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Maternofetal transmission of human parvovirus B19 genotype 3 in Ghana, West Africa. D Candotti, K Danso, A Parsyan, A Dompreh, J-P Allain. National Blood Service, England Div. Transfusion Medicine, University of Cambridge, UK
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Maternofetal transmission of human parvovirus B19 genotype 3 in Ghana, West Africa D Candotti, K Danso, A Parsyan, A Dompreh, J-P Allain National Blood Service, England Div. Transfusion Medicine, University of Cambridge, UK Dept. Obstetrics & Gynaecology and Dept. Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
B19 infection in Ghana • 82% seroprevalence in adults • B19 DNA prevalence: - 1.3% in blood donors - 11.5% in children (average age: 23 months) • 0.9% persistent infections: - IgG only - low viral load ( 102- 105 IU/ml) • Endemic region for B19 genotype 3
Phylogenetic tree of full length human parvovirus B19 genomes Genotype 2 100 Genotype 1 100 100 3A 100 V9 100 D91.1 Genotype 3 3B 0.005 substitutions/site
Study design Pregnant women plasmas (n=885) Anti-VP2 IgG B19 DNA screening Multiplex QPCR assay Single QPCR & nested PCR confirmation Cord blood plasmas Newborn whole blood Sequencing Genotyping Specific QPCR & nested PCR
Serological and viral markers in pregnant women Anti-VP2 IgG reactive 144/177 (81%) Confirmed DNA pos. 16/885 (1.8%) DNA load (IU/ml) Median Range 1.3E+03 46 - 3.6E+06 IgM reactive IgG reactive 3/16 16/16
Viral load (IU/ml) IgM titer IgG titer Viral load (IU/ml) IgM titer Maternofetal transmission Sample ID Type Mother Cord blood Newborn Viral load (IU/ml) 1964 2005 1655 1956 1774 1941 2246 2029 2106 1818 2196 1447 2409 2242 2143 1577 3 3 3 3 3 3 3 1 3 3 3 3 3 3 3 3 1.1E+04 1.2E+06 3.6E+06 5.9E+03 4.2E+03 2.1E+03 1.5E+03 1.3E+03 1.2E+03 1.1E+03 6.5E+02 5.6E+02 3.3E+02 5.8E+01 4.6E+01 4.6E+01 1:1000 1:1000 1:100 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 1:1000 1:1000 1:100000 1:10000 1:1000 1:10000 1:100 1:1000 1:1000 1:100 1:1000 1:1000 1:1000 1:1000 1:100 1:100 1.1E+03 2.1E+06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 <1:10 1:1000 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 <1:10 1.7E+03 - 0 - - - - - - - 0 - 0 - - -
Conclusions • B19 genotype 3 is dominant in Ghana and is characterised by high genetic variability • 2/3 cases of primary maternal B19 infection resulted in vertical transmission • No evidence that maternal persistent B19 is vertically infectious
Acknowledgements Pr J.-P. Allain Dr A. Parsyan Div. of Transfusion Medicine University of Cambridge Cambridge, UK Dr K. Danso Dept. of Obstetrics & Gynaecology Komfo Anokye Teaching Hospital Kumasi, Ghana Mr A. Dompreh Serology laboratory Dept. of Microbiology Komfo Anokye Teaching Hospital Kumasi, Ghana Mr C Horn Plasmacute Norway National Blood Service England