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Blood, 15 January 2004, Vol. 103, No. 2, pp. 422-427.
Prepublished online as a Blood First Edition Paper on October 2, 2003; DOI 10.1182/blood-2003-01-0069.


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Submitted January 8, 2003
Accepted May 13, 2003

The epidemiology of human parvovirus B19 in children with sickle cell disease

Kim Smith-Whitley*, Huaqing Zhao, Richard L Hodinka, Janet Kwiatkowski, Renee Cecil, Tamara Cecil, Avital Cnaan, and Kwaku Ohene-Frempong

Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
Division of Biostatistics and Epidemiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

* Corresponding author; email: WhitleyK{at}email.chop.edu.

Human parvovirus (HPV) B19 causes significant morbidity and mortality in children with sickle cell disease (SCD), but little data are published about the epidemiology of HPV B19 infection and its associated complications in this patient population. In this study, prevalence and incidence rates of HPV B19 were determined in 633 patients with SCD followed at The Children's Hospital of Philadelphia between November 1996 and December 2001. Thirty percent (30%) were HPV B19 IgG positive at first testing and the 70% without evidence of past HPV B19 infection were tested annually. One hundred and ten patients developed evidence of HPV B19 infection for an incidence rate of 11.3/100 patient-years. Sixty-eight episodes of HPV B19-induced transient red cell aplasia (TRCA) occurred with the following clinical events: fever (89.7%), pain (61.8%), acute splenic sequestration (19.1%), and acute chest syndrome (11.8%). Pain, fever and ASS were more frequent events with acute HPV B19 infections compared to acute events in uninfected patients. The results of this epidemiologic study, the largest and most comprehensive to date, justify the development of HPV B19 prevention strategies to diminish the frequent and often severe complications associated with HPV B19 infections in patients with SCD.


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N. S. Young and K. E. Brown
Parvovirus B19
N. Engl. J. Med., February 5, 2004; 350(6): 586 - 597.
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