Molecular and Serological Study of Human Parvovirus B19 among Children with Thalassemia in Mansoura University Children Hospital, Egypt

Background: Human parvovirus B19 (HPV-B19) is a member of the Parvoviridae family. Children with thalassemia can acquire HPV-B19 through blood transfusions and through contact with other children with infection.

The aim of this study was to detect the prevalence of HPV-B19 infection in children with beta-thalassemia major in Mansoura University Children Hospital, Egypt.

Methods: This study is a cross-sectional case control study that included 63 Egyptian children with beta thalassemia major attending the hospital for blood transfusion and regular blood counts and 60 healthy children as control group.

Blood samples were obtained for determination of specific antibodies IgG and IgM for HPV-B19 by enzyme linked immunoassay (ELISA) and for detection of HPV-B19 DNA by nested PCR.

Results: HPV-B19 IgM was positive in 21 beta-thalassemia patient (33.3%), IgG was positive in 27 patient (42.8%) and PCR was positive in 12 patients (19.04%). Comparing these results with the finding in healthy children by Chi-square test, there was statistically significant difference (P <0.001).

Hematological parameters between beta-thalassemia children with recent HPV-B19 infection and control group, showed statistically significant decrease in total leukocytes counts (4.49±1.3) with reduced neutrophils counts (2.5± 0.73) and increase in lymphocytes (4.1±1.2), P value 0.018, ,0.004 and 0.001, respectively. In our study, There was no significant association between blood transfusion and HPV-B19 infection.

Conclusion: HPV-B19 infection is detected in high rates among children with beta thalassemia major (recent infection 19% and prior infection, 42.8%). Direct detection of HPV-B19 DNA by PCR in serum needs to be coupled with serological testing for a more reliable diagnosis of HPV-B19 infections in those children.

HPV-B19 infection in our study, has significant effects on hematological parameters in children with thalassemia with recent infection.

In our study, There was no statistically significant association between number of blood transfusion units and HPV-B19 infection. However the source of HPV-B19 in these patients may be blood transfusion. Whether it is needed for screening of blood units for HPV-B19 or not should be evaluated in larger population studies.