Effect of HLA type and hypocomplementaemia on the expression of parvovirus arthritis: one year follow up of an outbreak

• Published in: Annals of the rheumatic diseases Vol. 55; no. 1; pp. 63 - 65
• Main Authors: Gendi, N S, Gibson, K, Wordsworth, B P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.01.1996; BMJ; Elsevier Limited
• Subjects: Adult; Arthritis, Infectious - epidemiology; Arthritis, Infectious - immunology; Biological and medical sciences; Complement C3 - analysis; Complement C4 - analysis; Complement System Proteins - analysis; Disease Outbreaks; England - epidemiology; Erythema Infectiosum - epidemiology; Erythema Infectiosum - immunology; Female; Follow-Up Studies; HLA Antigens - analysis; HLA-B27 Antigen - analysis; HLA-DR Antigens - analysis; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; parvovirus; Viral diseases; England; Human; HLA-System; Parvovirus; Diseases of the osteoarticular system; Class II histocompatibility antigen; Evolutivity; Parvovirus B19; Arthritis; Complement; Infection; Virus; Hypocomplementemia; Association; Parvoviridae; Viral disease; Arthropathy
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.55.1.63

OBJECTIVES--To determine the effect of HLA type and hypocomplementaemia on the duration and severity of joint involvement in parvovirus infection (HPV). METHODS--Forty seven patients were selected on a geographical basis from 83 with proven HPV infection during an outbreak that occurred in Oxfordshire in 1993. They were contacted by questionnaire a year later. Thirty five patients were available for examination and blood sampling. Subjects were typed for HLA-DRB1 alleles and HLA-B27 status. Immunological profiles, including C3 and C4 complement components, were determined. RESULTS--Joint symptoms occurred in all patients. They resolved within a week in 12 patients and persisted beyond one year in 19. On review, none had a picture of rheumatoid arthritis, but three patients had developed carpal tunnel syndrome. Decreased C4 was found in four. The HLA frequencies were similar to those in controls; however, joint symptoms persisted for more than one week in all HLA-DR4 positive patients (p = 0.009). There was no relation between the severity of joint symptoms and either HLA type, or hypocomplementaemia. CONCLUSIONS--Joint symptoms are common in parvovirus infection and the presence of HLA-DR4 may be associated with persistence of joint symptoms beyond one week. This study revealed no evidence of progression to rheumatoid arthritis.