B.J. Cohen

Human parvovirus arthropathy.

19 of 153 patients attending an early-synovitis clinic were shown to have been recently infected by the human parvovirus (HPV). 5 other patients had evidence of some other closely preceding infection. HPV-infected patients typically presented with symmetrical peripheral polyarthropathy of sudden onset and moderate severity. Usually there was some improvement within 2 weeks, but in 17 patients symptoms persisted for more than 2 months, and in 3 for more than 4 years. Arthropathy in the absence of the facial rash that characterises HPV infection in children is a common presentation of the infection in adults.

Human Parvovirus Infection in Pregnancy and Hydrops Fetalis

Abstract Human parvovirus is the causative agent of erythema infectiosum, a mild epidemic illness. In a recent outbreak in northeast Scotland, six women had serologic evidence of having contracted human parvovirus infection during pregnancy. Two of the women had midtrimester abortions, and both abortuses were grossly hydropic with anemia. They had similar microscopical histopathological features — a pronounced leukoerythroblastic reaction, hepatitis, excessive iron pigment in the liver, and eosinophilic changes in the hematopoietic cell nuclei. Dot hybridization with Radio-labeled human parvovirus DNA probes revealed viral DNA in several tissues from both fetuses, indicating that they had been infected by the virus in utero. The remaining four women had uncomplicated pregnancies and delivered apparently healthy babies, none of whom had human parvovirus–specific IgM antibody at delivery. We conclude that this common virus may pose a serious risk to the fetus after maternal infection. (N Engl J Med 1987; 31...

The prevalence of antibody to human parvovirus B 19 in England and Wales

The prevalence of antibody to human parvovirus B19 (anti-B19 IgG) in England and Wales was measured by an antibody-capture radioimmunoassay. Over 2000 sera were examined; 1422 from the general population, 374 from unselected children admitted to hospital and 300 from women attending an antenatal clinic. Waning levels of maternally-derived antibody were found in infants under 1 year old. In children 1-5 years old, 5-15% had anti-B19 IgG and this rose to 50-60% in older children, young adults and women of child-bearing age. In older people, the prevalence of anti-B19 IgG increased with age, rising to more than 85% in those over 70 years old.

An outbreak of erythema infectiosum associated with human parvovirus infection

Erythema infectiosum (EI) or fifth disease is a mild, acute exanthematous disease, occurring mainly among children, for which a causative virus has long been sought. In May 1983 an outbreak of exanthematous illness was reported in a primary school in North London. Children attending the school were investigated by questionnaire and 162 (43.9%) reported an illness with the features of EI. In each of 36 cases investigated virologically the illness was associated with parvovirus infection. Moreover, pre-existing antibody to parvovirus was correlated with protection from EI in 16 of 17 close family contacts of cases. We propose therefore that EI is the common manifestation of infection with the human parvovirus.

Diagnostic assays with monoclonal antibodies for the human serum parvovirus-like virus (SPLV).

Monoclonal antibodies to the serum parvovirus-like virus (SPLV) were prepared by the hybridoma technique. They provided an antibody reagent which was used to develop solid phase antibody-capture assays for anti-SPLV IgM and IgG and for SPLV antigen. These assays were more sensitive than those based on human convalescent antibody as a reagent, and were more economical in the use of SPLV antigen. Their use enabled the serological responses to SPLV to be studied more fully and their sensitivity revealed the extent of SPLV infection. SPLV antigen was detected in four patients by both counter-immuno electrophoresis (CIE) and radioimmunoassay (RIA) and in two others by RIA alone. Parvovirus particles were seen in all six by electron microscopy. The anti-SPLV IgM response was measured in patients infected by SPLV. It was strong 5-18 days after the onset of illness, then declined and was only detectable in trace amounts after 6 months. Anti-SPLV IgG was also formed early, and persisted for at least 6 months. In a survey of 310 blood donors anti-SPLV was detected in 134 (43%) by CIE, but in 190 (61%) by IgG antibody capture RIA.

Immediate and long term outcome of human parvovirus B19 infection in pregnancy

Objective To estimate more precisely the risk of fetal loss and congenital abnormalities after maternal parvovirus B19 infection, and to assess the long term outcome for surviving infants.

TRANSMISSION OF SERUM PARVOVIRUS-LIKE VIRUS BY CLOTTING-FACTOR CONCENTRATES

The serum parvovirus-like virus (SPLV) is a ubiquitous human virus that suppresses the growth of bone-marrow stem cells in vitro. Antibody to it (anti-SPLV) was found in 28 (97%) of 29 children and young adults with haemophilia treated with clotting-factor concentrates but in only 36% of those who had received multiple blood transfusions and in 20% of age-matched controls. The increased anti-SPLV prevalence in haemophiliacs was significant and was not due to passive acquisition of antibody. Haemophiliacs in a residential school showed seroconversion and rises in anti-SPLV titre following the introduction of concentrate treatment. 10 days after receiving his first dose of factor-VIII concentrate a patient had viraemia and then an anti-SPLV IgM response. These observations show that SPLV is often transmitted in clotting-factor concentrates but not in transfused blood. Whether this transmission has any harmful effect is uncertain.

REACTIVATION OF HEPATITIS B AFTER TRANSPLANTATION OPERATIONS

Surveillance of the staff and patients at the Cambridge Transplant and Dialysis Unit for hepatitis-B infection since 1968 has revealed the onset of antigenaemia in 6 patients in eight years. When the first serum of each patient admitted was examined for anti-HBc antibody, 23 of 380 (6-1%) patients were found positive. Since the presence of anti-HBc is taken to be evidence of previous infection, the occurence of antigenaemia in 3 of the positives when they were immunosuppressed after transplantation is believed to be due to reactivation of latent infection. This is a new factor to be considered in the control of hepatitis B after transplantation;

HEPATITIS C VIRUS ANTIBODY

The present invention relates to polyclonal and monoclonal antibodies which selectively bind to antigens associated with hepatitis C viral particles or HCV aggregated antigens isolated from infected patients and to processes which may be used to isolate hepatitis C virus from infected patients including a procedure by which HCV is partially purified. The use of these antibodies in diagnostic immunological assays is also described.

Acute parvovirus B19 infection associated with fulminant hepatitis of favourable prognosis in young children

BACKGROUND The cause of fulminant hepatitis (FH) in children is unexplained in up to 50% of cases. We report parvovirus B19 as an agent associated with FH in children and compare clinical characteristics of these patients with those of age-matched patients with FH of other origin. METHODS 45 patients presented with FH. No cause was apparent in 21 patients. Parvovirus B19 genome was retrospectively sought by PCR in serum collected at admission in 41 patients. FINDINGS Parvovirus B19 genome was detected in serum from four of 21 patients with unexplained FH (four of 11 younger than 5 years). No B19 DNA was detected in serum from patients with other types of FH or from 82 patients with biliary atresia. Parvovirus B19 IgM was detected in one of the four patients. Patients with parvovirus B19 infection had significantly lower bilirubin concentrations than age-matched patients with FH due to hepatitis A (nine) or other causes (nine) (poisoning with amanita excluded). All patients with parvovirus B19 survived without orthotopic liver transplantation, with restoration of normal liver function within 17 days. INTERPRETATION In patients younger than 5 years with FH of unexplained origin, evidence of acute parvovirus B19 was associated with a distinct clinical pattern. In particular, low bilirubin concentrations and rapid recovery of liver function without transplantation were distinctive features.