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Parvovirus B19 changes iron homeostasis during pathological pregnancy

Voleva S, Manolov V*, Angelova S, Vasilev V, Gramatikova Z, Bogov I, Marinov B & Shishkov S

Objective: Viral infections during pregnancies are one of the main reasons for mother and fetus severe complications and mortality. Infections are associated with significant changes in iron homeostasis. The post-infectious anemic syndrome is characterized by low serum iron and increased hepcidin, which accumulates iron in endothelial macrophage system. The study aims to find the involvement of parvovirus B19 in the anemic syndrome development during pathological pregnancy. Methods: 52 pregnant women with anemia, diagnosed and hospitalized in University Obstetrics and Gynaecology “Maichin Dom” hospital were enrolled. The serological (indirect Enzyme-Linked Immunosorbent Assay (ELISA) tests) and molecular (B19V- Polymerase Chain Reaction (PCR) test) methods were used. In anemic pregnant women were evaluated iron homeostasis parameters with CLIA, ELISA and Ferrozine methods. For statistical evaluation of results the researchers used SPSS 13.0 (IBM). Correlations and significance were rated by Student’s paired t-test and Pearson’s correlation. Results: 8/52 (15.4%) of patients showed presence of B19V-IgM antibodies. B19-IgG antibodies were detected in 21/52 (40.4%) women. A positive PCR signal was determined in all patients with positive B19V-IgM, and 1 patient with anemia and positive B19V-IgG result. In two pregnant and positive women for acute viral B19V infection, anemia was classified as iron-deficiency, based on low serum hepcidin concentration 2.19 ± 0.5 µg/l, compared to 20.4 ± 2.9 µg/l pregnant women without B19V infection (Р<0.001). In other acute B19V infection women we found statistically increased serum hepcidin concentrations (61.9 ± 6.2 µg/l), Р<0.001. Conclusion: Because of transplanted pathway of parvovirus B19 infection transmission, in combination to B19V affinity for hematopoietic cell systems quantification of serum hepcidin levels would contribute for etiological clarification of anemia and prevention from inadequate iron supplementation in pregnant women.