It is an example of a known virus with a pathogenicity that can vary depending on the conditions. It is resistant to solvent/detergent treatment and pasteurization

[84, 85], is only partly removed by nanofiltration [86], and has been shown to be transmissible via blood donations and pdCFCs [80]. The prevalence of B19 parvovirus is higher in patients exposed to pdCFCs than in those exposed to recombinant products or to no replacement factor products at all (Fig. 5). When the independent effect of product exposure on the likelihood of B19 parvovirus positivity was calculated, the odds of positivity of parvovirus B19V were found to be 70% higher among subjects exposed to pdCFCs alone, relative to those unexposed to any type of concentrate [80]. Parvovirus B19 infection typically causes a benign, flu-like illness which occurs most frequently in childhood [80]. It does not normally have any serious implications for the majority of people with haemophilia; BAY 80-6946 price however, cases of aplastic anaemia have been reported in those patients with existing haematological

disease [87], and infection during pregnancy may cause foetal death [80]. Infection in immunocompromised individuals may also lead to severe anaemia and bone marrow alterations [88]. Prions are self-replicating proteins which can cause transmissible spongiform encephalopathies, and several studies have shown that prions can be transmitted through the blood [89]. The most concerning manifestation of transmissible spongiform encephalopathies for humans is vCJD, which is caused by a prion found in lymphoid Alpelisib price tissue and can therefore potentially

contaminate pdCFCs [89]. In the 1990s, vCJD was identified in blood donated within the UK, and subsequently UK-donated plasma ceased to be used to reduce any potential risk of transmission of vCJD [82]). The 2011 European Medicines Agency position statement on CJD and plasma-derived products also states that ‘there is strong evidence that vCJD may be transmitted through transfusion of blood and plasma products’ [90]. Cases of probable transmission Resveratrol of vCJD by blood from donors who subsequently developed the disorder have been reported [89]. In one case, the vCJD prion was detected in the autopsied spleen of a neurologically asymptomatic 73-year-old patient with severe haemophilia A; UK-sourced pdCFCs were determined to be the most likely source of the infection [81]. Emerging pathogens such as B19 parvovirus and vCJD not only threaten the health of recipients of pdCFCs, but also threaten the security of supply of replacement factor concentrates [91], posing the question of whether more complete blood screenings are required. At the same time, it is simply not practical (or even feasible with current technology) to screen for all circulating viruses in the blood; in the case of emerging pathogens, it is obviously impossible to screen for unknown agents.