Parvovirus B19 IgG Antibodies Test

What is Parvovirus B19?

Parvovirus B19 is the first known human virus of the family parvoviridae. This virus is known to most commonly affect the pediatric population. It causes a disease called, “fifth disease” or “erythema infectiousum” or “slapped cheek syndrome: in the pediatric population. Adults can also be infected.

What is the “fifth disease”?

This condition, most commonly affects children of age group six to ten years, though any age can be affected. Once infected, this disease has an incubation period of four to fourteen days. Initially, when the viral load is high, symptoms are high-grade fever and malaise.

Following are other characteristic symptoms:

a) A viral prodrome -fever, headache, nausea, diarrhea.
b) Slapped cheek rash: a red rash forms on the cheeks with relative pallor around the mouth sparing nasolabial folds, forehead, and mouth.
c) “Reticular” (lace-like): red rash on trunk or extremities. This is followed by facial rash.
d) Exacerbation of rash by sunlight, heat, stress.

What are the symptoms of Parvovirus B19 infection in adults?

Infection in adults results in fever, malaise, a reticular rash, and multiple joints pain. Teenagers or young adults can have presentations like so-called ‘papular purpuric gloves and socks syndrome. Arthritis and arthralgias is a very common finding in adults. The presentation of symptoms of arthralgia and initial detection of circulating IgM and IgG antibodies usually coincides. Seronegative arthritis is usually seen in adults which resolves using analgesics.

What are the manifestations of Parvovirus B19 infection in HIV/AIDS patients?

In individuals who are immunocompromised following AIDS/HIV infection, Parvovirus B19 infection will cause a condition of chronic anemia. This infection can trigger an inflammatory reaction in patients who have been just started on anti-retroviral therapy. Symptoms usually resolve with Immunoglobulin therapy, however, relapse can occur.

What are the manifestations of Parvovirus B19 infection in pregnant females?

Following are the various manifestations

a) Hydrops fetalis: severe fetal anemia usually results in hydrops fetalis ( condition seen in fetuses characterized by accumulation of fluid or edema in at least two fetal compartments.
b) Miscarriages, stillbirths 
c) Risk of fetal loss is about 10% if females get infected before 20 weeks of gestation. Risk is very less if infection occurs after 20 weeks.

Routine screening of antenatal samples can help in determining the risk of infection. Also, pregnant women are advised to avoid close contact with individuals who are infected with Parvovirus B19.

What is the role of IgM antibody screening for Parvovirus B19?

IgM antibodies usually develop in the initial phase of infection. They usually are detectable in the first two weeks. They rise for a short time and then fall down to below detectable levels. They indicate the development of immunity following infection in the recent past.

What is the role of DNA screening for Parvovirus B19?

Testing for Parvovirus B19 DNA confirms the presence of active infection.

What are the indications of testing individuals for Parvovirus B19 antibodies?

a) Pregnant females: who have flu-like symptoms or have a history of contact with a positive Parvovirus B19 infected patient.

b) Individuals presenting with severe acute anemia or joint pain: patients presenting with these complaints and who are immunocompromised, need to be tested for antibodies.

c) Parvovirus B19 DNA or antibodies testing can be repeated if the initial investigations are normal but the clinician has a strong suspicion of the same.