False-negative serology in patients with acute parvovirus B19 infection

J Clin Virol. 2011 Jun;51(2):115-20. doi: 10.1016/j.jcv.2011.03.012. Epub 2011 May 6.


Background: Acute parvovirus B19 (B19V) infection is characterized by high-level viremia. Antibodies against the capsid proteins VP1 and VP2 may complex with B19V-particles thereby becoming undetectable in diagnostic tests.

Objectives: We intended to obtain data on the frequency of false-negative serology in acute B19V-infection.

Study design: 129 plasma or serum samples of healthy blood donors and of patients with suspected B19V-infection were analyzed for B19V-DNA by qPCR and VP1/VP2-specific IgG and IgM by ELISA. Eleven of these samples were derived from four pregnant women with previous contact to B19V-infected individuals. Using acidic conditions virus/antibody-complexes were disrupted and detected by WesternLine and ELISA.

Results: 83/118 samples were derived from acutely infected individuals displaying viremia (10(3)-10(12)geq/mL). In 24/83 viremic samples (28.9%) VP1/VP2-specific IgM and IgG were undetectable in ELISA, but could be demonstrated to be complexed with B19V-particles. Each 7/83 (8.4%) was IgM-positive/IgG-negative and IgM-negative/IgG-positive, in 45/83 samples (54.2%) IgG and IgM could be detected. 35 samples did not contain B19V-DNA; five of these were from seronegative persons. Analyzing consecutive sera derived from four pregnant women, B19V-DNA was demonstrated in 10/11 samples, B19V-specific IgG- and IgM-antibodies were detectable in 10/11 and 4/11 samples, respectively. In 2/4 women seroconversion was observed, but IgM was not detected in 50% of the samples. B19V-specific IgG but not IgM was detectable in 2/4 women.

Conclusion: Acute B19V-infection cannot be diagnosed by exclusive analysis of B19V-specific antibodies. Only the combination of assays for detection of B19V-DNA and antibodies enables correct serodiagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Viral / blood*
  • DNA, Viral / blood*
  • Enzyme-Linked Immunosorbent Assay
  • False Negative Reactions*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Parvoviridae Infections / diagnosis*
  • Parvoviridae Infections / virology
  • Parvovirus B19, Human / immunology*
  • Parvovirus B19, Human / isolation & purification*
  • Pregnancy
  • Serologic Tests


  • Antibodies, Viral
  • DNA, Viral
  • Immunoglobulin G