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パルボウイルスB19感染症(含む伝染性紅斑/リンゴ病)

関連論文:
img  10:  False-negative serology in patients with acute parvovirus B19 infection.
 
著者: Simon Bredl, Annelie Plentz, Jürgen J Wenzel, Heiko Pfister, Johannes Möst, Susanne Modrow
雑誌名: J Clin Virol. 2011 Jun;51(2):115-20. doi: 10.1016/j.jcv.2011.03.012. Epub 2011 May 6.
Abstract/Text BACKGROUND: Acute parvovirus B19 (B19V) infection is characterized by high-level viremia. Antibodies against the capsid proteins VP1 and VP2 may complex with B19V-particles thereby becoming undetectable in diagnostic tests.
OBJECTIVES: We intended to obtain data on the frequency of false-negative serology in acute B19V-infection.
STUDY DESIGN: 129 plasma or serum samples of healthy blood donors and of patients with suspected B19V-infection were analyzed for B19V-DNA by qPCR and VP1/VP2-specific IgG and IgM by ELISA. Eleven of these samples were derived from four pregnant women with previous contact to B19V-infected individuals. Using acidic conditions virus/antibody-complexes were disrupted and detected by WesternLine and ELISA.
RESULTS: 83/118 samples were derived from acutely infected individuals displaying viremia (10(3)-10(12)geq/mL). In 24/83 viremic samples (28.9%) VP1/VP2-specific IgM and IgG were undetectable in ELISA, but could be demonstrated to be complexed with B19V-particles. Each 7/83 (8.4%) was IgM-positive/IgG-negative and IgM-negative/IgG-positive, in 45/83 samples (54.2%) IgG and IgM could be detected. 35 samples did not contain B19V-DNA; five of these were from seronegative persons. Analyzing consecutive sera derived from four pregnant women, B19V-DNA was demonstrated in 10/11 samples, B19V-specific IgG- and IgM-antibodies were detectable in 10/11 and 4/11 samples, respectively. In 2/4 women seroconversion was observed, but IgM was not detected in 50% of the samples. B19V-specific IgG but not IgM was detectable in 2/4 women.
CONCLUSION: Acute B19V-infection cannot be diagnosed by exclusive analysis of B19V-specific antibodies. Only the combination of assays for detection of B19V-DNA and antibodies enables correct serodiagnosis.

Copyright © 2011 Elsevier B.V. All rights reserved.
PMID 21530386  J Clin Virol. 2011 Jun;51(2):115-20. doi: 10.1016/j.jcv.2011.03.012. Epub 2011 May 6.
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