STUDIES ON CLINICAL SPECTRUM AND DIAGNOSTIC METHODS OF CHILDREN PARVOVIRUS B19 INFECTION

CAO Y-H, ZHANG G-C, ZHANG G-Y, XU D-L

Xijing Hospital, Fourth Military Medical University, Xian, China

Objective：To study the clinical spectrum of B19 infection and the value of nested PCR, ELISA and indirect immunofluoscence (IIF) for B19 infection.

Methods：ELISA and nested PCR were used to detect B19-IgM and DNA in the sera of 49 children with hematonosis and 29 children with connective tissue diseases, B19 antigen and DNA in the bone marrow samples of 21 patients with acute aplastic anemia (AAA) were examined by IIF and nested PCR.

Results：(1) Of 49 children with hematonosis, 17 patients were sera B19-DNA positive and 8 were were IgM positive, with a positive rate of 34.69% （17/49）and 16.33% (8/49); among 29 children with connective tissue diseases, 8 patients were sera B19-DNA positive and 7 were were IgM positive, with a positive rate of 27.59% （8/29）and 24.14 % (7/29); of 50 healthy children in the control group, 2 were sera B19-DNA positive and none was IgM positive, B19 infection rates of 49 children with hematonosis, 29 children with connective tissue diseases and 50 children in the control group were respectively 34.69% （17/49）, 31.03% （9/29）and 2％ （1/50）(P<0.05). The positive rates of B19-DNA and antigen in the bone marrow samples of 21 AAA patients were 33.33% (7/21) and 14.29% (3/21). (2) Compared with nested PCR, the sensitivity, specificity, crude agreement, positive predictive value, negative predictive value of ELISA were 60.00%, 98.11%, 85.90%, 93.75%, 83.87%, respectively, while those of IIF were 42.86%, 100%,80.95%, 100%, 77.78%.

Conclusion：(1) The sensitivity of ELISA and IIF for B19 infection is lower than nested PCR. Both B19-DNA and IgM or antigen should be detected when we diagnose B19 infection. (2) The infection rate in chinese children with hematonosis and connective tissue diseases is higher. B19 is linked with a broadening spectrum.

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