Parvovirus B19 and inflammatory arthritis: from viral mimicry to infection-associated autoimmunity.

INTRODUCTION

Parvovirus B19 is a clinically important viral mimic of systemic inflammatory rheumatic diseases, frequently presenting as an abrupt-onset inflammatory polyarthritis in adults. While typically self-limiting, B19V infection can induce transient autoantibodies, cytopenias, and phenotypes resembling rheumatoid arthritis or systemic lupus erythematosus. In specific contexts, it may also lead to persistent or atypical musculoskeletal manifestations.

AREAS COVERED: This narrative review summarizes the epidemiology, immunopathogenesis, clinical spectrum, diagnostic approach, and management of B19V-associated arthritis. Literature was identified through searches of PubMed/MEDLINE and relevant reference lists from inception to 23 September 2026, using terms related to parvovirus B19, arthritis, rheumatoid arthritis, autoimmunity, synovitis, cytokines, PCR, serology, and intravenous immunoglobulin.

EXPERT OPINION: B19V-associated arthritis should be recognized as a time-sensitive clinicovirological diagnosis, not merely a diagnosis of exclusion. Advancing the field requires prospective outbreak-based cohort studies, standardized diagnostic criteria, and the integration of virological and immunological biomarkers to distinguish self-limiting infection from evolving autoimmune disease.