Parvovirus B19: Insights and implication for pathogenesis, prevention and therapy

Parvovirus B19 (B19V) is a small ssDNA non-enveloped virus, member of Parvoviridae family. The infection is widely diffused and is responsible for a broad range of clinical manifestations including fifth disease in children, transient aplastic crisis in patients with haematological disorders, non-immune hydrops fetalis in pregnant women, persistent anaemia in immunocompromised patients, arthropathy and inflammation of various other tissues. B19V infects and replicates in erythroid progenitor cells (EPCs) in the bone marrow. The depletion of infected EPCs represents the pathogenetic mechanisms of some haematological B19V-associate diseases.

Following a primary infection, the virus can establish lifelong persistence in several tissues. Currently, the pathological potential of persistent virus on the cellular signalling pathways remains unclear. In non-erythroid tissues, the infection is usually, abortive, and the virus seems to exert its pathological role through indirect mechanisms, such as induction of inflammatory and autoimmune processes, or through virus-induced apoptosis mediated by viral proteins. In addition to the diseases for which the etiological role of B19V has been fully demonstrated, there are several clinical conditions, including autoimmune diseases, that are presumably, but not certainly, associated with B19V infection.

In this review, we describe recent findings that may give us new insight into the pathogenic role of B19V in systemic sclerosis, an autoimmune disease of unknown multifactorial aetiology. Furthermore, we describe the latest findings on the intrauterine B19V infections. Moreover, since there are some ongoing interesting studies focused on vaccine development and antiviral drug discovery for the prevention and treatment of parvovirus B19 infection we described some advances in this field of research.