Thomas Lora D, Vilchez Regis A, White Zoe S, Zanwar Preeti, Milstone Aaron P, Butel Janet S, Dummer Stephen
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
J Infect Dis. 2007 Feb 1;195(3):442-9. doi: 10.1086/510625. Epub 2006 Dec 22.
Polyomavirus infection causes renal dysfunction after kidney transplantation, but it has not been thoroughly investigated in nonrenal solid-organ transplantation.
Fifty lung-transplant recipients provided prospective urine and blood samples over the course of 17 months. Samples were analyzed for BK virus (BKV), JC virus (JCV), and simian virus 40 (SV40) using conventional polymerase chain reaction (PCR), sequence analysis, and quantitative real-time PCR.
Thirty-one (62%) of 50 patients had polyomavirus detected in at least 1 urine specimen, including 16 (32%) for BKV, 12 (24%) for JCV, and 6 (12%) for SV40. Mean BKV loads (5.0 log(10) copies/mL) did not differ from those of JCV (5.7 log(10) copies/mL; P=.38), but SV40 loads (2.5 log(10) copies/mL) were lower than those of BKV (P=.006) and JCV (P=.002). Blood samples were negative. Infection with individual polyomaviruses or polyomavirus infection in aggregate was not associated with reduced creatinine clearance. Patients not shedding polyomavirus had better survival than patients shedding polyomavirus (P=.049).
Polyomaviruses BKV and JCV were commonly detected in urine from lung-transplant recipients. SV40 was found in 12% of patients but was shed at a lower frequency and with lower viral loads than the other viruses. Polyomavirus infection was not associated with renal dysfunction.
多瘤病毒感染可导致肾移植后肾功能障碍，但在非肾实体器官移植中尚未得到充分研究。
50名肺移植受者在17个月的时间里前瞻性地提供了尿液和血液样本。使用传统聚合酶链反应（PCR）、序列分析和定量实时PCR对样本进行BK病毒（BKV）、JC病毒（JCV）和猿猴病毒40（SV40）分析。
50例患者中有31例（62%）在至少1份尿液标本中检测到多瘤病毒，其中BKV 16例（32%），JCV 12例（24%），SV40 6例（12%）。BKV平均载量（5.0 log₁₀拷贝/毫升）与JCV（5.7 log₁₀拷贝/毫升；P = 0.38）无差异，但SV40载量（2.5 log₁₀拷贝/毫升）低于BKV（P = 0.006）和JCV（P = 0.002）。血液样本均为阴性。单个多瘤病毒感染或多瘤病毒总体感染与肌酐清除率降低无关。未排出多瘤病毒的患者比排出多瘤病毒的患者生存率更高（P = 0.049）。
在肺移植受者的尿液中普遍检测到BKV和JCV。12%的患者检测到SV40，但与其他病毒相比，其排出频率较低且病毒载量较低。多瘤病毒感染与肾功能障碍无关。
