Occurrence and Clinical Role of Active Parvovirus B19 Infection in Transplant Recipients

AbstractHuman parvovirus B19 (B19V) infection is not notifiable in Belarus and its most common clinical presentation erythema infectiosum (EI) is often difficult to distinguish from other exanthematous diseases. The objective of this study was to provide comprehensive data about EI epidemiology in Belarus based on the serological and molecular investigation of samples from measles and rubella discarded cases collected between 2005 and 2019. Overall, 4919 sera were investigated for IgM antibodies against B19V and the positive cases were analysed according to year, season and age. B19V DNA was amplified by PCR in a total of 238 sera from all over the country, and sequenced for phylogenetic analyses. B19V infection was confirmed in 1377 (27.8%) measles and rubella discarded cases. Two high incidence periods and a seasonal increase of EI between mid-February to mid-July were identified. Children from 4 to 6 and from 7 to 10 years of age represented the largest groups of patients (22.51% and 22.66% of all cases, respectively), followed by adults between 20 and 29 years of age (14.23%). Among the 238 B19Vs sequenced, one belonged to subgenotype 3b and 237 to subgenotype 1a with 81 (34.2%) clustering with subtypes 1a1 and 153 (64.6%) with 1a2. Three strains (1.2%) formed an additional, well-supported cluster suggesting the presence of another subtype of 1a, tentatively named 1a3. The epidemiological and molecular analyses highlighted not only the prominent role of B19V in exanthematous diseases in Belarus, but also suggested a previously underestimated diversity of subgenotype 1a sequences with a third subtype 1a3.

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Role of Surgical Intervention in Hereditary Spherocytosis with Haemolytic Anaemia, Splenomegaly and Jaundice

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i57a33990 ◽

2021 ◽

pp. 222-226

Author(s):

K. Senthil Kumar ◽

K. Abinaya ◽

R. Anantharamakrishnan ◽

K. Pranay

Keyword(s):

Haemolytic Anaemia ◽

Surgical Intervention ◽

Hereditary Spherocytosis ◽

Parvovirus B19 ◽

Folic Acid Deficiency ◽

Acid Deficiency ◽

Parvovirus B19 Infection ◽

Current Infection ◽

One Year

haemolytic anaemia, splenomegaly and jaundice, admitted in Chettinad hospital and research institute during one year period from January 2019 to January 2020. Surgical intervention is indicated for selected patients with hereditary spherocytosis with haemolytic anaemia and jaundice to abate the hemolytic process after correction of anaemia with blood transfusion. Pigmented gallstones are seen in more than 50% cases for which incidence increases with severity of hemolysis and with age. Complications include aplastic anemia (most common after parvovirus B19 infection), haemolytic crisis during inter-current infection, megaloblastic crisis – during folic acid deficiency, cardiomyopathy, hematological malignancies.

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Adjustment of Immunosuppression for Liver Transplant Recipients Infected with HCV and Treated with Paritaprevir / Ritonavir - Ombitasvir/ Dasabuvir and Ribavirin

Latin american journal of clinical sciences and medical technology ◽

10.34141/ljcs9894522 ◽

2020 ◽

Vol 2 (2) ◽

pp. 18-23

Author(s):

Liz Toapanta - Yanchapaxi ◽

Erwin Chiquete ◽

Víctor Manuel Páez-Zayas ◽

Juan Francisco Sánchez-Ávila ◽

Alan G. Contreras - Saldívar ◽

...

Keyword(s):

Sustained Viral Response ◽

Calcineurin Inhibitors ◽

Blood Levels ◽

Transplant Recipients ◽

Clinical Role ◽

Simple Method ◽

Viral Response ◽

Liver Transplant Recipients

Introduction. Eradication rates of hepatitis C virus (HCV) infection is likely to rise after liver transplantation (LT). We aimed to evaluate the clinical role of a simple method for calcineurin inhibitors (CNI) adjustment in post-LT patients receiving paritaprevir / ritonavir / ombitasvir / dasabuvir and ribavirin (3D scheme). Material and Methods. We included post-LT adult patients between 2014 and 2017. All selected subjects had at least a 12-month follow-up receiving a stable dose of a CNI. All patients had HCV-1 infection, no liver cirrhosis and received the 3D scheme for 24 weeks. Serial blood concentration measurements of immunosuppressant drugs were obtained. CNI dose was adjusted since 3D scheme initiation and during follow-up until adequate levels were obtained. Results. A total of 10 LT patients (mean age 58.7 ± 11.26 years, 60 % women), out of LT 22, received the 3D regime. Tacrolimus was used in 9 patients: four patients received a dose of 0.5 mg every 10 days and 5 received doses of 0.25 mg every 5 days (mean levels, 9.07 ± 5.56 ng/mL). The trough concentration (Ctrough) was 2 ng / mL and the maximum concentration (Cmax) was 30 ng / mL. Only one patient was treated with cyclosporine (mean blood levels of 152.85 ± 54.55 ng / mL). All cases exhibited a sustained viral response. Discussion and Conclusions. It is possible to adjust CNI in LT patients under the 3D regime, with high response rates. Low CNI doses are required to avoid toxicity and side effects in HCV patients receiving protease inhibitors.

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