Transient hypoplastic anemia caused by primary human parvovirus B19 infection in a previously untreated patient with hemophilia transfused with a plasma-derived, monoclonal antibody-purified factor VIII concentrate

Background: Modern plasma-derived clotting factor concentrates are produced using various virus-inactivation protocols and an assumed to be safer than they were previously with regard to the risk for transmitting viral infect ions such as human immunodeficiency virus, hepatitis B, and hepatitis C. Th e risks from viruses that are relatively resistant to the current inactivat ion procedures remain uncertain. Patient: A 7-year-old boy with mild hemophilia A who had not been previousl y infused with any blood products was treated with a plasma-derived, monocl onal antibody-purified factor III concentrate to cover orthopedic surgery a fter traumatic fracture of his left arm. Results: A typical primary human parvovirus (HPV)-B19 infection was observe d associated with transient hypoplastic anemia. Retrospective studies inclu ding serologic examination and polymerase chain reaction analysis confirmed that the HPV-B19 infection was transmitted by the factor VIII concentrate. Conclusions: Clotting factor concentrates for the treatment of hemophilia r etain a risk for HPV-B 19 contamination. HPV-B 19 viral infection might ind uce hypoplastic anemia in these patients, particularly during enhanced hemo poiesis after acute blood loss.