Helanterä Ilkka, Ortiz Fernanda, Auvinen Eeva, Räisänen-Sokolowski Anne, Lappalainen Maija, Lautenschlager Irmeli, Koskinen Petri
Department of Medicine, Division of Nephrology, Helsinki University Central Hospital and University of Helsinki, FIN-00029 HUS, Helsinki, Finland.
Transpl Int. 2009 Jul;22(7):688-93. doi: 10.1111/j.1432-2277.2009.00847.x. Epub 2009 Feb 10.
Since 2003, only one case of polyomavirus-associated nephropathy (PVAN) has occurred in our clinic despite screening protocols. In contrast to BK virus, the role of JC virus in PVAN is unclear. We studied the incidence and impact of polyomavirus BK and JC viruria and PVAN in well-matched Finnish kidney transplant recipients. All Helsinki University Hospital kidney transplant recipients between 2004 and 2006 were prospectively followed (n = 163). Patients with a 12-month protocol-biopsy taken and polyomavirus urinary secretion screened by PCR were studied (n = 68). Cyclosporine-based triple-drug immunosuppression was usually used. BK or JC viruria was detected in 18 (27%) and 14 (21%) patients after transplantation respectively. Persistent BK or JC viruria was found in 5 (7%) and 9 (13%) patients. No cases of PVAN were diagnosed from protocol biopsies or from biopsies taken for clinical indications. A positive BK or JC viruria or persistent viruria was not associated with reduced renal function at follow-up, histopathologic changes in 12-month protocol biopsies, or acute rejections. The incidence of BK and JC viruria was similar to what has been previously reported, but no cases of polyomavirus-associated nephropathy were seen in our well-matched kidney transplant population.
自2003年以来，尽管有筛查方案，但我们诊所仅发生过1例多瘤病毒相关性肾病（PVAN）。与BK病毒不同，JC病毒在PVAN中的作用尚不清楚。我们研究了多瘤病毒BK和JC病毒尿症以及PVAN在匹配良好的芬兰肾移植受者中的发生率和影响。对2004年至2006年间赫尔辛基大学医院的所有肾移植受者进行了前瞻性随访（n = 163）。对进行了12个月方案活检并通过PCR筛查多瘤病毒尿分泌的患者进行了研究（n = 68）。通常使用基于环孢素的三联药物免疫抑制。移植后分别在18例（27%）和14例（21%）患者中检测到BK或JC病毒尿症。在5例（7%）和9例（13%）患者中发现了持续性BK或JC病毒尿症。方案活检或因临床指征进行的活检均未诊断出PVAN病例。随访时，BK或JC病毒尿症阳性或持续性病毒尿症与肾功能降低、12个月方案活检中的组织病理学变化或急性排斥反应无关。BK和JC病毒尿症的发生率与先前报道的相似，但在我们匹配良好的肾移植人群中未发现多瘤病毒相关性肾病病例。
