Parvovirus B19 in Kidney Transplant Recipients: Prevalence and Clinical Spectrum in an Albanian Cohort

(1) Background: Parvovirus B19 (B19V) represents an underrecognized viral complication in kidney transplant recipients (KTR), with a clinical spectrum ranging from asymptomatic viremia to severe anemia and pure red cell aplasia (PRCA). Data on the prevalence of B19V in the Albanian population and the wider Western Balkans are currently lacking. (2) Methods: We conducted a cross-sectional, multi-center study at two Albanian tertiary referral centers, universally screening 110 kidney transplant recipients for B19V DNAemia by centralized PCR testing. Patients were classified as asymptomatic or symptomatic based on clinical and laboratory correlates. A secondary analysis compared B19V positivity between early (≤1 year) and late (>1 year) post-transplant periods. (3) Results: B19V DNAemia was identified in 4 of 110 patients (3.6%, 95% CI 1.4–9.0%). Two patients were asymptomatic, with normal hematologic and renal parameters. Two patients were symptomatic: one developed pure red cell aplasia 2 months post-transplant, confirmed by bone marrow examination, managed with immunosuppression reduction and intravenous immunoglobulin (IVIG). The other, with a previously failed allograft on maintenance hemodialysis, developed probable B19V-associated anemia 96 months post-transplant and achieved full hematologic recovery following complete immunosuppression withdrawal alone. B19V positivity did not differ significantly between early and late post-transplant groups (4.2% vs. 3.5%, p = 1.000, Fisher’s exact test), though this comparison was underpowered given the small number of positive cases. (4) Conclusions: B19V DNAemia occurs in a small but clinically relevant proportion of KTR with a broad clinical spectrum across the post-transplant course and should be incorporated into the differential diagnosis of severe, unexplained anemia in this population.