Parvovirus infection in children and pregnant women

Parvovirus (PV) is a widespread infection, despite the fact that this pathogen was discovered only recently. The therapeutic effect of PV, in particular its oncolytic activity, is being actively studied now. Notably, PVs causing infections in animals, such as rat PV H-1, caninae PV, and rodent protoparvovirus (minute virus of mice) suppress oncogenesis in these animals. There is an ex vivo evidence of rat glioblastoma and gliosarcoma sensitivity to PV. The affinity of PV B19 to P-antigen located primarily on the membranes of erythroid cells is crucial for the disease pathogenesis. The teratogenic effect of PV B19 is associated with its ability to infect placental cells (P-antigen is present on the cells of chorionic villi and surface of the trophoblast). PV infection can be acquired or congenital, typical or atypical. The outcome of intrauterine infection with PV B19 largely depends on the gestation age when the infection occurred. Women infected during the second trimester are at higher risk of vertical transmission and severe intrauterine pathology with a poor outcome than those infected during the third trimester. Constant contact with young children significantly increases the risk of PV B19 infection among pregnant women with no immunity to this virus. Serum is the most convenient biomaterial for detecting both PV DNA and virus-specific antibodies. One test for anti-PV IgG using enzyme-linked immunosorbent assay is sufficient to determine the immune status of a patient. Polymerase chain reaction with amniotic fluid is used to diagnose intrauterine infection with PV B19. Blood components and products should be checked for PV B19. High frequency of PV B19 detection in the blood of donors necessitates the development of special measures aimed at prevention of virus transmission. Key words: pregnant women, children, parvovirus B19, parvovirus infection

Parvovirus B19 and Human Parvovirus 4 Encode a Homologous "X Protein" in a Reading Frame Overlapping the VP1 Capsid Gene

30 years ago, researchers noticed that the capsid (VP1) gene of B19 parvovirus might encode a second protein, called "X", in an overlapping reading frame. Since then, experimental approaches failed to detect it. In contrast, sequence analyses can reliably predict whether a protein is expressed from an overlapping frame, provided that it is beneficial to the virus and thus under selection pressure. We used a dedicated software, Synplot2, to identify regions of VP1 likely to encode functional proteins in overlapping frames. Synplot2 detected the X open reading frame and confirmed it is under highly significant selection pressure. We discovered that the X protein is homologous to the ARF1 protein of human parvovirus 4, another suspected protein encoded in a frame overlapping VP1. These findings provide compelling evidence that the X protein must be expressed and functional. We predict that it contains a predicted transmembrane region. We found that the X frame contains a potential AUG start codon in parvovirus B19 and in all related species. Yet no currently known viral transcript has the potential to encode the X protein in a monocistronic fashion. Therefore, the X protein is probably expressed either from an unmapped monocistronic mRNA, or translated by a non-canonical mechanism from the VP1 mRNA or from a short transcript, R3, which has no currently known function. Finally, Synplot2 also detected proteins likely to be expressed from a frame overlapping VP1 in species distantly related to parvovirus B19: porcine parvovirus 2 and bovine parvovirus 3.

Preservative Monitoring of a Greek Woman with Hydrops Fetalis due to Parvovirus B19 Infection

Primate erythroparvovirus 1 (parvovirus B19) is a member of theErythrovirusgenus of the Parvoviridae family and it is one of the few members of the family known to be pathogenic in human. B19 infection is common and widespread with the virus being associated with numerous rheumatologic and haematologic manifestations. More specifically, maternal infection with parvovirus B19 during pregnancy can cause severe anemia which may lead to nonimmune hydrops or fetal demise, as a result of fetal erythroid progenitor cells infection with shortened half-life of erythrocytes. We present a rare case reported in the Greek population, of subclinical transient reticulocytopenia due to B19 parvovirus infection, in an asymptomatic pregnant woman, without medical history of hemoglobinopathy, and with the presence of hydrops fetalis during the third trimester of her pregnancy.

Pure red cell aplasia

Pure red cell aplasia (PRCA) is a syndrome defined by a normocytic normochromic anemia with severe reticulocytopenia and marked reduction or absence of erythroid precursors from the bone marrow. Diamond-Blackfan anemia is a congenital form of PRCA. Acquired PRCA may be either a primary disorder or secondary to some other disorder or agent. Primary acquired PRCA is an autoimmune disorder that is frequently antibody-mediated. Myelodysplastic syndromes may also present with the morphologic appearance of PRCA. Secondary acquired PRCA may be associated with collagen vascular/autoimmune disorders such as systemic lupus erythematosus; lymphoproliferative disorders such as chronic lymphocytic leukemia or large granular lymphocyte leukemia; infections, particularly B19 parvovirus; thymoma and other solid tumors; or a variety of other disorders, drugs, or toxic agents. The therapeutic approach to PRCA typically involves immunosuppression, but specific pathogenic subtypes are associated with specific therapeutic approaches. Cyclosporine A, with or without concurrent corticosteroids, appears to be the single most effective immunosuppressive agent.

Pure red cell aplasia

Pure red cell aplasia (PRCA) is a syndrome defined by a normocytic normochromic anemia with severe reticulocytopenia and marked reduction or absence of erythroid precursors from the bone marrow. Diamond-Blackfan anemia is a congenital form of PRCA. Acquired PRCA may be either a primary disorder or secondary to some other disorder or agent. Primary acquired PRCA is an autoimmune disorder that is frequently antibody-mediated. Myelodysplastic syndromes may also present with the morphologic appearance of PRCA. Secondary acquired PRCA may be associated with collagen vascular/autoimmune disorders such as systemic lupus erythematosus; lymphoproliferative disorders such as chronic lymphocytic leukemia or large granular lymphocyte leukemia; infections, particularly B19 parvovirus; thymoma and other solid tumors; or a variety of other disorders, drugs, or toxic agents. The therapeutic approach to PRCA typically involves immunosuppression, but specific pathogenic subtypes are associated with specific therapeutic approaches. Cyclosporine A, with or without concurrent corticosteroids, appears to be the single most effective immunosuppressive agent.