CLINICAL RELEVANCE OF PARVOVIRUS B19 AS A CAUSE OF ANEMIA IN PATIENTSWITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Parvovirus B19 (B19) DNA was detected by dot blot hybridization in ser a from 5 (17%) of 30 human immunodeficiency virus (HIV)-infected patie nts with hematocrits (HCT) of less than or equal to 24 and 4 (31%) of 13 HIV-infected patients with HCT of less than or equal to 20, suggest ing that B19 is a reasonably common cause of severe anemia in HIV infe ction. The anemia promptly remitted after immunoglobulin therapy in 3 of 4 treated patients. The presence of IgM to B19, the clinical circum stance in which anemia developed, and the marrow morphology were poor predictors of chronic B19 infection. DNA hybridization studies of sera from 191 HIV-infected and 117 HIV-seronegative homosexual males atten ding a clinic in the Seattle area revealed that 1 (0.5%) and 2 (2%) sa mples, respectively, from the 2 groups contained B19. However, when as sayed by polymerase chain reaction (PCR), 5% of the serum samples from HIV-infected persons and 9% from uninfected persons contained B19, al though each had an HCT of less than or equal to 40. The data argue tha t anemia results from chronic high-titer B19 infection. Although a neg ative PCR assay excludes this diagnosis, DNA hybridization may be the more specific serum test.