Clinical illness due to parvovirus B19 infection after infusion of solvent/detergent-treated pooled plasma

BACKGROUND: Lipid-enveloped viruses such as HIV, HBV, and HCV can be inacti vated by treatment with solvents and detergents. HAV and human parvovirus B 19 lack lipid envelopes and are not inactivated. Solvent/detergent-treated pooled plasma (S/D plasma) contains neutralizing antibodies, but it is not known whether the parvovirus B19 antibody content is sufficient to prevent transmission of the disease. A patient is described who developed a clinica l illness due to parvovirus B19 infection after the infusion of S/D plasma. CASE REPORT: A 36-year-old woman with myasthenia gravis underwent five plas ma exchange procedures from January 15 to January 25, 1999, using albumin, except for 5 units of SD plasma given because of a low fibrinogen level. Fo ur of the 5 units were implicated in a recall after high levels of parvovir us B19 DNA were found in several lots. Two weeks after the infusion, the pa tient developed fatigue, a rash, and severe polyarthralgias. Parvovirus B19 IgG and IgM antibody titers were consistent with an acute infection. CONCLUSION: Clinically apparent parvovirus B19 infection can follow the use of SID plasma that contains high levels of parvovirus B19 DNA.