Byline: Zakieh. Khameneh, Haleh. Hanifian, Razieh. Barzegari, Nariman. Sepehrvand
Background: Parvovirus B19 infection is associated with clinical symptoms that vary in the spectrum from trivial to severe. The important clinical manifestations are erythema infectiosum or the fifth disease, transient aplastic anemia in patients with hemoglobinopathies, acute polyarthralgia syndrome in adults, hydrops fetalis, spontaneous abortion and stillbirth. Acute infection in nonimmune pregnant women can lead to fetal hydrops. In view of the many complications that can result from acute parvovirus B19 infections during pregnancy, documenting the seroprevalence of anti-parvovirus B19 IgG and its association with the history of abortion in an Iranian population of pregnant women would be of value. Materials and Methods: Serum samples from 86 pregnant women were collected between May and September 2011 in West Azerbaijan province of Iran. Every pregnant woman completed a questionnaire which included age, history of tattooing, blood transfusion, and abortion. Anti-B19 specific IgG was detected by using commercial enzyme-linked immunosorbent assays. Results: Anti-B19-specific IgG antibody was detected in (65/86, 75.6%) of pregnant women. The mean age was 25.56 [+ or -] 5.30 years and three women had a documented history of blood transfusion (2 of them tested seropositive for B19). 16/18 (88.8%) of women with a history of abortion were IgG positive. The frequency of abortion sessions in the seropositive group (25 sessions of abortion: 11 women experienced once, 2 twice, 2 thrice and one 4 times) was 4.03 times greater than abortion in seronegative group (2 abortions/21 seronegative women). Conclusion: Our study reaffirms previous reports regarding the higher frequency of abortion among anti-B19 IgG seropositive pregnant women and a possible role of this viral infection in the pathogenesis of abortion.
Parvovirus B19 is a member of the Parvoviridae family, genus Erythrovirus . It is a naked single-stranded DNA virus and the only known human pathogenic parvovirus. [sup] Its genome of about 2500 base pairs encodes for three major proteins. Two structural proteins (VP1 and VP2) make up the viral capsid, [sup] and the nonstructural protein (NS1) is presumed to be involved in viral replication, activation of viral gene transcription and inducing apoptosis in target cells. [sup]
The infection usually occurs in childhood and the most frequent manifestation of parvovirus B19 infection is erythema infectiosum, also called the fifth disease or "slapped-cheek" disease. [sup] However, it can cause a wide variety of clinical manifestations. Since the virus replicates within the nucleus of erythroid precursor cells, the infection is lytic, and it causes a transient cessation of red blood cell production, so it leads to transient aplastic crisis, especially in persons with underlying hemolytic disorders. [sup],
The virus usually distributes through respiratory droplets; recurrent blood transfusions and immunosuppression are also risk factors for B19 virus infection. Fetal loss results from fetal red blood cell destruction in nonimmune pregnant women. [sup]
Infection by parvovirus during pregnancy is not associated with increased risk of fetal malformation. However, infection during pregnancy is an important cause of intrauterine fetal death, stillbirth, and nonimmune hydrops fetalis. [sup]