EXPLORING THE EFFECTS OF PARVOVIRUS B19 ON SICKLE CELL DISEASE: INSIGHTS FROM A LARGE-SCALE BRAZILIAN STUDY
- 1Hemorio, Rio de Janeiro, RJ, Brasil
- 2Fundação Oswaldo Cruz (FIOCRUZ), Recife, PE, Brasil
- 3Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brasil
Abstract
Introduction: Parvovirus B19 (B19V) infection poses a critical threat to patients with hematological disorders, potentially causing fatal transient aplastic crises (TAC). In Brazil, although Sickle Cell Disease (SCD) is the most prevalent inherited monogenic disorder, robust epidemiological data on B19V in this population remain scarce. Objectives: To investigate the prevalence, markers of recent infection, and clinical impact of B19V infection in a large SCD cohort at a single Brazilian institution. Methods: Between March 2024 and March 2025, this prospective virological surveillance study enrolled 2,049 patients with SCD (emergency and routine outpatients) and 2,596 blood-donor controls. We detected and quantified B19V DNA by real-time PCR and identified genotypes by sequencing. In 585 patients, ELISA was used to evaluate IgM/IgG markers. Clinical and laboratory data were retrieved from medical records, and the study was approved by the Ethics Committee. Results: B19V DNA detection was significantly higher in SCD patients than in controls (1.51% vs. 0.04%; p<0.0001; 40-fold increased risk). Median viral load was 7.6×10⁶ IU/mL. B19V-positive patients were significantly more likely to present to the emergency department than to routine outpatient clinics (67.7% vs. 32.2%; p=0.0014). The highest prevalence of B19V DNAemia occurred in patients aged 10–19 years (3.4%; p=0.01). Sequencing identified genotype 1a in all viremic cases. 6.5% of viremic patients were IgM-negative. Recent B19V infection was detected in 3.27% of patients, and IgG+ prevalence was 61.96%. B19V DNAemia was associated with reductions in reticulocytes (p=0.03), neutrophils (p=0.01), and total leukocytes (p=0.02). Twelve of 27 viremic patients (44%) developed TAC, showing severe erythroblastopenia (mean 0.05×10⁶/µL; p=0.01); 58% experienced hemoglobin drops >2g/dL. Main TAC symptoms included asthenia (92%), pallor (75%), vaso-occlusive events (75%), headache (67%), and fever (50%). One patient (age 12-years) had erythema infectiosum, and 42% developed severe pancytopenia. Most (83%) required transfusion during the current hospitalization. Viral load did not correlate with TAC severity. Discussion: This study represents one of the largest global cohorts evaluating B19V in SCD. B19V infection was approximately 40-fold more frequent in SCD than in blood donors. Acute B19V infection was associated with emergency presentation, reticulocytopenia, and transient aplastic crisis, suggesting that it contributes to acute SCD-related complications. In addition, IgM testing alone could not reliably exclude B19V infection. The higher prevalence of B19V in SCD may reflect multiple factors, including increased healthcare exposure and transfusion requirements. As routine B19V screening of blood donors is not mandatory in Brazil, transfusion-mediated transmission cannot be excluded. Conclusion: These findings support considering PCR-based molecular B19V testing in SCD patients presenting with anemia and reticulocytopenia, enabling early diagnosis and timely transfusion support, and suggest implementing B19V testing in Brazilian blood donors.
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BibTeX
@article{lopes2026exploring,
title = {{EXPLORING THE EFFECTS OF PARVOVIRUS B19 ON SICKLE CELL DISEASE: INSIGHTS FROM A LARGE-SCALE BRAZILIAN STUDY}},
author = {Josiane Iole França LOPES and Arthur Daniel Rocha ALVES and Aline Dantas Almeida DE SAMPAIO and Alexandra Martins SOARES and Guilherme Louzada Silva MEIRA and Miriam De Almeida Porteiro CARDOSO and Regilene Rocha de Paiva Braga FERNANDES and Luiz De Melo Amorim FILHO and Luciane Almeida Amado LEON},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.106569},
url = {https://doi.org/10.1016/j.htct.2026.106569},
note = {CC BY},
}
RIS
TY - JOUR
TI - EXPLORING THE EFFECTS OF PARVOVIRUS B19 ON SICKLE CELL DISEASE: INSIGHTS FROM A LARGE-SCALE BRAZILIAN STUDY
AU - Josiane Iole França LOPES
AU - Arthur Daniel Rocha ALVES
AU - Aline Dantas Almeida DE SAMPAIO
AU - Alexandra Martins SOARES
AU - Guilherme Louzada Silva MEIRA
AU - Miriam De Almeida Porteiro CARDOSO
AU - Regilene Rocha de Paiva Braga FERNANDES
AU - Luiz De Melo Amorim FILHO
AU - Luciane Almeida Amado LEON
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.106569
UR - https://doi.org/10.1016/j.htct.2026.106569
AB - Introduction: Parvovirus B19 (B19V) infection poses a critical threat to patients with hematological disorders, potentially causing fatal transient aplastic crises (TAC). In Brazil, although Sickle Cell Disease (SCD) is the most prevalent inherited monogenic disorder, robust epidemiological data on B19V in this population remain scarce. Objectives: To investigate the prevalence, markers of recent infection, and clinical impact of B19V infection in a large SCD cohort at a single Brazilian institution. Methods: Between March 2024 and March 2025, this prospective virological surveillance study enrolled 2,049 patients with SCD (emergency and routine outpatients) and 2,596 blood-donor controls. We detected and quantified B19V DNA by real-time PCR and identified genotypes by sequencing. In 585 patients, ELISA was used to evaluate IgM/IgG markers. Clinical and laboratory data were retrieved from medical records, and the study was approved by the Ethics Committee. Results: B19V DNA detection was significantly higher in SCD patients than in controls (1.51% vs. 0.04%; p<0.0001; 40-fold increased risk). Median viral load was 7.6×10⁶ IU/mL. B19V-positive patients were significantly more likely to present to the emergency department than to routine outpatient clinics (67.7% vs. 32.2%; p=0.0014). The highest prevalence of B19V DNAemia occurred in patients aged 10–19 years (3.4%; p=0.01). Sequencing identified genotype 1a in all viremic cases. 6.5% of viremic patients were IgM-negative. Recent B19V infection was detected in 3.27% of patients, and IgG+ prevalence was 61.96%. B19V DNAemia was associated with reductions in reticulocytes (p=0.03), neutrophils (p=0.01), and total leukocytes (p=0.02). Twelve of 27 viremic patients (44%) developed TAC, showing severe erythroblastopenia (mean 0.05×10⁶/µL; p=0.01); 58% experienced hemoglobin drops >2g/dL. Main TAC symptoms included asthenia (92%), pallor (75%), vaso-occlusive events (75%), headache (67%), and fever (50%). One patient (age 12-years) had erythema infectiosum, and 42% developed severe pancytopenia. Most (83%) required transfusion during the current hospitalization. Viral load did not correlate with TAC severity. Discussion: This study represents one of the largest global cohorts evaluating B19V in SCD. B19V infection was approximately 40-fold more frequent in SCD than in blood donors. Acute B19V infection was associated with emergency presentation, reticulocytopenia, and transient aplastic crisis, suggesting that it contributes to acute SCD-related complications. In addition, IgM testing alone could not reliably exclude B19V infection. The higher prevalence of B19V in SCD may reflect multiple factors, including increased healthcare exposure and transfusion requirements. As routine B19V screening of blood donors is not mandatory in Brazil, transfusion-mediated transmission cannot be excluded. Conclusion: These findings support considering PCR-based molecular B19V testing in SCD patients presenting with anemia and reticulocytopenia, enabling early diagnosis and timely transfusion support, and suggest implementing B19V testing in Brazilian blood donors.
SN - 2531-1379
SN - 2531-1387
ER -