How are patients with chronic joint symptoms arising from parvo B19 treated?
Treatment of the acute arthritis associated with parvo B19 is generally supportive, which includes NSAIDs and rest. Persistent arthritis is reported in only a small percentage of patients, and hydroxychloroquine may be successful in this setting. Some patients with chronic parvo B19 arthropathy are unable to develop IgG antibodies to the minor capsid protein VP1, which encodes neutralizing epitopes. This may account for their inability to clear viral B19 DNA. In these patients with chronic joint pain and persistent B19 IgM antibodies and/or viral B19 DNA, intravenous immunoglobulin may be an effective treatment, although it appears to be more effective in immunocompromised (hypogammaglobulinemic) patients.
