EFFECT OF HLA TYPE AND HYPOCOMPLEMENTEMIA ON THE EXPRESSION OF PARVOVIRUS ARTHRITIS - ONE-YEAR FOLLOW-UP OF AN OUTBREAK

Objectives-To determine the effect of HLA type and hypocomplementaemia on the duration and severity of joint involvement in parvovirus infec tion (HPV). Methods-Forty seven patients were selected on a geographic al basis from 83 with proven HPV infection during an outbreak that occ urred in Oxfordshire in 1993. They were contacted by questionnaire a y ear later. Thirty five patients were available for examination and blo od sampling. Subjects were typed for HLA-DRB1 alleles and HLA-B27 stat us. Immunological profiles, including C3 and C4 complement components, were determined. Results-Joint symptoms occurred in all patients. The y resolved within a week in 12 patients and persisted beyond one year in 19. On review, none had a picture of rheumatoid arthritis, but thre e patients had developed carpal tunnel syndrome. Decreased C4 was foun d in four. The HLA frequencies were similar to those in controls; howe ver, joint symptoms persisted for more than one week in all HLA-DR4 po sitive patients (p=0.009). There was no relation between the severity of joint symptoms and either HLA type, or hypocomplementaemia. Conclus ions-Joint symptoms are common in parvovirus infection and the presenc e of HLA-DR4 may be associated with persistence of joint symptoms beyo nd one week. This study revealed no evidence of progression to rheumat oid arthritis.