.72％ (341/2 039).结论 开展育龄妇女人细小病毒B19感染筛查工作,对优生优育、提高人口素质具有非常重要意义.     

中国献血人群中人细小病毒B19的分子流行病学调查

目的人细小病毒B19(Human parvovir-usB19)属于细小病毒科(Parvoviridae),嗜红细胞病毒属(Erythrovirus)。B19是1种单链无包膜病毒,其病毒基因组长约5.6kb,目前B19在世界范围的流行株有3种基因型。B19可通过呼吸道传播,引起胎儿水肿、宫内死胎、自发性流产、传染性红斑、急性关节炎等多种疾病。B19还可通过血液和血液制品传播,并且可抵抗大多数病毒灭活/去除方法,显示其在输血安全中的重要性。然而其在中国献血人群中的存在情况、流行株和病毒的载量还不清楚。由于B19有较高的发病率,献血者B19感染时会出现较高的病毒血症,因而用于加工的大量汇集血浆中会含有B19病毒。在欧美等国家都将小样本汇集的Q-PCR方法引入了他们的血液筛查方案中,病毒载量高于104IU/ml的样本都要拆分和废弃。在我国,B19的检测并没有被列为血液制品的筛查项目。本研究旨在调查中国献血人群中人细小病毒B19的病毒DNA和血清学流行率,了解我国B19病毒在献血人群中的流行情况,对我国未来的献血筛查策略提供数据支持。同时,献血人群中,存在一部分HIV感染者,而B19感染免疫缺陷病人,能造成严重的慢性贫血,并由于机体无法形成B19抗体或抗体无效,因而造成持续性感染。本研究也检测了HIV阳性献血者中人细小病毒B19的病毒DNA和血清学流行率,了解我国B19病毒在HIV阳性献血人群中的流行情况,并对B19病毒在正常人群和免疫缺陷人群中不同的表现进行比较研究,从而对这一人群的抗病毒治疗提供指导。     

小儿血液病患者细小病毒B19携带状况

小儿血液病患者细小病毒Ｂ１９携带状况张宝荣王琦贾万英朱近人细小病毒Ｂ１９（ＨＰＶ－Ｂ１９）感染可引起患儿发热、急性再生障碍性贫血危象、关节炎、传染性红斑等。因此我们对５０例小儿血液病患者进行了ＨＰＶ－Ｂ１９的检测，其中２５例有ＨＰＶ－Ｂ１９的感染，现...     

人细小病毒B19主要抗片段的表达及临床初步应用

我国临床人细小病毒Ｂ19(Ｂ19)感染的诊断和流行病学调查以及献血员筛查等方面的工作尚未广泛开展 ,原因之一是受诊断试剂和方法的局限。目前国际上商业Ｂ19抗体诊断试剂盒均以重组抗原为基础。本研究获取能表达Ｂ19结构蛋白ＶＰ1独特区和ＶＰ1/ＶＰ2共同区主要抗原片段 ,建立改良酶联免疫吸附法 (ＥＬＩＳＡ) ,检测发病期患者和献血员血清中抗Ｂ19 ＩｇＭ ,并与德国ＩＢＬ试剂盒平行比较。一、材料和方法1 标本来源 :全血细胞减少、再生障碍性贫血发病期患者血清 4 2份 ,来自天津血液病研究所和北京人民医院。献血员血清 12份 ,来自某研究…     

巢式PCR法检测健康人群人类细小病毒B19感染的研究

目的：探讨肇庆地区健康人群人类细小病毒Ｂ１９感染状况，方法：采用巢式聚合物酶链反应（Ｎｅｓｔｅｄ－ＰＣＲ）技术包括对４１１名新生儿，１８６名婴幼儿童，３７４名成人，６８９名孕妇的健康人１６６２名的脐血或指端，静脉血检测Ｂ１９ＤＮＡ。结果：１６６２名Ｂ１９阳性检出率为８．７２％，无性别差异，其中正常新生的Ｂ１９阳性检出率１０．７１％接近孕妇１０．２７％，均高于正常成人的５．０８％，（Ｐ〈０．０１），     

流产胚胎组织中人类微小病毒B19的检测分析

目的 通过对三组不同妊娠民政部组别胚胎组织标本检测人类微小病毒Ｂ１９（Ｂ１９Ｖ）结果的分析。探讨Ｂ１９Ｖ感染与人类自然流产之间的关系。方法 实验对象由７２例不明原因自然流产的病人、３２例妊娠情况正常的人工流产者、３６例足月分娩新生儿正常的产妇组织,计１４０例,惧订流产组织和正常产妇胎盘组织为检测标本。应用聚合酶链反应（ＰＣＲ）方法检测Ｂ１９Ｖ。结果 ７２份自然流产病人流产组织标本Ｂ１９Ｖ的检出率为２７．８％（２０／７２）,３６份正常产妇胎盘组织标本Ｂ１９Ｖ的检出率为５．６％（２／３６）,３２份人工流产者的流产组织标本未检测出Ｂ１９Ｖ,自然流产者与人工流产者、正常分娩者组织标本ＰＣＲ－Ｂ１９Ｖ结果的差别有显著性（卡方检验。Ｐ〈０．０５）。结论 自然流产病人流产组织ＰＣＲ－Ｂ１９Ｖ的检出率显著性高于人工流产者和正常     

Detection of parvovirus B19 in synovial fluids of patients with osteoarthritis

We aimed to determine the possible role of parvovirus B19 (PVB19) in the etiology of osteoarthritis. PVB19 DNA, anti-VP1 IgM and IgG, and interleukin IL-6 levels were also assayed in synovial fluids of 42 patients with osteoarthritis and 10 controls. PVB19 DNA was detected in 28 of 42 (66.66%) in patients and in 3 of 10 (30%) in controls. IgG and IgM response were detected in 21 of 42 (50.00%) and in 2 of 42 (4.76%) patients, respectively. IL-6 were positive in 15 of 42 (36%) patients and in 3 of 10 (30%) controls. All IgG (+) samples had PVB19 DNA (100%, P < 0.001). Eleven of 15 IL-6 (+) samples had PVB19 DNA (+) (73.33%, P < 0.05). Moreover, all IL-6 (+) samples (n = 5) in stage IV had PVB19 DNA (+) (100%, P < 0.001). We have detected a significant association between the stages of osteoarthritis and PVB19 DNA (P < 0.05). These findings support the presence of PVB19 acting as a transactivator of IL-6 expression as reported earlier. Our results also suggest that the higher stages of osteoarthritis might be related to the increased inflammation and cell damage on joint cartilage due to PVB19.     

Intravenous immunoglobulin therapy for severe arthritis associated with human parvovirus B19 infection

Symptoms caused by acute human parvovirus B19 (HPV-B19) infection can vary considerably, from asymptomatic to severely symptomatic. A 39-year-old Japanese woman complained of sudden, severe arthralgia with edematous limbs coincident with an outbreak of HPV-B19 infection at the elementary school attended by her daughter. A diagnosis of acute HPV-B19 infection was made by the detection of serum antibody to HPV-B19 IgM and HPV-B19 DNA. Magnetic resonance imaging revealed bilateral synovitis of the cubital joints. The patient was immunocompetent and suffered from severe arthralgia associated with persistent HPV-B19 viremia for more than 4 months after the diagnosis of acute HPV-B19 infection. The administration of high-dose intravenous immunoglobulin resulted in remission, with little change in the serum HPV-B19 DNA level. Even in our immunocompetent patient, severe and prolonged arthritis was found to be associated with persistent viremia.     

2016-2017年武汉地区儿童细小病毒B19感染及流行情况分析

摘要：目的 了解武汉地区儿童细小病毒B19感染状况及流行病学特征。 方法 采集自2016年1月1日至2017年12月31日在我院门、急诊和住院部就诊或住院治疗的疑似细小病毒B19感染儿童静脉血,通过ELISA法检测血清细小病毒B19-IgM,并对抗体活性值在10 ~20 U/mL之间的标本进行细小病毒B19 DNA定量检测,综合分析武汉地区儿童细小病毒B19感染状况及流行病学特征。结果 武汉地区2017年儿童细小病毒B19感染率为2.83%,较2016年6.31%的感染率显著下降,两年平均总体感染率为4.34%;儿童细小病毒B19感染状况具有明显的年龄（2岁以上）及性别（女性高于男性）差异; ELISA法检测HPV-B19抗体活性值处于10~13 U/mL之间的标本与PCR检测结果一致性较好,阴性符合率为93.54%;抗体活性值处于13~17 U/mL之间的标本结果一致性较差,阳性符合率为43.21%。抗体活性值17~20 U/mL的标本,阳性符合率为74.81%。结论 武汉地区儿童细小病毒B19感染具有年龄、性别差异,同时对于经ELISA法检测抗体活性值处于13~20 U/mL之间的标本,有必要进行PCR检测确诊。     

Increased seroprevalence of parvovirus B 19 IgG in complex regional pain syndrome is not associated with antiendothelial autoimmunity.

The etiology of complex regional pain syndrome (CRPS) is unclear yet. Recently autoantibodies and antecedent viral infections have been discussed to be involved in the pathogenesis of CRPS. We investigated sera from 39 CRPS patients and healthy controls for parvovirus B19 IgG and the occurrence of antiendothelial autoantibodies (AECA). CRPS patients showed a higher seroprevalence of parvovirus B19 IgG than controls (p < 0.01). All CRPS 2 patients were positive. 10.2% of the CRPS patients and 10.0% of the controls had AECA (n.s.) and AECA were not associated with parvovirus B19 seropositivity. Our findings suggest the involvement of parvovirus B19, but not autoantibody-mediated endothelial cell damage, in the pathogenesis of CRPS.     

Pure red cell aplasia caused by parvovirus B19 in two patients without chronic hemolysis

Infection with human parvovirus B19 (PVB19) induces acquired pure red cell aplasia (PRCA). Chronic hemolytic anemia is well known as an underlying condition. However, additional factors have been recognized to accompany parvoviral PRCA; however, there are only limited reports on iron-deficiency anemia (IDA) and rituximab-induced B-cell dysfunction. We report two patients with PVB19-associated PRCA confirmed by positivity of viral DNA. Although they had no chronic hemolysis, patient 1 had IDA, and patient 2 had remitted small-lymphocytic lymphoma treated with rituximab-containing chemotherapy. Absence of reticulocytes in peripheral blood and marked depletion of erythroid precursors in bone marrow were observed both. Whereas patient 1 received only symptomatic therapy because anemia was not severe, patient 2 was treated with steroids, as PRCA etiology was at first uncertain, and immunological PRCA was not excluded. Both showed rapid increase of reticulocyte counts and recovery from anemia. Although immunoglobulin is considered effective for parvoviral PRCA, notable adverse reactions have been reported. When anemic symptom is not severe, reticulocyte observation only is recommended. The effects of steroids should also be re-evaluated. Optimal treatment according to disease severity remains to be established.     

微小病毒B19感染引起新生儿重度贫血尸检1例及文献复习

目的　研讨微小病毒B19感染的病理组织学诊断及其在新生儿中引起重度贫血的临床病理特征。方法　对 1例死于该类贫血的新生儿进行尸检和常规病理学检查。结果　在骨髓造血组织、肝和脾的髓外造血灶和肺血管中的红细胞前驱细胞中找到诊断性的核内包涵体。结论　微小病毒B19感染引起的重度贫血可导致新生儿死亡 ,病理组织学诊断的关键是在原红细胞中找到诊断性核内包涵体。     

肝移植患者人类微小病毒B19感染与相关贫血的临床特点分析

目的：探讨肝移植术后人类微小病毒B19（human parvovirus B19, HPV B19）感染致纯红细胞再生障碍性贫血（pure red cell aplasia, PRCA）的诊断和治疗方法。方法：描述和分析19例肝移植术后HPV B19感染引起的PRCA病例的临床特点、诊断、治疗及预后。结果：19例肝移植受者术后2个月内出现贫血,排除导致贫血的其他原因,经实时定量聚合酶链反应（quantitative real-time polymerase chain reaction, qRT-PCR）检测HPV B19 DNA诊断为HPV B19感染致PRCA。所有患者给予静脉注射用免疫球蛋白（intravenous immunoglobulins, IVIG）等治疗后,贫血症状得到改善。结论：对于肝移植术后早期不明原因的PRCA患者,排除其他病因后可考虑HPV B19感染可能。PCR检测HPV B19 DNA是诊断PRCA的主要依据。早期应用IVIG治疗对于治疗肝移植后HPV B19感染相关的PRCA效果良好。     

Immune reconstitution to parvovirus B19 and resolution of anemia in a patient treated with highly active antiretroviral therapy

Immune reconstitution inflammatory syndrome (IRIS) is an unsolved problem in the treatment of human immunodeficiency virus (HIV)-1 infection. Despite the high seroprevalence of parvovirus B19 (PVB19) among HIV-1-positive patients, reports on PVB19-induced anemia, especially that associated with PVB19-related IRIS, in these patients are limited. We present the case of a man with acquired immunodeficiency syndrome who developed severe transfusion-dependent anemia and was seropositive and borderline positive for immunoglobulin-M and IgG antibodies against PVB19, respectively. PVB19-DNA was also detected in his serum. The patient was diagnosed with pure red cell anemia (PRCA) caused by a primary PVB19 infection and was treated with periodical blood transfusions. However, he subsequently tested negative for IgG antibodies and developed chronic severe anemia with high levels of PVB19 viremia. This indicated a transition from primary to persistent infection. After initiation of highly active antiretroviral therapy, the patient showed an inflammatory reaction with rapid deterioration of anemia and seroconversion of the IgG antibody to PVB19. Subsequently, PRCA was completely resolved, but the patient’s serum still contained low levels of PVB19-DNA. Thus, this was a case of IRIS associated with PVB19 infection. Our report highlights the significance of seroconversion to PVB19 in the diagnosis of IRIS and re-emphasizes the finding that persistently high levels of PVB19 viremia after primary infection are probably because of the lack of protective antibodies.