What are the treatment options for parvovirus B19 (B19V) infection?

Updated: Oct 11, 2019
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Russell W Steele, MD  more...
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Answer

Treatment may include the following:

  • Acetaminophen or ibuprofen is effective for treating fever in patients with parvovirus B19 (B19V) infection. Fever does not always require treatment with antipyretics; however, consider antipyretics if a patient appears clinically uncomfortable.

  • Resolution of infection depends on the presence of immunoglobulins against parvovirus B19. Intravenous immunoglobulin (IVIG) has been used with good results for patients suffering pure red cell aplasia (PRCA). Patients should be monitored for relapsed viremia. [8, 2, 28, 41]

  • Patients in aplastic crisis require packed RBC transfusions. [9] In some studies, more than 80% of patients with sickle cell disease in transient aplastic crisis (TAC) have required transfusion. [8] IVIG is not recommended for TAC.

  • In patients receiving immunosuppressive agents, temporarily decreasing the dose of immunosuppressive agents usually enables the immune system to produce sufficient immunoglobulin G (IgG) to eradicate the infection and confer lifelong protection. In some individuals with human immunodeficiency virus (HIV) infection, highly active antiretroviral therapy restores immune function, enabling resolution of chronic parvovirus B19 infection. [28]

  • Although its use is controversial and carries many risks, intrauterine blood transfusions may be helpful in cases of hydrops fetalis. [2, 14, 22, 25, 42]


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