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Parvovirus B19 infection during pregnancy

Authors
Laura E Riley, MD
Caraciolo J Fernandes, MD
Section Editors
Martin S Hirsch, MD
Morven S Edwards, MD
Leonard E Weisman, MD
Charles J Lockwood, MD, MHCM
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

Parvovirus B19 infection is a common childhood illness. Asymptomatic or mild infection occurs most often when B19 affects immunocompetent adults. Rarely, acute infection in pregnancy may lead to fetal loss or hydrops fetalis. The issues surrounding B19 infection during pregnancy are reviewed here.

MICROBIOLOGY/PATHOGENESIS

The Parvoviruses were discovered in 1975 by electron microscopy during evaluation of tests for hepatitis B surface antigen [1]. Parvoviridae are small, non-enveloped DNA viruses that infect a variety of animals, usually in a species-specific fashion. Two parvoviruses have been isolated from humans, the adeno-associated parvoviruses (genus Dependovirus) and human parvovirus B19 (B19) (genus Erythrovirus). Only B19 is known to cause disease in humans. (See "Clinical manifestations and diagnosis of parvovirus B19 infection".)

Parvovirus B19 has a single-stranded DNA genome containing approximately 5,000 nucleotides. It encodes at least two major structural proteins and one nonstructural protein and serves as the template for its own replication.

Parvovirus B19 preferentially infects rapidly dividing cells and is cytotoxic for erythroid progenitor cells [2,3]. B19 also may stimulate a cellular process initiating apoptosis (programmed cell death) [4]. The latter may account for the minimal inflammatory response noted in tissues infected with B19.

EPIDEMIOLOGY

Antibodies to B19 are found in 30 to 60 percent of adults [5-7]. The secondary attack rate for household contacts may be as high as 50 percent; a susceptible individual exposed in a classroom has a 20 to 30 percent risk of infection [8]. (See "Microbiology, epidemiology, and pathogenesis of parvovirus B19 infection".)

                       

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Literature review current through: Nov 2016. | This topic last updated: Mon Mar 14 00:00:00 GMT+00:00 2016.
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