1. Maternofetal transmission of human parvovirus B19 genotype 3 in Ghana, West Africa D Candotti, K Danso, A Parsyan, A Dompreh, J- P Allain National Blood Service, England Div. Transfusion Medicine, University of Cambridge, UK Dept. Obstetrics & Gynaecology and Dept. Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana

2. B19 infection in Ghana 82% seroprevalence in adults B19 DNA prevalence: - 1.3% in blood donors - 11.5% in children (average age: 23 months) 0.9% persistent infections: - IgG only - low viral load ( 10 2 - 10 5 IU/ml) Endemic region for B19 genotype 3

3. Phylogenetic tree of full length human parvovirus B19 genomes 0.005 substitutions/site Genotype 2 Genotype 1 Genotype 3 3A 3B 100 V9 D91.1

4. Study design Pregnant women plasmas (n=885) B19 DNA screening Multiplex QPCR assay Single QPCR & nested PCR confirmation Specific QPCR & nested PCR Cord blood plasmas Newborn whole blood Anti-VP2 IgG Sequencing Genotyping

5. Serological and viral markers in pregnant women Anti-VP2 IgG reactive144/177 (81%) Confirmed DNA pos.16/885 (1.8%) DNA load (IU/ml) Median Range 1.3E+03 46 - 3.6E+06 IgM reactive IgG reactive 3/16 16/16

6. Maternofetal transmission 1964 2005 1655 1956 1774 1941 2246 2029 2106 1818 2196 1447 2409 2242 2143 1577 MotherCord bloodNewborn Viral load (IU/ml) IgM titer IgG titer Viral load (IU/ml) IgM titer Viral load (IU/ml) Sample ID Type 1.1E+04 1.2E+06 3.6E+06 5.9E+03 4.2E+03 2.1E+03 1.5E+03 1.3E+03 1.2E+03 1.1E+03 6.5E+02 5.6E+02 3.3E+02 5.8E+01 4.6E+01 1:1000 1:100 <1:10 1:1000 1:100000 1:10000 1:1000 1:10000 1:100 1:1000 1:100 1:1000 1:100 1.1E+03 2.1E+06 0 <1:10 1:1000 <1:10 1.7E+03 - 0 - 0 - 0 - 33333331333333333333333133333333

7. Conclusions B19 genotype 3 is dominant in Ghana and is characterised by high genetic variability 2/3 cases of primary maternal B19 infection resulted in vertical transmission No evidence that maternal persistent B19 is vertically infectious

8. Acknowledgements Pr J.-P. Allain Dr A. Parsyan Div. of Transfusion Medicine University of Cambridge Cambridge, UK Dr K. Danso Dept. of Obstetrics & Gynaecology Komfo Anokye Teaching Hospital Kumasi, Ghana Mr A. Dompreh Serology laboratory Dept. of Microbiology Komfo Anokye Teaching Hospital Kumasi, Ghana Mr C Horn Plasmacute Norway National Blood Service England