Parvovirus B19 infections in paediatric sickle cell disease patients: Genotype and hydroxyurea treatment influence disease severity
Abstract
Summary In patients with sickle cell disease (SCD), parvovirus B19 infection (B19V) leads to acute anaemia (aplastic crisis), but may also be associated with other serious complications. We retrospectively analysed clinical data from paediatric SCD patients with B19V infections between 2023 and 2025, including symptoms, laboratory parameters, diagnostic procedures and treatment details to detect differences between SCD genotypes (HbSS and HbS/β 0 ‐thalassaemia, i.e. HbSS/Sβ 0 , and HbSC) and to determine the effect of hydroxyurea (HU; hydroxycarbamide) treatment in HbSS/Sβ 0 patients. Ninety‐eight patients (76 HbSS/Sβ 0 , 22 HbSC) were included in the study. There were significant differences in the symptoms of infection between genotypes, with a high prevalence of back pain as well as higher C‐reactive protein and lactate dehydrogenase levels in HbSC. HbSC patients also received chest X‐ray more frequently and required longer inpatient treatment. In addition, HbSC patients showed a significantly higher rate of immunoglobulin G seroconversion at the onset of symptoms, suggesting that antibody formation influences clinical appearance. In HbSS/Sβ 0 patients, HU treatment was associated with higher haemoglobin and reduced transfusion requirements, but more frequently with neutropenia. In summary, B19V infections induce different clinical presentations depending on SCD genotypes, with HbSC patients showing a distinct phenotypic presentation. HU treatment reduces the need for transfusions in patients with HbSS/Sβ 0 .
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Authors: Matthias Bleeke, Arne Simon, Beate Winkler, Sabine Heine, Anna Eichinger, Ulrich von Both, Meinolf Siepermann, Sonya El Amouri, Arndt Borkhardt, Yvonne Pritschow, Wolfgang Novak, Michael Dworzak, Sarah Goretzki, Clara Held, Karin Beutel, Franziska Gams, Henriette Rudolph, Leila Koscher, Piet E. Beusker, Eckard Hamelmann, Stefan Weichert, Svenja Häuser, Maximilian David Mauritz, Malik Aydin, Verena Wiegering, Regine Grosse, Rainer Misgeld, Martina Stiefel, Nicole Töpfner, Uta Falke, Lara Imhof, Laura Tagliaferri, Daniel Ebrahimi‐Fakhari, Andreas H. Groll, Marion Appel, Nora Naumann‐Bartsch, Michaela Nathrath, Olaf Beck, Solvej Heidtmann, Philipp Tischer, Ulf Schulze‐Sturm, Urs Mücke, Holger Cario
Institutions: University Hospital Cologne, Heinrich Heine University Düsseldorf, University Hospital Münster, Ludwig-Maximilians-Universität München, Heidelberg University, Universitätsklinikum Erlangen, Universitätsklinikum Würzburg, University Hospital Carl Gustav Carus, Universitätsklinikum Aachen, RWTH Aachen University, Universität Hamburg, University Medical Center Hamburg-Eppendorf, Johannes Gutenberg University Mainz, German Centre for Cardiovascular Research, Goethe University Frankfurt, Saarland University, Technical University of Munich, Martin Luther University Halle-Wittenberg, Medical University of Vienna, Medizinische Hochschule Hannover, University of Duisburg-Essen, Universität Ulm, Bethel University, Gemeinschaftsklinikum Mittelrhein, University of Mannheim, Technische Universität Dresden, University Children's Hospital Tübingen, University Medical Center of the Johannes Gutenberg University Mainz, Hopp Children's Cancer Center Heidelberg, Klinikum Kassel, Witten/Herdecke University, St Anna Children's Hospital, Johannes Wesling Klinikum Minden, Vestische Caritas-Kliniken