Human parvovirus B19 infection in acute fulminant liver failure

We previously reported detection of human parvovirus B19 DNA in livers from patients requiring transplantation for acute fulminant liver failure. In t his study, we used immune adherence PCR (IA-PCR) to bind B19 virions in rec ipient native liver onto solid phase with specific monoclonal antibodies fo llowed by PCR amplification of virion DNA. IA-PCR had sensitivity and speci ficity similar to conventional PCR. We examined liver tissue from 16 patien ts with non-A, non-B, non-C, non-E (NA-E) acute fulminant liver failure (AF LF) (6 of unknown etiology associated with aplastic anemia (AA), 4 of unkno wn etiology without AA; and 6 patients with AFLF of known etiology). IA-PCR detected B19 virions in 5 of 6 (83%) of livers from patients with idiopath ic NA-E AFLF associated with AA and in 2 of 3 (75%) without AA, compared to 1 of 6 (17%) of livers from patients with AFLF of known etiology and to 6 of 34 (18%) of 33 control patients with chronic or neoplastic liver disease . Viral mRNA encoding the structural protein was detected in the liver tiss ue from three B19 IA-PCR positive patients with AFLF. Detection of B19 viri ons and mRNA for capsid proteins provided strong evidence for B19 infection during the course of NA-E AFLF and argues for involvement of B19 virus in liver injury.