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Parvovirus B19 DNA, Qualitative Real-time PCR

Parvovirus B19 DNA, Qualitative Real-time PCR

Test Summary

Parvovirus B19 DNA, Qualitative Real-time PCR

  

Clinical Use

  • Determine etiology of acute and chronic anemias, erythema infectiosum, and polyarthropathy

  • Diagnose parvovirus infection as the causative agent for fetal hydrops

  • Diagnose parvovirus infection in immunosuppressed individuals (HIV infected individuals, transplant patients)

  • Diagnose parvovirus infection prior to seroconversion

Clinical Background

Parvovirus B19 is an unenveloped single-stranded DNA virus that infects, replicates in, and lyses red cell progenitors. Clinical symptoms of infection result from subsequent erythroid aplasia or from the host immune response. In children, the infection manifests as a nonspecific illness or with erythema infectiosum (fifth disease) with a characteristic “slapped-cheek” rash. Parvovirus B19 occasionally causes polyarthritis in adults and transient aplastic crisis may occur in patients with chronic hemolytic anemia (sickle cell, hereditary spherocytosis, beta thalassemia, etc). Although usually self-limiting, parvovirus infection may cause acute or chronic anemia in the immunocompromised host and is the leading cause of red cell aplasia in AIDS patients. In pregnant women, the infection may be transmitted to the fetus. Fetal anemia, hydrops fetalis, or fetal demise may occur in a small percentage of intrauterine infections.

An intense viremia develops 7 to 14 days after parvovirus infection. Clinical symptoms occur with the onset of specific IgM production, followed shortly by IgG production. Detection of parvovirus DNA is an earlier and more sensitive marker of viral infection than anti-viral antibodies and should be used in conjunction with anti-parvovirus IgM detection for optimal diagnostic sensitivity. Parvovirus DNA detection is especially useful for immunosuppressed patients, in whom antibody levels may be undetectable.

Method

  • Real-time polymerase chain reaction (PCR) with fluorescent dye-labeled probe

  • Primers specific for parvovirus B19 virion structural protein (VP1)

  • Amplification products detected by measuring fluorescent signals generated during the PCR

  • Results reported as parvovirus B19 DNA detected or not detected

  • Analytical Sensitivity: 400 copies/mL

Interpretive Information

A “detected” result is associated with parvovirus B19 infection. A “not detected” result is consistent with the absence of parvovirus B19 infection but does not exclude the diagnosis. Diagnosis of parvovirus infection should not rely solely on the result of a PCR test.

References

  1. Alger LS. Toxoplasmosis and parvovirus B19. Infect Dis Clin North Am. 1997;11:55-75.

  2. Cassinotti P, Bas S, Siegl G, et al. Association between human parvovirus B19 infection and arthritis. Ann Rheum Dis. 1995;54:498-500.

  3. Clewley JP. Polymerase chain reaction assay of parvovirus B19 DNA in clinical specimens. J Clin Microbiol. 1989;27:2647-2651.

  4. Clewley JP. PCR detection of parvovirus B19. In: Persing DH, Smith TF, Tevover FC, White TJ (eds). Diagnostic Molecular Microbiology: Principles and Applications. Washington, DC: American Society for Microbiology; 1993:367-373.

  5. Mori J, Beattie P, Melton W, et al. Structure and mapping of the DNA of human parvovirus B19. J Gen Virol. 1987;68:2797-2806.

  6. Musiani M, Zerbini M, Gentilomi G, et al. Parvovirus B19 clearance from peripheral blood after acute infection. J Infect Dis. 1995;172:1360-1363.

  7. Portmore AC. Parvovirus (Erythema Infectiosum, Aplastic Crisis). In: Mandell GL, Bennett JE, Dolan R (eds.): Principles and Practice of Infectious Diseases. 4th ed. New York: Churchill-Livingston; 1995:1439-1446.

  8. Torok TJ, Wang Q, Gary GW. Prenatal diagnosis of intrauterine infection with parvovirus B19 by the polymerase chain reaction technique. Clin Infect Dis. 1992;14:149-155.
     

This test was developed and its performance characteristics have been determined by Focus Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test.

Polymerase chain reaction (PCR) is performed pursuant to a license agreement with Roche Molecular Systems Inc.

Content reviewed 07/2013

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