What Happens To Untreated Parvovirus B19 Infection & When To Go To Doctor For It?

In the United States, there is a 30-50% serological prevalence of previous B19 infection in children with sickle cell disease with seroconversion rates increasing with age.(1)

During the b19 virus infection, the other cells can also be affected leading to pancytopenia and leukoerythroblastopenia.(1)

What Happens To Untreated Parvovirus B19 Infection?

Parvovirus B19 is a human pathogenic virus that is a single-stranded DNA virus that has a selective tropism for erythroid progenitor cells in the bone marrow. When there is an infection of the erythroid cells, it leads to apoptosis that will cause the temporary arrest of erythropoiesis. This condition will usually manifest later as underlying erythropoietic disorders or immune system deficiencies. The relevance of parvovirus as a cardiotropic virus is recently emerging while its capability to transmit through the placenta with fetal complications has been a reason for concern.

The infection is associated with an ample number of pathologies and clinical manifestations which largely depend on the physiological properties of the virus and immune status of the individual. Therefore b19 parvovirus can result from asymptomatic to mild to severe manifestations and in some cases life-threatening conditions that will affect the hemopoietic system.(2)

The virus is known to establish a complex relationship with the immune system that hampers the ability of the system to control the virus and the pathological course of the disease. According to some reports, it has been established that the primary infection can establish persistence in many tissues that can be lifelong. The virus remains in the dormant state and can manifest to its full potential in the later stage of life depending upon the relationship with the host.(2)

Surveillance Prophylaxis And Therapy

B19 infection is mostly a benign clinical condition that mostly resolves on its own. The virus is widely diffuse, and in the majority of the cases, the infection will go unnoticed or asymptomatic with an uneventful clinical course. However, hematological consequences are an area of concern, especially in patients who have an underlying hemolytic disorder that might complicate the situation. In these cases, the consequences can be severe, and there can be a need for transfusion therapy. While in healthy individuals, the development of chronic inflammatory and rheumatic manifestations can be severely impairing. Also, the risk of infection in pregnancy is an area of major concern as it can lead to fetal deaths.(3)

Therefore it becomes extremely important to not only promptly diagnose the infection but also consider prophylactic, therapeutic, and monitoring actions in the course of the disease. The specific measures include reducing the chances of transmission of the virus through blood and blood-derived products, the use of passive immunization and therapeutic intervention when needed. Lastly, there is a need for vaccination and the use of specific antiviral drugs in some cases.(2)

When To Go To A Doctor For Parvovirus B19 Infection?

In most cases, one can overcome the infection where there are mild or asymptomatic clinical manifestations. The need for therapy is reduced in these cases as the infection resolves on its own. However, if you notice alarming conditions, especially in individuals with an underlying hematological or cardiac implication, one should visit a healthcare professional for accurate treatment and follow-up. In the case of anemia, transfusions might be required to treat transient aplastic crisis. While in cases of arthralgia non-steroidal anti-inflammatory drugs will be beneficial in suppressing the infection. When fetal complications present in the form of infections and hydrops, intrauterine transfusions are indicated if the hemoglobin levels fall below the threshold levels. It can increase the survival rate of the fetus and preventing severe anemic consequences in the unborn.(3)

Passive immunization is an effective tool to reduce viral load in affected individuals, especially those who have chronic infections. The inability of the immune system to respond to the virus is compromised; hence IVIG is prepared from large pools of donors that will help neutralize the B19V antibodies. In immunocompromised patients with HIV infection, HAART therapy allows reconstituting the immune function.(3)

Recognition of the underlying condition and diagnosis of the infection becomes an important tool in managing the virus from multiplying and spreading out of control. Hence regular checkups with the doctors should be done to prevent complications and understand the course of therapy according to clinical manifestations.

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