Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology
Original article

Clinical Significance of Human Parvovirus B19 Infection in Kidney Transplant Recipients

In-Suk Kim, M.D., Chang-Seok Ki, M.D., Eun-Hae Cho, M.D., Kwang Woong Lee, M.D.1, Sung-Ju Kim, M.D.1, Jae-Won Joh, M.D.1, Beom Kim, M.D.2, Woo seong Huh, M.D.2, Ha Young Oh, M.D.2, Nam-Yong Lee, M.D., Sun Hee Kim, M.D., and Jong-Won Kim, M.D.

Department of Laboratory Medicine, Surgery1, and Internal Medicine2, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea

Corresponding to Jong-Won Kim, E-mail: jwonk@smc.samsung.co.kr

Ann Clin Microbiol 2004;7(1):59-65.
Copyright © Korean Society of Clinical Microbiology.

Abstract

Background : Human parvovirus B19 infection has been known to cause chronic anemia, pure red cell aplasia, glomerulopathy and allograft dysfunction in kidney transplant (KT) recipients. The aim of this study was to evaluate the prevalence and clinical significance of B19 infection in KT recipients.

Methods : Five hundred and thirty seven serum samples from 167 KT recipients were included in the present study. The prevalence of B19 infection was based on either qualitative or quantatitive polymerase chain reaciton (PCR) with LightCycler Parvovirus B19 Quantification kit (Roche Diganostics, Mannheim, Germany). Clinical significance of B19 infection was investigated by retrospective review of hemoglobin levels and the results of kidney and bone marrow biopsies.

Results : Overall PCR positive rate was 18.3% (98/537) and 52 out of 167 (31.1%) KT recipients showed at least one positive PCR result. In addition, 20 out of 167 subjects (12.0%) showed PCRpositivity more than two consecutive times and they had significantly lower hemoglobin level than those with negative PCR result or only one-positive result (P< 0.0001 by ANOVA and multiple comparison). In addition, two patients (1.2%) suffered from pure red cell aplasia which was confirmed by bone marrow biopsy. Nevertheless, B19 infection did not seem to affect the graft outcome.

Conclusions : The parvovirus B19 infection in KT recipeints was not uncommon and was associated with low hemoglobin level and pure red cell aplasia after KT. Therefore, routine examination for the B19 infection should be provided for the KT recipients. To the best of our knowledge, this is the first report of the incidence and clinical significance of B19 infection in Korean KT recipients. (Korean J Clin Microbiol 2004;7(1):59-65)

Keywords

Parvovirus B19, Kidney Transplantation, Polymerase Chain Reaction, Anemia, Pure Red Cell Aplasia