Pollara Caterina Patrizia, Corbellini Silvia, Chiappini Stefania, Sandrini Silvio, De Tomasi Dolores, Bonfanti Carlo, Manca Nino
Institute of Microbiology, University of Brescia, A.O. Spedali Civili, Brescia, Italy. patriziapollara@libero
New Microbiol. 2011 Apr;34(2):165-71. Epub 2011 Apr 30.
Infection by polyomavirus BK (BKV) is an emerging problem in the clinical management of renal transplant patients because it is responsible for nephropathy and consequently can cause loss of the transplanted organ (BKV associated nephropathy, BKVAN). Aim of this study was to evaluate the use of blood viral load measurement as a screening tool for diagnosis of BKV infection and to identify a threshold value for the management of patients. A total of 75 kidney transplant patients, corresponding to 338 consecutive plasma samples, were analyzed by an automatic system for nucleic acid extraction and quantitative real-time polymerase chain reaction (PCR) for detection of BKV. BKV was detected in 170 samples (26 patients) with a median viral load of 4.1 log10 copies/mL; among these 26 patients, seven (34.7%) were found to have BKVAN on allograft biopsy together with a median viral load of 5 log10 copies/mL. The ROC curve analysis identified a viral load equal to 4.1 log10 copies/mL as the best discriminant cut-off value to predict the disease and to identify patients at risk of developing BKVAN.
多瘤病毒BK（BKV）感染是肾移植患者临床管理中一个新出现的问题，因为它会导致肾病，进而可能导致移植器官丧失（BKV相关性肾病，BKVAN）。本研究的目的是评估血液病毒载量检测作为BKV感染诊断筛查工具的应用，并确定用于患者管理的阈值。通过自动核酸提取系统和定量实时聚合酶链反应（PCR）对总共75例肾移植患者（对应338份连续血浆样本）进行分析，以检测BKV。在170份样本（26例患者）中检测到BKV，病毒载量中位数为4.1 log10拷贝/mL；在这26例患者中，7例（34.7%）在移植肾活检时被发现患有BKVAN，病毒载量中位数为5 log10拷贝/mL。ROC曲线分析确定病毒载量等于4.1 log10拷贝/mL为预测疾病和识别有发生BKVAN风险患者的最佳判别临界值。
