Epidemiology of parvovirus B19 and anemia among kidney transplant recipients: A meta-analysis
Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of...
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| Published in: | Urology annals Vol. 12; no. 3; pp. 241 - 247 |
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01-07-2020
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| Abstract | Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia.
Materials and Methods: A systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716).
Results: Nineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%-76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1st year after KTx was 10.3% (95% CI: 5.5%-18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%-15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%-41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA (P = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses.
Conclusion: The overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime. |
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| AbstractList | BACKGROUNDPersistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia. MATERIALS AND METHODSA systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716). RESULTSNineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%-76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1st year after KTx was 10.3% (95% CI: 5.5%-18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%-15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%-41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA (P = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses. CONCLUSIONThe overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime. Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia. Materials and Methods: A systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716). Results: Nineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%–76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1st year after KTx was 10.3% (95% CI: 5.5%–18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%–15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%–41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA (P = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses. Conclusion: The overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime. Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia. Materials and Methods: A systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716). Results: Nineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%-76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1st year after KTx was 10.3% (95% CI: 5.5%-18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%-15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%-41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA (P = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses. Conclusion: The overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime. Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and parvovirus B19-related anemia after KTx remains unclear. We conducted this systematic review (1) to investigate the incidence of parvovirus B19 infection after KTx and (2) to assess the incidence of parvovirus B19 among KTx patients with anemia. A systematic review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception to March 2019 to identify studies that reported the incidence rate of parvovirus B19 infection and/or seroprevalence of parvovirus B19 in KTx recipients. Effect estimates from the individual studies were extracted and combined using random-effects, generic inverse variance method of DerSimonian and Laird. The protocol for this systematic review is registered with PROSPERO (no. CRD42019125716). Nineteen observational studies with a total of 2108 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of parvovirus B19 immunoglobulin G was 62.2% (95% confidence interval [CI]: 45.8%-76.1%). The pooled estimated incidence rate of positive parvovirus B19 DNA in the 1 year after KTx was 10.3% (95% CI: 5.5%-18.4%). After sensitivity analysis excluded a study that solely included KTx patients with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA after KTx was 7.6% (95% CI: 3.7%-15.0%). Among KTx with anemia, the pooled estimated incidence rate of positive parvovirus B19 DNA was 27.4% (95% CI: 16.6%-41.7%). Meta-regression analysis demonstrated no significant correlations between the year of study and the incidence rate of positive parvovirus B19 DNA ( = 0.33). Egger's regression asymmetry test was performed and demonstrated no publication bias in all analyses. The overall estimated incidence of positive parvovirus B19 DNA after KTX is 10.3%. Among KTx with anemia, the incidence rate of positive parvovirus B19 DNA is 27.4%. The incidence of positive parvovirus B19 DNA does not seem to decrease overtime. |
| Audience | Academic |
| Author | Leeaphorn, Napat Bathini, Tarun Cheungpasitporn, Wisit Boonpheng, Boonphiphop Watthanasuntorn, Kanramon Aeddula, Narothama Lertjitbanjong, Ploypin Chesdachai, Supavit Kaewput, Wisit Torres-Ortiz, Aldo Khoury, Nadeen Bruminhent, Jackrapong Thongprayoon, Charat Mao, Michael |
| AuthorAffiliation | 7 Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA 6 Department of Medicine, Renal Transplant Program, University of Missouri-Kansas City School of Medicine, Saint Luke's Health System, Kansas City, Missouri, USA 1 Department of Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, Michigan, USA 8 Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, USA 2 Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA 10 Department of Medicine, Division of Infectious Diseases, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 5 Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA 3 Department of Medicine, Division of Nephrology, Indiana University School of Medicine and Deaconess Health System, Evansville, Indiana, USA 11 Department of |
| AuthorAffiliation_xml | – name: 6 Department of Medicine, Renal Transplant Program, University of Missouri-Kansas City School of Medicine, Saint Luke's Health System, Kansas City, Missouri, USA – name: Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, USA – name: 1 Department of Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, Michigan, USA – name: 3 Department of Medicine, Division of Nephrology, Indiana University School of Medicine and Deaconess Health System, Evansville, Indiana, USA – name: 8 Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA – name: 4 Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA – name: 7 Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA – name: 9 Department of Military and Community Medicine, Phramongkutklao College of Medicine, Mahidol University, Bangkok, Thailand – name: 5 Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA – name: 11 Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida, USA – name: 2 Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA – name: 10 Department of Medicine, Division of Infectious Diseases, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand |
| Author_xml | – sequence: 1 givenname: Charat surname: Thongprayoon fullname: Thongprayoon, Charat organization: Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester – sequence: 2 givenname: Nadeen surname: Khoury fullname: Khoury, Nadeen organization: Department of Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, Michigan – sequence: 3 givenname: Tarun surname: Bathini fullname: Bathini, Tarun organization: Department of Internal Medicine, University of Arizona, Tucson, Arizona – sequence: 4 givenname: Narothama surname: Aeddula fullname: Aeddula, Narothama organization: Department of Medicine, Division of Nephrology, Indiana University School of Medicine and Deaconess Health System, Evansville, Indiana – sequence: 5 givenname: Boonphiphop surname: Boonpheng fullname: Boonpheng, Boonphiphop organization: Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee – sequence: 6 givenname: Ploypin surname: Lertjitbanjong fullname: Lertjitbanjong, Ploypin organization: Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York – sequence: 7 givenname: Kanramon surname: Watthanasuntorn fullname: Watthanasuntorn, Kanramon organization: Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York – sequence: 8 givenname: Napat surname: Leeaphorn fullname: Leeaphorn, Napat organization: Department of Medicine, Renal Transplant Program, University of Missouri-Kansas City School of Medicine, Saint Luke′s Health System, Kansas City, Missouri – sequence: 9 givenname: Supavit surname: Chesdachai fullname: Chesdachai, Supavit organization: Department of Medicine, University of Minnesota, Minneapolis, Minnesota – sequence: 10 givenname: Aldo surname: Torres-Ortiz fullname: Torres-Ortiz, Aldo organization: Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi – sequence: 11 givenname: Wisit surname: Kaewput fullname: Kaewput, Wisit organization: Department of Military and Community Medicine, Phramongkutklao College of Medicine, Mahidol University, Bangkok – sequence: 12 givenname: Jackrapong surname: Bruminhent fullname: Bruminhent, Jackrapong organization: Department of Medicine, Division of Infectious Diseases, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok – sequence: 13 givenname: Michael surname: Mao fullname: Mao, Michael organization: Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, Florida – sequence: 14 givenname: Wisit surname: Cheungpasitporn fullname: Cheungpasitporn, Wisit organization: Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi |
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| Keywords | meta-analysis systematic reviews renal transplantation parvovirus B19 Kidney transplantation |
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| Snippet | Background: Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of... Persistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of parvovirus B19 and... BACKGROUNDPersistent anemia has been described in kidney transplant (KTx) recipients with parvovirus B19 virus infection. However, the epidemiology of... |
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| SubjectTerms | Analysis Anemia Bias Blood Bone marrow Cytomegalovirus Cytotoxicity Deoxyribonucleic acid DNA Epidemiology Health aspects Immunoglobulins Infection Infections Kidney transplantation Kidney transplants Medical research Meta-analysis Original parvovirus b19 Patients renal transplantation Studies Systematic review systematic reviews Viral infections Viruses |
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| Title | Epidemiology of parvovirus B19 and anemia among kidney transplant recipients: A meta-analysis |
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