异基因造血干细胞移植后人细小病毒B19感染的诊治现状

The current status of diagnosis and treatment of human parvovirus B19 infection after allogeneic hematopoietic stem cell transplantation

人细小病毒B19(human parvovirus B19,HPVB19)属细小病毒科,红细胞病毒属,与多种疾病相关,是异基因造血干细胞移植后难治性贫血的重要原因之一。异基因造血干细胞移植后HPVB19感染最常见的临床表现为贫血伴网织红细胞计数下降,严重者可进展为纯红细胞再生障碍,同时可伴有白细胞和血小板减少症、皮疹、关节痛、心肌炎、肝炎、肺炎等,诊断主要依赖核酸检测。使用静脉注射免疫球蛋白与免疫抑制剂减量为有效的治疗手段。HPVB19感染预后好但复发率高。本文对异基因造血干细胞移植后HPVB19感染患者的临床特点及诊疗方案进行文献综述。

Human parvovirus B19(HPVB19)belongs to the parvoviridae family,erythroparvovirus,which is responsible for a variety of human diseases and is one of the important causes of refractory anemia after allogeneic hematopoietic stem cell transplantation(allo-HSCT).The most common clinical manifestations of HPVB19 infection after allo-HSCT is anemia with decreased reticulocyte count,which can progress to pure red cell aplasia,but it also can be accompanied by leukopenia and thrombocytopenia,rash,arthralgia,myocarditis,hepatitis,pneumonia,etc.The diagnosis of HPVB19 infection mainly depends on nucleic acid testing.Intravenous immunoglobulin and immunosuppressant dose reduction are effective treatments.HPVB19 infection has a good prognosis but a high recurrence rate.This article reviews the clinical features and diagnosis and treatment of HPVB19 infection in patients after allo-HSCT.