Recombinant Parvovirus B19 VP2 Protein (aa 233-781)

Introduction: The present study designed to investigate Human parvovirus B19 (HPV-B19) as an etiological agent of rash-fever ill patients confirmed negative for measles and rubella infection which is responsible for the same symptoms in North Indian population. Materials and Methods: Total 319, negative serum samples selected after measles/rubella IgM antibodies detection. The patients between the age of (4 to 52 years) with fever and rash-like illness were divided into four groups: 4-14. 15-25, 26-36 and >37 years old. The serological analysis was done by Indirect IgM ELISA and Real-time PCR used for molecular identification of HPV-B19 in this study. Results: The prevalence of HPV-B19 was found to be 29.4% by both methods in Measles and Rubella negative serum samples. We found a 29.4% positive result by HPV-B19 IgM ELISA and 7.5% positive by Real-time PCR against HPV-B19 infection. The results have been statistically significant (p= 0.0001*). The highest prevalence (38.5%) was found between 15-25 years of age group. Conclusion: The study was designed to find the frequency of HPV-B19 infection and observed that the patients with negative results for measles and rubella infection having the probability of HPV-B 19 infection in this region. The combined approach of the serological and molecular method confirms the contribution of HPV-B19 in the etiological role of fever-rash illness and provides the exact differential diagnostic approach for disease management.

Parvovirus B19 infections are prevalent in children and commonly present as slapped cheek fever, also known as the fifth disease. They are seen frequently in daycares and professions that require close contact with children. The most common presentation is a rash that is prominent on the cheeks; less common symptoms include painful or swollen joints (polyarthopathy syndrome). The infection is self-limited and resolves within one to two weeks. The virus has an affinity to the red blood cell (RBC) precursors and can rarely cause temporary cessation of the bone marrow's RBC production, leading to aplastic anemia. This is especially of significance in patients predisposed to increased RBC destruction, such as hereditary spherocytosis, sickle cell anemia, and other morphological abnormalities of the RBC. The overlapping arrest of RBC production and excessive destruction leads to a transient aplastic crisis (TAC), leading to severe life-threatening anemia, requiring blood urgent blood transfusions. There have been many studies reporting the incidence of TAC in patients with sickle cell crisis. Only a few cases have been reported in patients with hereditary spherocytosis.