{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:33:38Z","timestamp":1788798818026,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>An HIV positive, early adolescent girl from rural Southern Africa required multiple hospital admissions for severe normocytic anaemia. As she was virologically suppressed on antiretrovirals, the initial anaemia workup focused on nutritional deficiencies and excluding chronic haemolysis. A lack of readily available expertise and resources contributed to a delay in investigations, during which she was treated symptomatically with blood transfusions. She was later transferred to a tertiary hospital where she was diagnosed with parvovirus B19 (B19V) associated pure red cell aplasia. Intravenous immunoglobulin was administered with a good clinical response. The delayed diagnosis and treatment had a significant impact on her and her family and placed further strain on limited available transfusion resources. This case emphasises that B19V infection should not be overlooked as a cause of anaemia in people living with HIV, irrespective of virological and immunological HIV control. Environmental and age-group-specific risk factors should be considered.<\/jats:p>","DOI":"10.1136\/bcr-2025-264966","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T15:20:17Z","timestamp":1745853617000},"page":"e264966","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Parvovirus B19-associated pure red cell aplasia in the setting of HIV and competing health risks"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-4061","authenticated-orcid":false,"given":"Anne-Cecilia","family":"van Marle","sequence":"first","affiliation":[{"name":"Department of Haematology and Cell Biology, University of the Free State, Bloemfontein, South Africa"},{"name":"Department of Haematology and Cell Biology, Universitas Academic Hospital Laboratory, National Health Laboratory Service, Bloemfontein, Free State, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Erasmus","sequence":"additional","affiliation":[{"name":"Family Medicine, Kakamas District Hospital, Kakamas, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liezl","family":"du Plessis","sequence":"additional","affiliation":[{"name":"Paediatrics, Robert Mangaliso Sobukwe Hospital, Kimberley, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-2490","authenticated-orcid":false,"given":"Quintin Andre","family":"van Staden","sequence":"additional","affiliation":[{"name":"Department of Haematology and Cell Biology, University of the Free State, Bloemfontein, South Africa"},{"name":"Department of Haematology and Cell Biology, Universitas Academic Hospital Laboratory, National Health Laboratory Service, Bloemfontein, Free State, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2025082712113273000_18.4.e264966.1","unstructured":"Global HIV & AIDS statistics \u2014 fact sheet. UNAIDS. Available: https:\/\/www.unaids.org\/en\/resources\/fact-sheet [Accessed 22 Oct 2024]."},{"key":"2025082712113273000_18.4.e264966.2","unstructured":"StatsSA mid-year population estimates. 2021. Available: https:\/\/www.statssa.gov.za\/publications\/P0302\/P03022021.pdf [accessed 21 Nov 2024]"},{"key":"2025082712113273000_18.4.e264966.3","unstructured":"StatsSA mid-year population estimates, 2022. Available: https:\/\/www.statssa.gov.za\/publications\/P0302\/P03022022.pdf [accessed 21 Nov 2024]"},{"key":"2025082712113273000_18.4.e264966.4","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v21i1.1079"},{"key":"2025082712113273000_18.4.e264966.5","doi-asserted-by":"crossref","unstructured":"Opie J , Verburgh E , Bailly J , et al . Hematological Complications of Human Immunodeficiency Virus (HIV) Infection: An Update From an HIV-Endemic Setting. Open Forum Infect Dis 2024;11. doi:10.1093\/ofid\/ofae162","DOI":"10.1093\/ofid\/ofae162"},{"key":"2025082712113273000_18.4.e264966.6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12878-018-0102-7","article-title":"Prevalence of cytopenias in both HAART and HAART na\u00efve HIV infected adult patients in Ethiopia: a cross sectional study","volume":"18","author":"Fekene","year":"2018","journal-title":"BMC Hematol"},{"key":"2025082712113273000_18.4.e264966.7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1182\/blood.V91.1.301","article-title":"Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: results from the multistate adult and adolescent spectrum of HIV disease surveillance project","volume":"91","author":"Sullivan","year":"1998","journal-title":"Blood"},{"key":"2025082712113273000_18.4.e264966.8","doi-asserted-by":"crossref","first-page":"840","DOI":"10.7196\/SAMJ.2022.v112i11.16663","article-title":"Parvovirus B19: An opportunistic healthcare burden","volume":"112","author":"Goolam","year":"2022","journal-title":"S Afr Med J"},{"key":"2025082712113273000_18.4.e264966.9","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.jmii.2019.05.009","article-title":"Human parvovirus B19 infection in patients with or without underlying diseases","volume":"52","author":"Sim","year":"2019","journal-title":"J Microbiol Immunol Infect"},{"key":"2025082712113273000_18.4.e264966.10","doi-asserted-by":"crossref","first-page":"100334","DOI":"10.1016\/j.clinpr.2023.100334","article-title":"Parvovirus B19 induced acute severe anaemia in a well-controlled HIV-positive individual","volume":"21","author":"Swaine","year":"2024","journal-title":"Clin Infect Pract"},{"key":"2025082712113273000_18.4.e264966.11","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.3390\/v15051124","article-title":"Clinical Presentation of Parvovirus B19 Infection in Adults Living with HIV\/AIDS: A Case Series","volume":"15","author":"Mendes-de-Almeida","year":"2023","journal-title":"Viruses"},{"key":"2025082712113273000_18.4.e264966.12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/ID9.0000000000000091","article-title":"Pure Red Cell Aplasia Caused by Parvovirus B19 in Patients with Human Immunodeficiency Virus Infection: A Series of Four Cases","volume":"3","author":"Xu","year":"2023","journal-title":"Infect Dis Immun"},{"key":"2025082712113273000_18.4.e264966.13","doi-asserted-by":"crossref","first-page":"753","DOI":"10.7196\/SAMJ.2022.v112i9.16416","article-title":"Adult pure red cell aplasia at Universitas Academic Hospital, Bloemfontein, South Africa: A 9-year review","volume":"112","author":"Thibile","year":"2022","journal-title":"S Afr Med J"},{"key":"2025082712113273000_18.4.e264966.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0240918","article-title":"Transition from pediatric to adult care for adolescents living with HIV in South Africa: A natural experiment and survival analysis","volume":"15","author":"Zanoni","year":"2020","journal-title":"PLoS One"},{"key":"2025082712113273000_18.4.e264966.15","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1017\/S095026880600731X","article-title":"Current epidemiological aspects of human parvovirus B19 infection during pregnancy and childhood in the western part of Germany","volume":"135","author":"Enders","year":"2007","journal-title":"Epidemiol Infect"},{"key":"2025082712113273000_18.4.e264966.16","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/168.2.361"},{"key":"2025082712113273000_18.4.e264966.17","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.12688\/f1000research.120560.1","article-title":"Cost effectiveness of Electronic Gate Keeping (EGK) system on laboratory tests demand at a rural academic hospital in Eastern Cape, South Africa: a cross sectional study","volume":"11","author":"Mayekiso","year":"2022","journal-title":"F1000Res"},{"key":"2025082712113273000_18.4.e264966.18","doi-asserted-by":"crossref","first-page":"105","DOI":"10.7196\/SAJCH.2022.v16i2.1897","article-title":"Anaemia, iron and vitamin A status among South African school-aged children living with and without HIV","volume":"16","author":"Goosen","year":"2022","journal-title":"S Afr J Child Health"},{"key":"2025082712113273000_18.4.e264966.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0283645","article-title":"Determinants of anaemia among women of reproductive age in South Africa: A Healthy Life Trajectories Initiative (HeLTI)","volume":"18","author":"Silubonde","year":"2023","journal-title":"PLoS One"},{"key":"2025082712113273000_18.4.e264966.20","doi-asserted-by":"publisher","DOI":"10.2147\/HIV.S425807"},{"key":"2025082712113273000_18.4.e264966.21","doi-asserted-by":"crossref","first-page":"e182","DOI":"10.1097\/MPH.0000000000001338","article-title":"Hematologic Manifestations of Nutritional Deficiencies: Early Recognition is Essential to Prevent Serious Complications","volume":"41","author":"Yu","year":"2019","journal-title":"J Pediatr Hematol Oncol"},{"key":"2025082712113273000_18.4.e264966.22","unstructured":"Glatt N . The prevalence of parvovirus B19 infection in a cohort of HIV infected patients with severe anaemia. 2017."},{"key":"2025082712113273000_18.4.e264966.23","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.48.1.59"},{"key":"2025082712113273000_18.4.e264966.24","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1186\/s12889-024-18730-4","article-title":"Prevalence trends of anemia impairment in adolescents and young adults with HIV\/AIDS","volume":"24","author":"Li","year":"2024","journal-title":"BMC Public Health"},{"key":"2025082712113273000_18.4.e264966.25","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.2.257"},{"key":"2025082712113273000_18.4.e264966.26","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s13104-022-06006-2","article-title":"Past and current status of adolescents living with HIV in South Africa, 2005-2017","volume":"15","author":"Naidoo","year":"2022","journal-title":"BMC Res Notes"},{"key":"2025082712113273000_18.4.e264966.27","doi-asserted-by":"crossref","first-page":"e713","DOI":"10.1016\/S2352-3026(23)00160-6","article-title":"Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021","volume":"10","author":"Gardner","year":"2023","journal-title":"Lancet Haematol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-264966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:11:39Z","timestamp":1756321899000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-264966"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,28]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2025-264966"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-264966","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}