Division of Pediatric Nephrology, University of Florida College of Medicine & Shands Children's Hospital, 1600 SW Archer Road, PO Box 100296/HD 214, Gainesville, FL 32610-0296, USA.
Pediatr Nephrol. 2011 Oct;26(10):1763-74. doi: 10.1007/s00467-010-1716-6. Epub 2010 Dec 15.
The BK virus, a DNA virus from the Polyomavirus group, represents an opportunistic infection of immunosuppressed transplant recipients. Though the virus was discovered approximately 40 years ago, the emergence of BK virus nephropathy since 1995 onwards, with associated high graft loss rates, has revolutionized renal transplantation medicine. Kidney transplant professionals realized that the consequences of over-immunosuppression were as severe as the consequences of under-immunosuppression and we entered the era of immunosuppressive minimization. Despite this recognition, the optimal testing type for BK virus infections and frequency of testing are hotly debated. Similarly, optimal treatment strategies remain sources of intense controversy. The authors review the current strategies of screening, diagnosis, and possible treatment, and also review the amount and quality of evidence in favor or against. Similarities and differences between cytomegalovirus, Epstein-Barr virus, and BV virus, the three major viral infections in kidney transplantation, are highlighted.
BK 病毒是一种来自多瘤病毒科的 DNA 病毒，代表了免疫抑制移植受者的机会性感染。尽管该病毒大约在 40 年前被发现，但自 1995 年以来，BK 病毒肾病的出现以及与之相关的高移植物丢失率，彻底改变了肾移植医学。肾脏移植专业人员意识到过度免疫抑制的后果与免疫抑制不足的后果一样严重，我们进入了免疫抑制最小化的时代。尽管有了这种认识，但 BK 病毒感染的最佳检测类型和检测频率仍存在争议。同样，最佳治疗策略仍然是激烈争论的来源。作者回顾了目前的筛查、诊断和可能的治疗策略，并回顾了支持或反对这些策略的证据数量和质量。本文还强调了肾移植中三种主要病毒感染（巨细胞病毒、EB 病毒和 BK 病毒）之间的相似之处和不同之处。
