Parvovirus B19 infection in thoracic organ transplant recipients

Background: Clinical manifestations of parvovirus B19 infection in immunoco mpromised patients are mostly reported as acute or chronic hematologic diso rders. More recently, respiratory or renal involvement has been described. Objective: We started in 1994 a prospective study of parvovirus B19 infecti on in a group of lung (LTP) and heart-lung (HLTP) transplanted patients, in cluding occasionally heart transplanted (HTP) patients. Study design: 62 patients (49 LTP, 11 HLTP, 2 HTP) were included in a serol ogical survey and DNA detection by PCR was performed on each serum sample o f the first 29 patients; later we performed it only when serology could sug gest an acute episode, or when parvovirus infection could be suspected on c linical or biological observations. A total of 1655 sera were examined by s erological tests and DNA detection was done in 500 samples. Specific IgM, s eroconversion, significant increase of specific IgG levels, and/or parvovir us B19 DNA detection, were considered as markers of viral infection. Results: We observed the presence of both markers of infection in 24 patien ts (39%), with an individual combination of positive antibody and PCR resul ts. Acute or chronic anaemia, neutropenia were associated to these laborato ry findings in 19 patients, but in five cases, an asymptomatic clinical inf ection suggested viral persistence. Conclusions: We report parvovirus associated acute or chronic anaemia and p ancytopenia in a group of LTP, HLTP and HTP patients, as well as asymptomat ic cases of infection. In the hypothesis of a parvoviral persistent or late nt infection, current diagnosis methods may be unreliable to identify any o ther clinical manifestations. (C) 1999 Elsevier Science B.V. All rights res erved.