Persistence of parvovirus B19 DNA in synovial membranes of young patients with and without chronic arthropathy

Background Human parvovirus B19 replicates in erythroid precursors of the bone marrow, and several diseases have been attributed to this virus including some cases of juvenile chronic arthropathy. Methods Tissue samples from children with juvenile arthritis and from healthy young adults with recent joint trauma were examined for B19 DNA by PCR. We also studied the timing of the parvovirus infection serologically. Findings All samples of synovial fluid, bone marrow, and blood were negative for B19 DNA. Eight (28%) of the 29 children with chronic arthritis had B19 DNA in synovial tissue. However, an even higher proportion of the non-arthropathy controls were positive for B19 DNA in synovial membranes (13 [48%] of 27). All the individuals with B19 DNA in synovial membrane had serum lgG antibodies to B19. Interpretation Genomic B19 DNA can persist in the synovial membranes not only in patients with chronic arthropathy but also in healthy immunocompetent individuals. The diagnostic criteria for parvovirus arthropathy must be re-evaluated.