Abstract
Background: Maternofetal parvovirus B19 infection may result in fetal hydrops or abortion. Chronic infection has been associated with long term complications (polyarthritis, persistent aplastic anaemia, hepatitis). In pregnancy maternal immunosuppression caused by a TH2 dominant response to viral antigens has been observed. There is little information on long term reactivity to intrauterine infection.
Aims: To assess the serological status in children and their mothers after maternofetal parvovirus B19 infection and development of fetal hydrops.
Methods: A total of 18 children and their mothers, and 54 age matched control infants were studied. Main outcome measures were parvovirus B19 DNA, specific IgM and IgG against the virus proteins VP1/VP2, and NS-1 in venous blood.
Results: Parvovirus B19 DNA and antiparvovirus B19 (IgM) were undetectable in all sera. A significant larger proportion of maternal sera compared to study children's sera contained IgG against the non-structural protein NS-1. Mean levels of VP1/VP2 IgG antibodies were significantly lower in the children than in their mothers (48 (36) v 197 (95) IU/ml). There was no history of chronic arthritis in mothers and children. Five women had subsequent acute but transient arthritis postpartum, which was not correlated with antibodies against NS-1.
Conclusions: Serological evidence of persistent infection after maternofetal parvovirus B19 disease could not be detected. Increased maternal prevalence of anti NS-1 (IgG) and increased levels of antiparvovirus B19 (IgG) may reflect prolonged viraemia compared to fetal disease.
Full Text
The Full Text of this article is available as a PDF (86.2 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Corcoran A., Doyle S., Waldron D., Nicholson A., Mahon B. P. Impaired gamma interferon responses against parvovirus B19 by recently infected children. J Virol. 2000 Nov;74(21):9903–9910. doi: 10.1128/jvi.74.21.9903-9910.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dealtry G. B., O'Farrell M. K., Fernandez N. The Th2 cytokine environment of the placenta. Int Arch Allergy Immunol. 2000 Oct;123(2):107–119. doi: 10.1159/000024441. [DOI] [PubMed] [Google Scholar]
- Dieck D., Schild R. L., Hansmann M., Eis-Hübinger A. M. Prenatal diagnosis of congenital parvovirus B19 infection: value of serological and PCR techniques in maternal and fetal serum. Prenat Diagn. 1999 Dec;19(12):1119–1123. [PubMed] [Google Scholar]
- Eis-Hübinger A. M., Dieck D., Schild R., Hansmann M., Schneweis K. E. Parvovirus B19 infection in pregnancy. Intervirology. 1998;41(4-5):178–184. doi: 10.1159/000024933. [DOI] [PubMed] [Google Scholar]
- Eis-Hübinger A. M., Oldenburg J., Brackmann H. H., Matz B., Schneweis K. E. The prevalence of antibody to parvovirus B19 in hemophiliacs and in the general population. Zentralbl Bakteriol. 1996 Jul;284(2-3):232–240. doi: 10.1016/s0934-8840(96)80098-3. [DOI] [PubMed] [Google Scholar]
- Giannakopoulou C., Hatzidaki E., Giannakopoulos K., Papanicolaou N., Patrikalakis A., Kokori H., Relakis K. Congenital infection by human parvovirus B19 ascites-anaemia. Clin Exp Obstet Gynecol. 1998;25(3):92–93. [PubMed] [Google Scholar]
- Gigler A., Dorsch S., Hemauer A., Williams C., Kim S., Young N. S., Zolla-Pazner S., Wolf H., Gorny M. K., Modrow S. Generation of neutralizing human monoclonal antibodies against parvovirus B19 proteins. J Virol. 1999 Mar;73(3):1974–1979. doi: 10.1128/jvi.73.3.1974-1979.1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hemauer A., Gigler A., Searle K., Beckenlehner K., Raab U., Broliden K., Wolf H., Enders G., Modrow S. Seroprevalence of parvovirus B19 NS1-specific IgG in B19-infected and uninfected individuals and in infected pregnant women. J Med Virol. 2000 Jan;60(1):48–55. doi: 10.1002/(sici)1096-9071(200001)60:1<48::aid-jmv9>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
- Jensen I. P., Thorsen P., Jeune B., Møller B. R., Vestergaard B. F. An epidemic of parvovirus B19 in a population of 3,596 pregnant women: a study of sociodemographic and medical risk factors. BJOG. 2000 May;107(5):637–643. doi: 10.1111/j.1471-0528.2000.tb13306.x. [DOI] [PubMed] [Google Scholar]
- Jordan J. A., Huff D., DeLoia J. A. Placental cellular immune response in women infected with human parvovirus B19 during pregnancy. Clin Diagn Lab Immunol. 2001 Mar;8(2):288–292. doi: 10.1128/CDLI.8.2.288-292.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Koch W. C., Harger J. H., Barnstein B., Adler S. P. Serologic and virologic evidence for frequent intrauterine transmission of human parvovirus B19 with a primary maternal infection during pregnancy. Pediatr Infect Dis J. 1998 Jun;17(6):489–494. doi: 10.1097/00006454-199806000-00011. [DOI] [PubMed] [Google Scholar]
- Margni R. A., Malan Borel I. Paradoxical behavior of asymmetric IgG antibodies. Immunol Rev. 1998 Jun;163:77–87. doi: 10.1111/j.1600-065x.1998.tb01189.x. [DOI] [PubMed] [Google Scholar]
- Margni R. A., Zenclussen A. C. During pregnancy, in the context of a Th2-type cytokine profile, serum IL-6 levels might condition the quality of the synthesized antibodies. Am J Reprod Immunol. 2001 Sep;46(3):181–187. doi: 10.1034/j.1600-0897.2001.d01-1.x. [DOI] [PubMed] [Google Scholar]
- Miller E., Fairley C. K., Cohen B. J., Seng C. Immediate and long term outcome of human parvovirus B19 infection in pregnancy. Br J Obstet Gynaecol. 1998 Feb;105(2):174–178. doi: 10.1111/j.1471-0528.1998.tb10048.x. [DOI] [PubMed] [Google Scholar]
- Minowa H., Nishikubo T., Uchida Y., Nogami K., Yamashita C., Kamitsuji H., Takahashi Y., Yoshioka A. Neonatal erythema infectiosum. Acta Paediatr Jpn. 1998 Feb;40(1):88–90. doi: 10.1111/j.1442-200x.1998.tb01411.x. [DOI] [PubMed] [Google Scholar]
- Mitchell L. A., Leong R., Rosenke K. A. Lymphocyte recognition of human parvovirus B19 non-structural (NS1) protein: associations with occurrence of acute and chronic arthropathy? J Med Microbiol. 2001 Jul;50(7):627–635. doi: 10.1099/0022-1317-50-7-627. [DOI] [PubMed] [Google Scholar]
- Nascimento J. P., Buckley M. M., Brown K. E., Cohen B. J. The prevalence of antibody to human parvovirus B19 in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo. 1990 Jan-Feb;32(1):41–45. doi: 10.1590/s0036-46651990000100007. [DOI] [PubMed] [Google Scholar]
- Reinhard G., Noll A., Schlebusch H., Mallmann P., Ruecker A. V. Shifts in the TH1/TH2 balance during human pregnancy correlate with apoptotic changes. Biochem Biophys Res Commun. 1998 Apr 28;245(3):933–938. doi: 10.1006/bbrc.1998.8549. [DOI] [PubMed] [Google Scholar]
- Rodis J. F., Borgida A. F., Wilson M., Egan J. F., Leo M. V., Odibo A. O., Campbell W. A. Management of parvovirus infection in pregnancy and outcomes of hydrops: a survey of members of the Society of Perinatal Obstetricians. Am J Obstet Gynecol. 1998 Oct;179(4):985–988. doi: 10.1016/s0002-9378(98)70203-0. [DOI] [PubMed] [Google Scholar]
- Rodis J. F., Rodner C., Hansen A. A., Borgida A. F., Deoliveira I., Shulman Rosengren S. Long-term outcome of children following maternal human parvovirus B19 infection. Obstet Gynecol. 1998 Jan;91(1):125–128. doi: 10.1016/s0029-7844(97)00575-9. [DOI] [PubMed] [Google Scholar]
- Schild R. L., Bald R., Plath H., Eis-Hübinger A. M., Enders G., Hansmann M. Intrauterine management of fetal parvovirus B19 infection. Ultrasound Obstet Gynecol. 1999 Mar;13(3):161–166. doi: 10.1046/j.1469-0705.1999.13030161.x. [DOI] [PubMed] [Google Scholar]
- Searle K., Guilliard C., Enders G. Parvovirus B19 diagnosis in pregnant women--quantification of IgG antibody levels (IU/ml) with reference to the international parvovirus B19 standard serum. Infection. 1997 Jan-Feb;25(1):32–34. doi: 10.1007/BF02113504. [DOI] [PubMed] [Google Scholar]
- Skjöldebrand-Sparre L., Tolfvenstam T., Papadogiannakis N., Wahren B., Broliden K., Nyman M. Parvovirus B19 infection: association with third-trimester intrauterine fetal death. BJOG. 2000 Apr;107(4):476–480. doi: 10.1111/j.1471-0528.2000.tb13265.x. [DOI] [PubMed] [Google Scholar]
- Suandork P., Theamboonlers A., Likitnukul S., Hirsch P., Poovorawan Y. Parvovirus B19 antibodies in immunocompromized children in Thailand. Asian Pac J Allergy Immunol. 2000 Sep;18(3):161–164. [PubMed] [Google Scholar]
- Wolff K., Broliden K., Marsk A., Tolfvenstam T., Papadogiannakis N., Westgren M. One stillborn and one severely hydropic twin due to parvovirus B19 infection; successful outcome of the surviving twin. Acta Obstet Gynecol Scand. 1999 Oct;78(9):828–830. [PubMed] [Google Scholar]
- Zakrzewska K., Azzi A., De Biasi E., Radossi P., De Santis R., Davoli P. G., Tagariello G. Persistence of parvovirus B19 DNA in synovium of patients with haemophilic arthritis. J Med Virol. 2001 Oct;65(2):402–407. doi: 10.1002/jmv.2048. [DOI] [PubMed] [Google Scholar]
- de Krijger R. R., van Elsacker-Niele A. M., Mulder-Stapel A., Salimans M. M., Dreef E., Weiland H. T., van Krieken J. H., Vermeij-Keers C. Detection of parvovirus B19 infection in first and second trimester fetal loss. Pediatr Pathol Lab Med. 1998 Jan-Feb;18(1):23–34. [PubMed] [Google Scholar]
- von Kaisenberg C. S., Bender G., Scheewe J., Hirt S. W., Lange M., Stieh J., Kramer H. H., Jonat W. A case of fetal parvovirus B19 myocarditis, terminal cardiac heart failure, and perinatal heart transplantation. Fetal Diagn Ther. 2001 Nov-Dec;16(6):427–432. doi: 10.1159/000053953. [DOI] [PubMed] [Google Scholar]
- von Kaisenberg C. S., Jonat W. Fetal parvovirus B19 infection. Ultrasound Obstet Gynecol. 2001 Sep;18(3):280–288. doi: 10.1046/j.1469-0705.2001.00471.x. [DOI] [PubMed] [Google Scholar]
