Viruses identified in endomyocardial biopsy samples in idiopathic dilated cardiomyopathy patients in central South Africa

  • H.A. Hanekom University of the Free State https://orcid.org/0000-0003-4133-2709
  • E.M. Makotoko University of the Free State
  • L. Botes Central University of Technology
  • S.C. Brown University of the Free State
  • C. Baumeier Institut Kardiale Diagnostik und Therapie
  • H.-P. Schultheiss Institute of Cardiac Diagnostics and Therapy
  • F.E. Smit University of the Free State
DOI: https://doi.org/10.24170/22-2-6739

Abstract

Background: Heart failure and cardiomyopathy are problematic in South Africa. Viruses are important causes of myocarditis and cardiomyopathy. This study aimed to determine the distribution of viruses in endomyocardial heart biopsy samples in patients with dilated cardiomyopathy.

Methods: Endomyocardial biopsies (EMB) were analysed using histology, immunohistochemical staining, and polymerase chain reaction. The level of fibrosis, presence and type of cellular infiltration, and the prevalence of viral genomes with their replication activity were determined. 

Results: Viral genomes were found in 73.7% of patients, with parvovirus B19 (B19V) present in 96.4%. No Coxsackievirus was identified, and 2 patients presented with transcriptional intermediates, which indicated active B19V viral replication. Most patients (71.4%) presented with single infections, but some (28.6%) with co-infections. Three patients presented with acute myocardial inflammation and moderate / severe increased lymphocytic infiltration. 

Conclusions: This study found B19V predominant and present in almost all virus-positive EMB samples. Our results support the possible virus etiological shift towards B19V. These findings underscore the need to further investigate the pathophysiological role of B19V in the development and progression of DCM.

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Author Biographies

H.A. Hanekom, University of the Free State

Department of Cardiothoracic Surgery, Robert W.M. Frater Cardiovascular Research Centre, School of Clinical Medicine, University of the Free State, Bloemfontein

E.M. Makotoko, University of the Free State

Department of Cardiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein

L. Botes, Central University of Technology

Department of Health Sciences, Central University of Technology, Bloemfontein

S.C. Brown, University of the Free State

Department of Paediatric Cardiology, School of Clinical Medicine, University of the Free State, Bloemfontein

C. Baumeier, Institut Kardiale Diagnostik und Therapie

Institute of Cardiac Diagnostics and Therapy, IKDT Institut Kardiale Diagnostik und Therapie GmbH, Berlin, Germany

H.-P. Schultheiss, Institute of Cardiac Diagnostics and Therapy

Institute of Cardiac Diagnostics and Therapy, IKDT GmbH, Berlin, Germany

F.E. Smit, University of the Free State

Department of Cardiothoracic Surgery, Robert W.M. Frater Cardiovascular Research Centre, School of Clinical Medicine, University of the Free State, Bloemfontein

Published
2025-06-19
Issue
Vol. 22 No. 2 (2025)
Section
Articles

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