PREVALENCE AND FACTORS ASSOCIATED WITH HUMAN PARVOVIRUS B19 INFECTION IN SICKLE CELL PATIENTS HOSPITALIZED IN TANZANIA
Main Article Content
Keywords
Human Parvovirus B19; Sickle cell disease; RT-PCR
Abstract
Background: The distribution of human parvovirus B19 (HPV B19) infection is ubiquitous and occurs worldwide. The virus has high tropism to red blood cells progenitor`s cells leading to temporary infection of bone marrow and transient arrest of erythropoiesis. People with frequent episodes of haemolytic anaemia including sickle cell disease (SCD) and thalassemia are at increased risk of infection. This study aimed at assessing prevalence and factors associated with HPV B19 infections among hospitalized SCD patients.
Methodology: This is a cross-sectional hospital-based study among 329 SCD patients hospitalized at Muhimbili National Hospital (MNH). HPV B19 was detected using RT-PCR. Haematological and Chemistry tests were done using Sysmex XT2000i and Chemistry analyser respectively.
Results: The prevalence of HPV B19 among hospitalized 329 SCD patients was 29%. The median age for hospitalized SCD patients with HPV B19 was 15 years (IQR; 7-22), no variation of prevalence with age. In multivariate logistic regression model, HPV B19 infection was associated with pain (OR=4.28, 95%CI: 1.20–15.19; p=0.025), low neutrophil counts (OR=0.57,95%CI: 0.35–0.92, p=0.022) and MCH (OR=0.92, 95%CI: 0.85–0.99; p=0.033). In univariate analysis, HIV infection was slightly higher in SCD patients infected with HPVB19 (exact p-value=0.083).
Conclusion: The prevalence of HPV B19 among hospitalized SCD patients at MNH was high. SCD patients with HPV B19 were more likely to present with pain, low neutrophils levels and MCH. HIV infection might be associated with high risk of HPV infection in SCD patients, however this requires further investigation.
Methodology: This is a cross-sectional hospital-based study among 329 SCD patients hospitalized at Muhimbili National Hospital (MNH). HPV B19 was detected using RT-PCR. Haematological and Chemistry tests were done using Sysmex XT2000i and Chemistry analyser respectively.
Results: The prevalence of HPV B19 among hospitalized 329 SCD patients was 29%. The median age for hospitalized SCD patients with HPV B19 was 15 years (IQR; 7-22), no variation of prevalence with age. In multivariate logistic regression model, HPV B19 infection was associated with pain (OR=4.28, 95%CI: 1.20–15.19; p=0.025), low neutrophil counts (OR=0.57,95%CI: 0.35–0.92, p=0.022) and MCH (OR=0.92, 95%CI: 0.85–0.99; p=0.033). In univariate analysis, HIV infection was slightly higher in SCD patients infected with HPVB19 (exact p-value=0.083).
Conclusion: The prevalence of HPV B19 among hospitalized SCD patients at MNH was high. SCD patients with HPV B19 were more likely to present with pain, low neutrophils levels and MCH. HIV infection might be associated with high risk of HPV infection in SCD patients, however this requires further investigation.
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References
1. Obeid OE. Brief Original Article Molecular and serological assessment of parvovirus B19 infections among sickle cell anemia patients. J Infect Dev Ctries 2011;5(7):535–339.
2. Servey JT, Reamy B V., Hodge J. Clinical presentations of parvovirus B19 infection. Am Fam Physician 2007;75(3).
3. Bukar AA, Abjah UAM, Kagu MB, et al. Seroprevalence of parvovirus B19 and its clinical effect among anaemic SCA patients in Northeastern Nigeria Department of Haematology and Blood Transfusion University of Maiduguri Teaching Department of Medical Microbiology University of Maiduguri Teachin 2013;4(2):195–200
4. Wildig JW, Cossart Y, Peshu N, et al. Parvovirus B19 infection and severe anaemia in Kenyan children: a retrospective case control study. BMC Infect Dis. BioMed Central 2010;10(1):88.
5. Bukar A. A, Kagu M.B, Abjah UAM, Ladu AL. Prevalence of Parvovirus B 19 Infection in Children with Aplastic Anemia. Am J Sci Ind Res 2013;4(2):195–200.
6. Wildig J, Michon P, Siba P, Mellombo M, et al. Parvovirus B19 infection contributes to severe anemia in young children in Papua New Guinea. J Infect Dis 2006;194(2):146–53.
7. Vineeta Gupta IS and GN. Prevalence of Parvovirus B 19 Infection in Children with Aplastic Anemia. Indian Pediatr 2013;50:489–91.
8. Sant ALM, Rita A, De C, et al. Study of chronic hemolytic anaemia patients in rio de janeiro?: Prevalence of anti-human parvovirus b19 IgG antibodies and the development of transient aplastic crises 2002;44(4):187–90.
9. Makani, J., Cox, S.E., Soka, D., et al. Mortality in sickle cell anemia in africa: A prospective cohort study in Tanzania. PLoS ONE 2011;6. e14699.
10. Sant’anna ALM, Garcia R de CNC, Marzoche M, et al. Study of chronic hemolytic anaemia patients in Rio de Janeiro: Prevalence of anti-human parvovirus B19 IgG antibodies and the developement aplastic crises. Rev Inst Med Trop Sao Paulo. Instituto de Medicina Tropical de São Paulo 2002; 44(4):187–90.
11. Al KHSDHRLJKP et.al. The age-specific prevalence of human parvovirus immunity in Victoria , Australia compared with other parts of the world 2000; 449–57.
12. Iwalokun BA, Iwalokun SO, Hodonu SO, et al. A study on the association between parvovirus B19 infection, serum tumour necrosis factor and C-reactive protein levels among Nigerian patients with sickle cell anaemia. Singapore Med J 2012;53 0037–5675
13. Smith-Whitley K, Zhao H, Hodinka RL, et al. Epidemiology of human parvovirus B19 in children with sickle cell disease. Blood 2004;103(2):422–7
14. Sakai N, Sawada K, Koizumi K, et al. Human parvovirus-induced transient anemia and leukopenia after delivery. Rinsho Ketsueki 1992; 33:1077–83
15. Ana V. Villanueva and P.H.Chandrasekar. Parvovirus B19 infection in a patient with sickle cell crisis. Hospital physician 1999;64-66
16. https://www. sahealth.sa.gov.au/wp
17. Frickhofen N, Abkowitz JL, Safford M, et al. Persistent BI9 parvovirus infection in patients infected with human immunodeficiency virus type 1 (HIV-I): a treatable cause of anemia in AIDS. Ann Intern Med 1990; 113:926-32.
2. Servey JT, Reamy B V., Hodge J. Clinical presentations of parvovirus B19 infection. Am Fam Physician 2007;75(3).
3. Bukar AA, Abjah UAM, Kagu MB, et al. Seroprevalence of parvovirus B19 and its clinical effect among anaemic SCA patients in Northeastern Nigeria Department of Haematology and Blood Transfusion University of Maiduguri Teaching Department of Medical Microbiology University of Maiduguri Teachin 2013;4(2):195–200
4. Wildig JW, Cossart Y, Peshu N, et al. Parvovirus B19 infection and severe anaemia in Kenyan children: a retrospective case control study. BMC Infect Dis. BioMed Central 2010;10(1):88.
5. Bukar A. A, Kagu M.B, Abjah UAM, Ladu AL. Prevalence of Parvovirus B 19 Infection in Children with Aplastic Anemia. Am J Sci Ind Res 2013;4(2):195–200.
6. Wildig J, Michon P, Siba P, Mellombo M, et al. Parvovirus B19 infection contributes to severe anemia in young children in Papua New Guinea. J Infect Dis 2006;194(2):146–53.
7. Vineeta Gupta IS and GN. Prevalence of Parvovirus B 19 Infection in Children with Aplastic Anemia. Indian Pediatr 2013;50:489–91.
8. Sant ALM, Rita A, De C, et al. Study of chronic hemolytic anaemia patients in rio de janeiro?: Prevalence of anti-human parvovirus b19 IgG antibodies and the development of transient aplastic crises 2002;44(4):187–90.
9. Makani, J., Cox, S.E., Soka, D., et al. Mortality in sickle cell anemia in africa: A prospective cohort study in Tanzania. PLoS ONE 2011;6. e14699.
10. Sant’anna ALM, Garcia R de CNC, Marzoche M, et al. Study of chronic hemolytic anaemia patients in Rio de Janeiro: Prevalence of anti-human parvovirus B19 IgG antibodies and the developement aplastic crises. Rev Inst Med Trop Sao Paulo. Instituto de Medicina Tropical de São Paulo 2002; 44(4):187–90.
11. Al KHSDHRLJKP et.al. The age-specific prevalence of human parvovirus immunity in Victoria , Australia compared with other parts of the world 2000; 449–57.
12. Iwalokun BA, Iwalokun SO, Hodonu SO, et al. A study on the association between parvovirus B19 infection, serum tumour necrosis factor and C-reactive protein levels among Nigerian patients with sickle cell anaemia. Singapore Med J 2012;53 0037–5675
13. Smith-Whitley K, Zhao H, Hodinka RL, et al. Epidemiology of human parvovirus B19 in children with sickle cell disease. Blood 2004;103(2):422–7
14. Sakai N, Sawada K, Koizumi K, et al. Human parvovirus-induced transient anemia and leukopenia after delivery. Rinsho Ketsueki 1992; 33:1077–83
15. Ana V. Villanueva and P.H.Chandrasekar. Parvovirus B19 infection in a patient with sickle cell crisis. Hospital physician 1999;64-66
16. https://www. sahealth.sa.gov.au/wp
17. Frickhofen N, Abkowitz JL, Safford M, et al. Persistent BI9 parvovirus infection in patients infected with human immunodeficiency virus type 1 (HIV-I): a treatable cause of anemia in AIDS. Ann Intern Med 1990; 113:926-32.