Hemophagocytic Syndrome Secondary to Human Parvovirus B19 Infection in an Acquired Immunodeficiency Syndrome Patient:Report of One Case / 中国医学科学院学报

The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.

A molecular survey reveals high occurrence of co-infections in intensive pork production farms with increased rates of mummified swine fetuses in Southern Brazil / [Pesquisa molecular revela alta ocorrência de coinfecções em granjas de produção intensiva de suínos com altas taxas de mumificação fetal no sul do Brasil]

Neste estudo, 308 amostras de fetos mumificados foram testadas para parvovírus suíno (PPV), circovírus suíno tipos 2 e 3 (PCV2 e PCV3) e leptospiras patogênicas. A idade gestacional no momento da perda gestacional e a frequência da mumificação fetal de acordo com a ordem de parto também foram investigadas. As amostras foram coletadas em granjas comerciais de criação de suínos da região sul do Brasil que apresentassem taxas de mumificação fetal igual ou maiores a 2,5%. Fragmentos de pulmão, rim, fígado e coração de fetos suínos mumificados foram coletados para análise molecular. Resultados da PCR foram classificados de acordo com a região de origem das amostras, tendo Santa Catarina, Paraná e Rio Grande do Sul contabilizado 87 (28,25%), 89 (28,90%) e 132 (42,86%) do total de amostras de fetos suínos mumificados, respectivamente. Coinfecções foram observadas na maioria dos casos e PCV3 foi o agente mais prevalente detectado, encontrado em 298 amostras (96,75%). A maioria das perdas gestacionais foi observada entre 50 e 70 dias de gestação (168; 54,5%) e a mumificação fetal não foi associada à ordem de parto das matrizes. Os achados sugerem que as altas taxas de fetos suínos mumificados na região Sul do Brasil podem ser explicadas pela infecção com esses agentes virais.(AU)

Infección por parvovirus humano B19 en pacientes con enfermedad de células falciformes: a propósito de dos hermanos / Human parvovirus B19 infection in sickle cell disease patients: a two siblings report

Resumen La infección por parvovirus humano B19 es una de las complicaciones comunes en pacientes diagnosticados de enfermedad de células falciformes (ECF). Se caracteriza por una anemia grave con reticulocitopenia, pudiendo estar acompañada de otras manifestaciones clínicas. En ocasiones, la infección puede ocurrir de modo simultáneo en contactos intrafamiliares de un paciente también con ECF. Es fundamental el reconocimiento temprano de esta complicación y el diagnóstico diferencial con otras patologías para su correcto manejo y tratamiento. Presentamos el caso de dos hermanos con ECF e infección por parvovirus humano B19.

Abstract Human parvovirus B19 infection is one of the common complications of patients diagnosed with Sickle cell disease (SCD). Parvovirus infections are characterized by a severe anemia with reticulocytopenia, sometimes presenting with other clinical manifestations. The infection can occur simultaneously in patient's cohabitants also diagnosed with SCD. Early recognition and differential diagnosis are essential for a proper disease management and treatment. We present two siblings with SCD and human parvovirus B19 infection.

Hiperplasia eritroblástica secundaria a infección aguda por parvovirus B19

Resumen La infección aguda por parvovirus B19 es una enfermedad autolimitada en pacientes sin trastornos inmunitarios. Sin embargo, en pacientes con discrasias sanguíneas pueden manifestarse con una crisis aplásica. Presentamos el caso de un varón de 48 años, con una esferocitosis hereditaria no diagnosticada previamente, la cual debutó con una crisis aplásica inducida por una infección aguda de parvovirus B19. La sospecha clínica se planteó luego del análisis histopatológico de la médula ósea, en el que se observó una hiperplasia eritroblástica, con precursores eritroides gigantes e inclusiones nucleares virales, y cuyo análisis inmunohistoquímico fue positivo para la proteína de la cápside viral VP1 y VP2 de parvovirus B19 en células infectadas. Se confirmó la sospecha diagnóstica con la detección de anticuerpos IgM de parvovirus B19. De acuerdo a nuestra revisión, este es el primer reporte de un adulto en Latinoamérica que debutó con una crisis aplásica inducida por una infección aguda por parvovirus B19, como primera manifestación de una esferocitosis hereditaria.

Abstract Acute parvovirus B19 infection is a self-limiting disease in patients with normal immune response. However, in patients with blood dyscrasias, it is possible to present with an aplastic crisis. We present the case of a 48-year-old man who had developed an aplastic crisis as a result of an acute parvovirus B19 infection with an undiagnosed hereditary spherocytosis. Suspicions of the parvovirus infection began to arise after a routine bone marrow histopathological analysis which showed erythroblastic hyperplasia with giant erythroid precursor and viral inclusions. A subsequent immunohistochemical analysis tested positive for VP1 and VP2 capsid proteins of parvovirus B19 in infected cells. The diagnostic suspicion was later confirmed with the presence of anti-parvovirus B19 IgM. According to our review, this is the first published case in Latin America that documents an adult patient with normal immune response whose first symptom of hereditary spherocytosis was an aplastic crisis induced by an acute parvovirus B19 infection.

Prognostic values of physical and hematological parameters of dogs naturally infected with parvovirus PVC-2: retrospective study of 103 cases / [Valores prognósticos de parâmetros físicos e hematológicos de cães naturalmente infectados pelo parvovírus PVC-2: estudo retrospectivo de 103 casos]

Canine parvovirosis is a high mortality disease with acute clinical picture. However, there are few available resources to help stablish prognosis accurately. This study aimed to determine the prognostic threshold values for vital and hematological parameters of dogs naturally infected by the Carnivore protoparvovirus 1 (CPV). A retrospective study of 103 canine parvovirosis cases was carried out. Twenty seven percent of these (28/103) died, 96% (27/28) of which within the first four days of hospitalization. Deceased animals had significantly higher median values for heart (HR) and respiratory (f) rates, as well as significantly lower systolic blood pressure (SBP) than survivors. Severely leukopenic animals (<1,000 cells/µL), had a significantly higher mortality rate (68%, n=13) compared to that of other patients (P<0.0007). Animals with at least two of the following findings: severe hypotension (SBP< 90mmHg), tachycardia (HR > 150 bpm) and leukopenia, represented 34% (34/101) of the cases and had a survival rate of 29% (10/34), while animals with at most one of these parameters represented 66% (67/101) and had a survival rate of 94% (63/67). The presence of two or three abnormal parameters was significantly related to the higher death risk among dogs with parvovirosis (P<0.0001).(AU)

A parvovirose canina é uma doença de alta mortalidade e de quadro clínico agudo. No entanto, existem poucos recursos para se estabelecer prognóstico de maneira precisa. Este estudo objetivou analisar os valores prognósticos de parâmetros físicos e hematológicos de cães naturalmente infectados pelo Carnivore protoparvovirus 1 (CPV). Um estudo retrospectivo de 103 casos de parvovirose canina foi realizado. Desses, 27% dos animais (28/103) foram a óbito, sendo 96% (27/28) com ocorrência nos primeiros quatro dias de internamento. Os cães que foram a óbito apresentaram medianas das frequências cardíaca (FC) e respiratória (f) significativamente maiores e pressão arterial sistólica (PAS) consideravelmente menor que a dos sobreviventes. Entre os animais mais intensamente leucopênicos (<1.000 células/(L), a taxa de mortalidade (68%, n=13) foi expressivamente maior que a dos demais pacientes (P<0,0007). Os animais com hipotensão grave (PAS<90mmHg), taquicardia (FC>150bpm) e leucopenia intensa (leucometria<1.000 células/µL), ou duas dessas alterações clínicas, representaram 34% (34/101) dos casos e tiveram taxa de sobrevida de 29% (10/34), enquanto os animais com, no máximo, um desses parâmetros alterados representaram 66% (67/101) dos animais, com taxa de sobrevida de 94% (63/67). A presença de dois ou três parâmetros alterados esteve significativamente relacionada ao maior risco de óbito de cães com parvovirose (P<0,0001).(AU)

Infecção por parvovírus B19 em receptores de transplante renal: série de caso / Parvovirus B19 infection in kidney transplant recipients: a case series

Os receptores de transplante renal são mais suscetíveis a infecções, entre elas o parvovírus B19, que pode ser transmitido por via respiratória, adquirido por meio do enxerto ou por reativação de infecção latente. A anemia normocítica normocrômica, com diminuição dos reticulócitos e resistência ao tratamento com eritropoietina, é a principal forma de apresentação da infecção por parvovírus B19 em transplante renal. O diagnóstico requer alto índice de suspeição clínica e realização de testes diagnósticos selecionados. Tratamento com imunoglobulina e suspensão dos imunossupressores durante a infecção mostraram-se eficazes. Os autores relatam sua experiência com cinco casos de infecção por parvovírus B19 em receptores de transplante renal de um hospital universitário. Os aspectos clínicos, diagnósticos e terapêuticos são revistos.

Kidney transplant recipients are more susceptible to infections, including by parvovirus B19, spread through the respiratory tract, acquired through the graft or reactivation of latent infection. Normocytic normochromic anemia, with decreased reticulocytes and resistance to erythropoietin treatment, is the most common presentation of Parvovirus B19 infection in renal transplant. Diagnosis requires a higher clinical suspicion and the performance of selected diagnostic tests. Treatment with immunoglobulin and suspension of immunosuppressive therapy during the infection may be effective. The authors report five cases of PB19 infection in kidney transplant patients at a hospital. The clinical, diagnostic, and treatment features are reviewed.

Respuesta inmune y terapia gó©nica con vectores virales adenoasociados / Immune response and gene therapy with adenoassociated viral vectors

En los ó;ºltimos aó;±os la terapia gó;©nica se ha posicionado como una opció;n real y segura en el desarrollo de alternativas terapó;©uticas para la cura y la prevenció;n de diferentes enfermedades. Consiste en la inserció;n de material genó;©tico en un tejido o có;©lula defectuosa, mediante el uso de un vector. Existen varias consideraciones para seleccionar el vector más apropiado, incluyendo el potencial de unió;n y entrada a la có;©lula diana, la capacidad de transferencia del material genó;©tico al nó;ºcleo, la habilidad de expresió;n del inserto y la ausencia de toxicidad. En el panorama actual, los vectores virales más utilizados son los derivados de los virus adenoasociados (AAV). Características como su bioseguridad, baja toxicidad y tropismo selectivo, han posibilitado su evaluació;n como opció;n terapó;©utica en un amplio nó;ºmero de enfermedades monogó;©nicas o complejas. A pesar de sus ventajas, los vectores AAV presentan inconvenientes, siendo el más importante la respuesta inmune del paciente al vector, especialmente la respuesta mediada por anticuerpos neutralizantes (NAb). Los NAb disminuyen la transducció;n del vector e impiden la expresió;n del gen que transporta, limitando su aplicació;n clínica. Por lo tanto, identificar y cuantificar la presencia y actividad de los NAbs, es el primer paso en cualquier protocolo de terapia gó;©nica con vectores AAV. La presencia de NAb depende principalmente de la exposició;n al virus en la naturaleza y varía drásticamente segó;ºn edad, localizació;n geográfica y estado de salud de la persona evaluada.

In recent years, gene therapy has been positioned as a real and safe option in the development of therapeutic alternatives for the cure and prevention of different diseases. It consists in the insertion of genetic material in a defective tissue or cell, through the use of a vector. There are several considerations for selecting the most appropriate vector, including the potential for binding and entry to the target cell, the ability of the genetic material to transfer to the nucleus, the ability to express the insert, and the absence of toxicity. In the current scenario, the most commonly used viral vectors are those derived from adeno-associated viruses (AAV). Characteristics such as biosafety, low toxicity and selective tropism have enabled its evaluation as a therapeutic option in many monogenic or complex diseases. Despite their advantages, AAV vectors have drawbacks, the most important being the patient’s immune response to the vector, especially the response mediated by neutralizing antibodies (NAb). NAbs decrease the transduction of the vector and prevent the expression of the gene it transports, limiting its clinical application. Therefore, identifying and quantifying the presence and activity of NAbs is the first step in any gene therapy protocol with AAV vectors. The presence of NAbs depends mainly on exposure to the virus in nature and varies drastically according to age, geographic location and health status of the person evaluated.

Description of a human Bocavirus recombinant strain in the Americas

Human bocaviruses (HBoV) are mainly associated with respiratory and gastroenteric infections. These viruses belong to the family Parvoviridae, genus Bocaparvovirus and are classified in four subtypes (HBoV1-4). Recombination and point mutation have been described as basis of parvovirus evolution. In this study three viral sequences were obtained from positives HBoV sewage samples collected in two Uruguayan cities and were characterised by different methods as recombinant strains. This recombination event was localised in the 5' end of VP1 gene and the parental strains belonged to subtypes 3 and 4. These three Uruguayan strains are identical at the nucleotide sequences in the analysed genome region of the virus. As far as we known, this study represents the first detection of HBoV recombinants strains in the Americas.

Human parvovirus B19 genotype 1 in suspected dengue patients of Tefé, Amazonas State, Brazil

Abstract INTRODUCTION: Human parvovirus B19 (B19V) is a common pathogen, which on infection causes variety of clinical conditions from benign self-limiting exanthematous disease and other similar pathologies to fetal death. METHODS: We collected 341 serum samples between the first and fourth day after the onset of symptoms from all patients suspected of dengue fever who were attended at Regional Hospital of Tefé. Initially, patients were screened for malaria by blood smear test and negative samples were sent to Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) situated in Manaus (AM) for dengue testing using semi-nested multiplex PCR. Further, we investigated 44 malaria and dengue-negative samples of children for B19V DNA by nested-PCR. Positive samples were analyzed by BLAST against entire public non-redundant nucleotide database and genotyped by phylogenetic analyses using neighbor-joining clustering method. RESULTS: Eight samples (18.2%) were found to be PCR positive. Fever, headache, ocular pain, and/or muscle pain were reported as the most frequent symptoms by the patients and none were diagnosed with rash at the time of sample collection. Phylogenetic analysis of major capsid protein 2 (VP2) and VP3 coding region showed high similarity with B19V genotype 1. CONCLUSIONS: Our results reveal the spread of B19V genotype 1 in Tefé. Moreover, our results emphasize the significance of laboratorial differential diagnosis using molecular techniques in patients with acute febrile, and thereby aid the health surveillance system in improving patient care even in the remote areas of Amazon.

Epidemiological, clinical and pathological features of canine parvovirus 2c infection in dogs from southern Brazil / Aspectos epidemiológicos, clínicos e patológicos da infecção pelo parvovirus canino 2c em cães do Sul do Brasil

Canine parvovirus type 2c (CPV-2c) emerged in Europe in the early 2000's and rapidly spread out worldwide. Clinical and molecular data have demonstrated its circulation in Brazilian dogs, yet detailed descriptions of cases are still lacking. This article describes the epidemiological, clinical and pathological features of 24 cases of CPV-2c-associated disease in dogs submitted to veterinary clinics and laboratory diagnosis in southern Brazil (2014-2016). Most affected dogs presented signs/lesions suggestive of parvovirus enteritis: diarrhea, vomiting, hyperemia and hemorrhage of the serous membrane of the small intestine, diffuse segmental granulation, atrophy of the villi, necrosis and fusion of crypts, squamous metaplasia and epithelial syncytia. A number of cases presented features divergent from the classical presentations, including a wide variation in the color of feces (reddish and/or yellowish, light-brownish, orange-brown and brownish), involvement of adults (4/24) and vaccinated dogs (12/24), extensive involvement of the small intestine (8/20) and the presence of pulmonary edema (7/24) and convulsions (3/24). Feces and intestinal fragments submitted to PCR for the CPV-2 VP2 gene and to virus isolation in cell culture yielded positive results in 100% and 58.3% (14/24) of the cases, respectively. Nucleotide sequencing revealed a high nucleotide identity in VP2 (99.4 to 100%) and a consistent mutation at amino acid 426 (asparagine to glutamic acid), considered a signature of CPV-2c. These results confirm the involvement of CPV-2c in the described cases and demonstrate the importance of CPV-2c infection among Brazilian dogs, calling attention of veterinarians to correctly diagnose the disease, mainly considering the frequent atypical presentations.(AU)

O parvovírus canino tipo 2c (CPV-2c) surgiu na Europa no início do ano 2000 e rapidamente se espalhou pelas populações de cães ao redor do mundo. Dados clínicos e moleculares demonstraram a sua circulação em cães brasileiros, porém descrições detalhadas desses casos ainda são escassas. Este artigo descreve os aspectos epidemiológicos, clínicos e patológicos de 24 casos de doença gastroentérica associada com a infecção pelo CPV-2c em cães atendidos em clínicas veterinárias e submetidos ao diagnóstico laboratorial no Sul do Brasil (2014-2016). A maioria dos cães afetados apresentaram sinais e/ou lesões sugestivas de enterite por parvovírus: diarreia, vômitos, hiperemia e hemorragia na membrana serosa do intestino delgado, granulação segmentar difusa, atrofia das vilosidades, necrose e fusão de criptas, metaplasia escamosa e sincícios epiteliais. Alguns casos apresentaram características divergentes das apresentações clássicas, incluindo uma grande variação na cor das fezes (avermelhada e/ou amarelada, marrom-claro, marrom-alaranjada ou amarronzada), a participação dos adultos (4/24) e cães vacinados (12/24), um amplo envolvimento do intestino delgado (8/20), a presença de edema pulmonar (7/24) e convulsões (3/24). As fezes e fragmentos intestinais foram submetidos ao teste de PCR para o gene VP2 do CPV-2, e ao isolamento do vírus em cultura de células produziram resultados positivos em 100% e 58,3% (14/24) dos casos, respectivamente. O sequenciamento dos nucleótidos revelou uma alta identidade de nucleótidos na VP2 (99,4-100%) e uma mutação no aminoácido 426 (asparagina para ácido glutâmico), considerada uma assinatura de CPV-2c. Estes resultados confirmam o envolvimento do CPV-2c nos casos descritos e demonstra a importância da infecção pelo CPV-2c entre os cães do Brasil, chamando a atenção de veterinários para diagnosticar corretamente a doença, principalmente considerando-se as apresentações atípicas frequentes.(AU)

Surto de parvovirose cardíaca em filhotes de cães no Brasil / Outbreak of parvoviral myocarditis in puppies in Brazil

Descrevem-se os aspectos epidemiológicos, clínicos, patológicos e imuno-histoquímicos de um surto de parvovirose cardíaca em filhotes de cães. O surto ocorreu em um canil localizado na cidade de Parnamirim, Rio Grande do Norte, região Nordeste do Brasil. De uma ninhada de nove filhotes, um foi natimorto e seis morreram entre 35-57 dias de idade após apresentarem sinais clínicos cardiorrespiratórios com evolução de 10 minutos a três dias. Dos seis filhotes que morreram, dois foram encaminhados para necropsia. No exame macroscópico, ambos os animais apresentaram discreta efusão pericárdica, coração marcadamente globoso, difusa palidez nas superfícies epicárdica e miocárdica e dilatação da cavidade ventricular esquerda. Nos pulmões, observaram-se áreas multifocais avermelhadas na superfície pleural e ao corte fluía líquido espumoso e levemente avermelhado. O fígado estava difusamente aumentado de tamanho, com acentuação do padrão lobular e com áreas pálidas entremeadas por áreas escuras que, ao corte, se aprofundavam ao parênquima. Microscopicamente observou-se miocardite linfohistiocítica, necrosante, associada a fibrose intersticial e corpúsculos de inclusões virais basofílicos intranucleares em cardiomiócitos. Nos pulmões observou-se pneumonia intersticial e edema, e no fígado notou-se degeneração e necrose centrolobular a mediozonal associada à congestão e hemorragia. O diagnóstico foi confirmado por imuno-histoquímica. A forma miocárdica da parvovirose canina pode ocorrer ocasionalmente em filhotes de cadelas que não foram efetivamente vacinadas. Essa forma clínica da doença caracteriza-se por alterações cardiorrespiratórias e morte hiperaguda ou aguda dos animais afetados.(AU)

We describe the epidemiological, clinical, pathological and immunohistochemical aspects of parvoviral myocarditis outbreak in puppies. The outbreak occurred in a kennel located in Parnamirim, Rio Grande do Norte, Northeastern of Brazil. In a litter of nine pups, one was stillbirth and six died between 35-57 days of age after cardiopulmonary clinical signs with evolution of 10 minutes to three days. Of the six puppies that died, two were sent for necropsy. On gross examination, both animals had discreet pericardial effusion, markedly distended heart, diffuse pallor in epicardial and myocardial surfaces and dilation of the left ventricular cavity. The lungs were observed multifocal reddish areas in the pleural surface and at cutting flowed foamed and slightly red liquid. The liver was diffusely increased in size, with lobular standard accentuation and pale areas interspersed with dark areas wich deepened in the parenchyma. Microscopically observed linfohistiocítica myocarditis, necrotizing, associated with interstitial fibrosis and basophilic intranuclear viral inclusions corpuscles in cardiomyocytes. In the lungs there were edema and interstitial pneumonia and in the liver was noted centrilobular to mediozonal degeneration and necrosis associated with congestion and hemorrhage. The diagnosis was confirmed by immunohistochemistry. The parvoviral myocarditis can occasionally occur in puppies of bitches that have not been effectively vaccinated. This clinical form of the disease characterized by cardiorespiratory changes and hyperacute or acute death of the affected animals.(AU)

Three-dimensional Culture of Human Airway Epithelium in Matrigel for Evaluation of Human Rhinovirus C and Bocavirus Infections / 生物医学与环境科学（英文）

OBJECTIVE@#Newly identified human rhinovirus C (HRV-C) and human bocavirus (HBoV) cannot propagate in vitro in traditional cell culture models; thus obtaining knowledge about these viruses and developing related vaccines are difficult. Therefore, it is necessary to develop a novel platform for the propagation of these types of viruses.@*METHODS@#A platform for culturing human airway epithelia in a three-dimensional (3D) pattern using Matrigel as scaffold was developed. The features of 3D culture were identified by immunochemical staining and transmission electron microscopy. Nucleic acid levels of HRV-C and HBoV in 3D cells at designated time points were quantitated by real-time polymerase chain reaction (PCR). Levels of cytokines, whose secretion was induced by the viruses, were measured by ELISA.@*RESULTS@#Properties of bronchial-like tissues, such as the expression of biomarkers CK5, ZO-1, and PCK, and the development of cilium-like protuberances indicative of the human respiration tract, were observed in 3D-cultured human airway epithelial (HAE) cultures, but not in monolayer-cultured cells. Nucleic acid levels of HRV-C and HBoV and levels of virus-induced cytokines were also measured using the 3D culture system.@*CONCLUSION@#Our data provide a preliminary indication that the 3D culture model of primary epithelia using a Matrigel scaffold in vitro can be used to propagate HRV-C and HBoV.

Parvovirus B19: Un virus ADN asociado a múltiples manifestaciones cutáneas / Parvovirus B19: A DNA virus associated with multiple cutaneous manifestations

Resumen El parvovirus B19 es un virus ADN comunitario distribuido a nivel mundial con seroprevalencias que alcanzan hasta 85% en el adulto mayor. Existe un amplio espectro de manifestaciones clínicas en la infección por parvovirus B19 siendo las cutáneas las más frecuentes. Si bien, la mayoría de éstas son autolimitadas, existen numerosos síndromes y enfermedades autoinmunes en los cuales se postula al parvovirus B19 como factor gatillante, dada su capacidad de inducir la producción de numerosos autoanticuerpos y promover la presentación de autoantígenos a linfocitos T. En la presente revisión se describe el espectro de manifestaciones cutáneas de la infección por parvovirus B19 y la evidencia que apoya su asociación con cada una de ellas. Se propone una clasificación de las diferentes enfermedades con manifestaciones cutáneas vinculadas al parvovirus B19, basado en la cantidad y calidad de la evidencia disponible en la literatura científica.

Parvovirus B19 is a community DNA virus with worldwide distribution with up to 85% seroprevalence in the elderly. There is a wide spectrum of clinical manifestations in parvovirus B19 infection of which cutaneous involvement is the most frequent one. Although most of these are self-limiting conditions, there are numerous syndromes and autoimmune diseases in which parvovirus B19 is postulated as a triggering factor, given its ability to induce the production of various autoantibodies and promote the presentation of autoantigens to T cells. This review describes the spectrum of cutaneous manifestations of parvovirus B19 infection and the evidence supporting its association with each of them. We propose a new classification of different diseases with cutaneous manifestations linked to parvovirus B19, based on the amount and quality of available evidence in the literature.

Poliartritis agudas virales / Viral acute polyarthritis

Las poliartritis agudas son cuadros de menos seis semanas de duración, cuyas causas pueden o no ser infecciosas. Entre las primeras, destacan las virales, con gran varie-dad de agentes causales. Entre ellos se distinguen por su frecuencia: virus hepatitis B,virus hepatitis C, parvovirus B19, virus rubéola y la fiebre Chicungunya. Tienen elementos comunes, como su expresión poliarticular, generalmente simétrica, con predilección por las pequeñas articulaciones de las manos, siendo habitualmente autolimitadas. A su vez, poseen elementos propios, clínicos y de laboratorio, que permiten diferenciarlos, teniendo algunos una evolución más agresiva con morbilidad más significativa. A su vez, por sus características clínicas y de laboratorio, plantean el diagnóstico diferencial con enfermedades inmunoreumatológicas, como la artritis reumatoidea y el lupus eritematoso sistémico, entre otras.Se realiza una revisión del cuadro clínico y de laboratorio de las poliartritis causadas por los virus señalados, su diagnóstico diferencial y posibilidades terapéuticas.

The acute polyarthritis are pictures of less six weeks duration, whose causes can be or not to be infectious. Among the first, the viral ones stand out with a variety of causal agents. Among there distinguished by their frequency: virus hepatitis B, hepatitis C virus, parvovirus B19, rubella virus and the fever Chicungunya. They have common elements, such as his expression polyarticular, usually symmetrical, with a predilection for the small joints of the hands, being usually self-limiting. At the same time, they have own laboratory and clinical elements that allow differentiation, some having a more aggressive evolution with more significant morbidity. At the same time, for its clinical and laboratory characteristics, raise the differential diagnosis of immunohematological diseases, such as arthritis rheumatoid and systemic lupus erythematosus among others.Is done a review of clinical and laboratory of the polyarthritis caused by the mentioned viruses, differential diagnosis and therapeutic possibilities.

Identification of co-infection by rotavirus and parvovirus in dogs with gastroenteritis in Mexico

ABSTRACT This is the first report on circulating canine rotavirus in Mexico. Fifty samples from dogs with gastroenteritis were analyzed used polymerase chain reaction and reverse transcription polymerase chain reaction in order to identify parvovirus and rotavirus, respectively; 7% of dogs were infected with rotavirus exclusively, while 14% were co-infected with both rotavirus and parvovirus; clinical signs in co-infected dogs were more severe.

Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection / Parâmetros associados a desfechos fetais adversos na infecção congênita pelo parvovírus B19

Abstract Objective To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion. Methods This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered nonrecovery and categorized as an adverse outcome. Results The final analysis included ten singleton pregnancies: seven of which were categorized into the recovery group and three of which into the non-recovery group. The baseline characteristics were similar between the groups. All fetuses were hydropic at the time of diagnosis. No significant differences related to sonographic or intrauterine transfusion parameters were identified between the groups; however, the nonrecovery group tended to have an increased number of sonographic markers and lower fetal hemoglobin and platelet levels before the transfusion. Conclusion We were unable to firmly establish the clinical or sonographic parameters associated with adverse fetal outcomes in patients with parvovirus infection managed with intrauterine transfusions; however, edema, placental thickening and oligohydramnios may indicate greater fetal compromise and, subsequently, adverse outcomes. However, further studies are necessary, mainly due to the small number of cases analyzed in the present study.

Resumo Objetivo Investigar os parâmetros clínicos e ultrassonográficos associados ao desfecho fetal adverso em pacientes com infecção congênita por parvovírus B19 manejada por meio de transfusão intrauterina. Métodos Trata-se de um estudo retrospectivo de um único centro realizado entre janeiro de 2005 e dezembro de 2016, que avaliou pacientes com gestação única com infecção fetal por parvovírus confirmada por reação em cadeia da polimerase de líquido amniótico ou amostras de sangue fetal submetidas a pelo menos uma transfusão intrauterina. As características maternas, os achados ultrassonográficos e os parâmetros relacionados à transfusão intrauterina foram comparados entre os dois grupos (recuperação/não recuperação), que foram categorizados com base na resposta fetal após transfusão intrauterina. A progressão para morte fetal ou parto sem recuperação fetal após transfusões foi considerada não recuperação, e categorizada como um desfecho adverso. Resultados A análise final incluiu dez gravidezes únicas: sete foram categorizadas no grupo de recuperação, e três, no grupo de não recuperação. As características basais foram semelhantes entre os grupos. Todos os fetos estavam hidrópicos no momento do diagnóstico. Não foram identificadas diferenças significativas entre os grupos em relação aos parâmetros ultrassonográficos ou os das transfusões intrauterinas; Entretanto, o grupo de não recuperação tendeu a ter um número aumentado demarcadores ultrassonográficos e níveis mais baixos de hemoglobina e plaquetas fetais antes da transfusão. Conclusão Não foi possível estabelecer firmemente os parâmetros clínicos ou ultrassonográficos associados ao desfecho fetal adverso em pacientes com infecção por parvovírus manejada por meio de transfusões intrauterinas. Entretanto, edema de pele, espessamento placentário e oligoidrâmnio podem indicar maior comprometimento fetal e, posteriormente, desfechos fetais adversos. No entanto, estudos adicionais são necessários, principalmente devido ao pequeno número de casos analisados neste estudo.

Serological and molecular analysis of parvovirus B19 infection in Mayan women with systemic lupus erythematosus in Mexico / Análisis serológico y molecular de la infección por parvovirus B19 en mujeres mayas con lupus eritematoso sistémico en México

Abstract Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that mainly affects women, characterized by the production of autoantibodies. Its causal agent is unknown, but the combination of environmental, hormonal and genetic factors may favor the development of the disease. Parvovirus B19 has been associated with the development of SLE, since it induces the production of anti-single stranded DNA antibodies. It is unknown whether PV-B19 infection is an environmental factor that trigger or reactivate SLE in the Mexican Mayan population. Aim: A preliminary serological and molecular study of PV-B19 infection in Mayan women with established SLE was done. Methods: IgG and IgM anti PV-B19 were evaluated in 66 SLE patients and 66 control subjects, all women of Mayan origin. Viral DNA and viral load were analyzed by qPCR. Results: Insignificant levels of IgM were observed in 14.3% (4/28) of the patients and 11.4% (4/35) of control subjects. IgG was detected in 82.1% (23/28) of the patients and 82.9% (29/35) of control subjects, but were significantly higher in patients. Viral DNA was found in 86.0% (57/66) of the patients and 81.0% (54/66) of control subjects. Viral load, quantified in 28/66 patients and 31/66 controls which were positive for IgM and IgG, was significantly higher in controls. Conclusion: The high prevalence of PV-B19 in Yucatan, and the presence of IgM, IgG, and viral load in Mayan women with established SLE suggest that PV-B19 infection could be an environmental factor to trigger or reactivate SLE.

Resumen Antecedentes: Lupus eritematoso sistémico (LES) es una enfermedad sistemica autoinmune que afecta principalmente a las mujeres, caracterizada por la producción de autoanticuerpos. El agente causaal es desconocido. Pero la combinación de factores ambientales, hormonales y genéticos podría favorecer el desarrollo de la enfermedad. El parvovirus B19 se asoció con el desarrollo de LES, debido a que induce la producción de anticuerpos anti-cadena simple de DNA. Es desconocido si la infección PV-B19 es un factor ambiental que desencadena o reactiva LES en la población mexicana Maya. Objetivo: Se realizó un estudio serológico y molecular preliminar de la infección de PV-B19 en mujeres Mayas con LES. Métodos: Se evaluó IgG and IgM anti PV-B19 en 66 pacientes con LES y 66 controles sanos, todas las mujeres fueron de origen Maya. DNAViral y la carga viral fueron analizadas por qPCR. Resultados: Se determinaron niveles insignificantes de IgM en el 14.3% (4/28) de las pacientes y en el 11.4% (4/35) de los controles. IgG se detectó en el 82.1% (23/28) de los pacients y en el 82.9% (29/35) de los controles. Hubo un alta significancia en los pacientes con LES. DNA viral se encontró en el 86.0% (57/66) de los pacientes y en el 81.0% (54/66) de los controles. La carga viral se cuantifico en 28/66 pacientes y en 31/66 de los controles, la cual fueron positivos para IgM e IgG; fue significativamente mas alta en los controles. Conclusión: La alta prevalencia de PV-B19 en Yucatan y la presencia de IgM, IgG y una carga viral en mujeres Mayas con LES sugiere que la infección con PV-B19 poria ser un factor ambiental que desencadene o reactive el LES

Identification of Human Bocavirus type 4 in a child asymptomatic for respiratory tract infection and acute gastroenteritis - Goiânia, Goiás, Brazil

Abstract Human Bocavirus (HBoV) has been identified from feces and respiratory samples from cases of both acute gastroenteritis and respiratory illness as well as in asymptomatic individuals. The aim of this study was to detect and characterize HBoV from fecal samples collected from hospitalized children aged less than five years old with no symptoms of respiratory tract infection (RTI) or acute gastroenteritis (AGE). The study involved 119 children and one fecal sample was collected from each participant between 2014 and 2015. HBoV was detected using Nested-PCR, and the viral type identified by genomic sequencing. HBoV-4 was identified from one sample obtained from a hospitalized child with soft tissue tumor of the submandibular region. This is the first report of HBoV-4 identification in Brazil, but we consider that this type may be circulating in the country similar to the other types and new investigations are necessary.

Estudio de marcadores de infección e inmunidad frente a parvovirus B19 en Córdoba, Argentina

RESUMEN: El parvovirus B19 (B19V), descubierto en 1974, es un patógeno humano de distribución global. Si bien su infección puede transcurrir de manera asintomática, es conocido por ser capaz de causar un amplio espectro de manifestaciones clínicas como son el eritema infeccioso, artropatías, crisis aplásica en individuos con recambio acelerado de glóbulos rojos por una enfermedad de base, y anemia crónica en inmunocomprometidos, entre otras patologías en las que aún se investiga la causalidad del B19V. La infección durante el embarazo es un riesgo potencial para el feto...

ABSTRACT: Parvovirus B19 (B19V), discovered in 1974, is a pathogen of global distribution. While the infection can be asymptomatic, it is known for being able to cause a wide range of clinical manifestations such as erythema infectiosum (or fitth disease), arthropathy, aplastic crisis in persons with accelerated red blood cell renewal due to a base disease, and chronic anemia in immunocompromised individuals, among other pathologies inwhich B19V causality is still under research. In addition, infection during pregnancy is a potential risk for the fetus...

Viral type characterization and clinical aspects of canine parvovirus in naturally infected dogs in São Paulo State, Brazil / Caracterização viral e aspectos clínicos de parvovirose em cães naturalmente infectados no Estado de São Paulo

Since the first isolation of canine parvovirus type 2 (CPV-2) in late 70's new virus types as CPV-2a and CPV-2b have been emerged and becoming prevalent in natural canine population and more recently, a third subtype was identified , CPV-2c. The main purpose of this study was to detect and characterize canine parvovirus currently present in Central-West region of São Paulo state, in Brazil. Fecal samples were collected of vaccinated and non-vaccinated dogs, clinically suspected of having CPV infection brought to the Infectious Diseases Service, Veterinary Hospital of FMVZ-UNESP. All samples (n=30) were screening for canine parvovirus through hemagglutination test and those resulting as positive (n=20) were submitted to PCR and the products were subsequently sequenced for subtype characterization. Results were tested for association with age, hematological values, viral hemagglutination titers in the feces, vaccination status and survival. Leukopenia was found in all animals, death occurred in 30% of unvaccinated dogs and in 42% of vaccinated ones. In a total of 20 positive sequenced samples, 18 were classified as CPV-2b, one as CPV-2c, and one as CPV-2a, being CPV2a and CPV2c detected in unvaccinated puppies. Compared to the reference samples amino acid change at position 426 in those circling virus was identified. The study results demonstrate the predominance of CPV-2b and the presence of CPV-2a and CPV-2c in naturally infected, vaccinated and unvaccinated dogs in in São Paulo region.(AU)

Desde o primeiro isolamento do parvovirus canino tipo 2 (CPV-2) no final dos anos 70 novos subtipos virais como CPV-2a e CPV-2b surgiram e foram se tornando prevalentes na população canina; posteriormente um terceiro subtipo foi identificado, CPV- 2-C. O principal objetivo deste estudo foi detectar e caracterizar os subtipos de parvovírus canino atualmente presente na região Centro-Oeste do Estado de São Paulo-Brasil. Amostras de fezes foram coletadas de cães vacinados e não vacinados, atendidos no Serviço de Enfermidades Infecciosas dos Animais, Hospital Veterinário da FMVZ-UNESP, com suspeita clínica parvovirose . Todas as amostras (n = 30) foram submetidas teste de hemaglutinação para parvovirus canino e as positivas (n = 20) submetidas a PCR; os produtos amplificados foram subsequentemente sequenciados para caracterização do subtipo viral. Os resultados foram associados com a idade, os valores hematológicos, os títulos de hemaglutinação viral nas fezes, estado de vacinação e sobrevivência. A leucopenia foi encontrada em todos os animais; Obito foi observado em 30% dos cães não vacinados e 42% dos vacinados. Em um total de 20 amostras positivas sequenciadas, 18 foram classificadas como CPV-2b, uma como CPV-2c, e uma como CPV-2a. CPV 2a e CPV2c foram detectados em filhotes não vacinados. Em comparação com a amostra de referência foi evidenciada uma mudança de aminoácido na posição 426 nas amostras virais circulantes. Os resultados do estudo demonstram a predominância de CPV-2b e a presença de CPV-2a e CPV-2c em cães naturalmente infectados, vacinados e não vacinados na região de São Paulo.(AU)