Vox Sang. 1997;72(1):1-10. Unique Identifier : AIDSLINE MED/97183359
BACKGROUND AND OBJECTIVES: Human B19 parvovirus (B19), identified in
1975, was only recognised as the causative agent of fifth disease in
1983. The incidence of viraemia is low, around 1 in 1,000, but is
sufficient to ensure that most plasma pools for fractionation contain
some virus. While infection usually occurs in childhood and is benign,
chronic infection sometimes occurs and may be of concern in certain
patient groups. MATERIALS AND METHODS: This review is based on a meeting
held in March 1995, and addresses recent concerns regarding the
potential transmission of B19 infection by pooled plasma products.
RESULTS: Recent data on the pathophysiology and assay of this virus are
summarised along with possible approaches to donor screening, product
screening, and virus removal. Only five cases of symptomatic infection
have been reported in persons with haemophilia, but no technology for
virus removal is established, and infection may be of concern in
pregnant women, and in patients with enhanced red cell turnover or who
are immunosuppressed, including those infected with human
immunodeficiency virus, but only rarely in immunocompetent patients.
CONCLUSIONS: For the future, well-validated assays relevant to virus
infectivity are required if blood donations, plasma pools, or plasma
products are to be screened, and an in-process virus inactivation step
for B19 would be highly desirable. In the interim, non-plasma or
recombinant products or a selective transfusion policy might be used in
patient groups in which B19 infection is of particular concern. Further
clinical data on the prognosis and impact of B19 infection are needed to
justify both such policies and the future adoption of new technologies
designed to reduce any excess B19 infectivity arising from transfused
products.
*Blood Transfusion/ADVERSE EFFECTS *Parvoviridae
Infections/TRANSMISSION *Parvovirus B19, Human