Chronic human parvovirus B19 infection in rheumatic disease of childhood and adolescence

• Published in: Journal of clinical virology Vol. 25; no. 2; pp. 135 - 143
• Main Authors: Lehmann, Hartwig W, Kühner, Lucia, Beckenlehner, Karin, Müller-Godeffroy, Esther, Heide, Karl-Günter, Küster, Rolf-Michael, Modrow, Susanne
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.08.2002; Elsevier Science
• Subjects: Adolescent; Adult; Antibodies, Viral - blood; Biological and medical sciences; Capsid - immunology; Capsid Proteins; Child; Child, Preschool; Chronic Disease; Female; Human viral diseases; Humans; Immunoglobulin G - blood; Infant; Infectious diseases; Juvenile arthritis; Male; Medical sciences; Miscellaneous; NS1-protein; Parvoviridae Infections - complications; Parvovirus B19; Parvovirus B19, Human - growth & development; Parvovirus B19, Human - immunology; Rheumatic Diseases - physiopathology; Rheumatic Diseases - virology; Severity of Illness Index; Viral diseases; Viral Nonstructural Proteins - immunology; Viral persistence; NS1-protein; Viral persistence; Juvenile arthritis; Parvovirus B19; Human; Immune response; Antibody; Diseases of the osteoarticular system; Juvenile rheumatoid arthritis; Inflammatory joint disease; Review; Erythrovirus; Virus B19; Infection; Virus; Chronic; Parvoviridae; Persistent infection; Viral disease; Adolescent; Child; Humoral immunity; Parvovirinae
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/S1386-6532(01)00247-5

Parvovirus B19 causes erythema infectiosum in children, but the virus is associated with an increasing range of different diseases. About 20% of infections are associated with delayed virus elimination and viremia persisting over several months or years. These persistent B19-infections are characterised by the presence of IgG against the non-structural protein NS1. This study aimed to find further evidence for an association of parvovirus B19 persistence with VP1/2- and NS1-specific IgG-antibodies in children suffering from rheumatic diseases of childhood. Forty-eight children and adolescents with joint complaints lasting longer than 1 year including patients with juvenile systemic sclerosis and juvenile dermatomyositis showed antibodies against the viral NS1-protein. Laboratory markers of inflammation, humoral immune response against parvovirus B19 proteins and the presence of viral genomes in patients’ sera as well as in 124 healthy children were investigated. Almost 50% of the patients showed laboratory signs of chronic inflammation. B19-DNA was amplified in 31% of patients’ sera and 7% of the controls ( P<0.0001). VP2-specific IgM was detectable in 50% of the patients’ and 6% of control sera. NS1-specific immune reactions were linked to persistent B19-infection as indicated by the presence of viral genomes in the peripheral blood and of VP2-specific IgM years after disease onset. To estimate the severity of the disease and the clinical course, the number of affected and functionally impaired joints were noted and compared with the records from patients’ initial visit in the hospital. Disease related complications were registered. Impairment of activities of daily living was assessed by Childhood Health Assessment Questionnaire (CHAQ)- and Munich Quality of Life Questionnaire (KINDL)-tests. During observation the clinical state of four patients worsened, 27 improved, the others remained stable. Twenty-four children were restricted in their daily activities.