PMID- 20799048
OWN - NLM
STAT- MEDLINE
DCOM- 20110815
LR  - 20180509
IS  - 1437-7780 (Electronic)
IS  - 1341-321X (Linking)
VI  - 17
IP  - 2
DP  - 2011 Apr
TI  - Immune reconstitution to parvovirus B19 and resolution of anemia in a patient 
      treated with highly active antiretroviral therapy.
PG  - 283-7
LID - 10.1007/s10156-010-0111-3 [doi]
AB  - Immune reconstitution inflammatory syndrome (IRIS) is an unsolved problem in the 
      treatment of human immunodeficiency virus (HIV)-1 infection. Despite the high 
      seroprevalence of parvovirus B19 (PVB19) among HIV-1-positive patients, reports 
      on PVB19-induced anemia, especially that associated with PVB19-related IRIS, in 
      these patients are limited. We present the case of a man with acquired 
      immunodeficiency syndrome who developed severe transfusion-dependent anemia and 
      was seropositive and borderline positive for immunoglobulin-M and IgG antibodies 
      against PVB19, respectively. PVB19-DNA was also detected in his serum. The 
      patient was diagnosed with pure red cell anemia (PRCA) caused by a primary PVB19 
      infection and was treated with periodical blood transfusions. However, he 
      subsequently tested negative for IgG antibodies and developed chronic severe 
      anemia with high levels of PVB19 viremia. This indicated a transition from 
      primary to persistent infection. After initiation of highly active antiretroviral 
      therapy, the patient showed an inflammatory reaction with rapid deterioration of 
      anemia and seroconversion of the IgG antibody to PVB19. Subsequently, PRCA was 
      completely resolved, but the patient's serum still contained low levels of 
      PVB19-DNA. Thus, this was a case of IRIS associated with PVB19 infection. Our 
      report highlights the significance of seroconversion to PVB19 in the diagnosis of 
      IRIS and re-emphasizes the finding that persistently high levels of PVB19 viremia 
      after primary infection are probably because of the lack of protective 
      antibodies.
FAU - Watanabe, Dai
AU  - Watanabe D
AD  - AIDS Medical Center, National Hospital Organization Osaka National Hospital, 
      2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan. dai@onh.go.jp
FAU - Taniguchi, Tomohiro
AU  - Taniguchi T
FAU - Otani, Naruhito
AU  - Otani N
FAU - Tominari, Shinjiro
AU  - Tominari S
FAU - Nishida, Yasuharu
AU  - Nishida Y
FAU - Uehira, Tomoko
AU  - Uehira T
FAU - Shirasaka, Takuma
AU  - Shirasaka T
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20100827
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*immunology/virology
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Erythema Infectiosum/*immunology/virology
MH  - HIV Infections/complications/*drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*immunology
MH  - Male
MH  - Middle Aged
MH  - *Parvovirus B19, Human
EDAT- 2010/08/28 06:00
MHDA- 2011/08/16 06:00
CRDT- 2010/08/28 06:00
PHST- 2010/04/13 00:00 [received]
PHST- 2010/08/02 00:00 [accepted]
PHST- 2010/08/28 06:00 [entrez]
PHST- 2010/08/28 06:00 [pubmed]
PHST- 2011/08/16 06:00 [medline]
AID - S1341-321X(11)70530-X [pii]
AID - 10.1007/s10156-010-0111-3 [doi]
PST - ppublish
SO  - J Infect Chemother. 2011 Apr;17(2):283-7. doi: 10.1007/s10156-010-0111-3. Epub 
      2010 Aug 27.