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肾移植后第一年频繁发生细小病毒 B19 DNA 血症。

Frequent occurrence of parvovirus B19 DNAemia in the first year after kidney transplantation.

机构信息

Clinical and Molecular Virology Unit, University Hospital and EA-4684 Cardiovir SFR-CAP santé, Faculty of Medicine, Reims, France.

出版信息

J Med Virol. 2013 Jun;85(6):1115-21. doi: 10.1002/jmv.23557.

DOI:10.1002/jmv.23557
PMID:23588740
Abstract

Described for the first time in 1986, Parvovirus B19 (B19V) infection in kidney transplant recipients remains little-known and probably underestimated. The aims of this study were to establish B19V infection frequency during the first year after kidney transplant and to determine predisposing factors and manifestations of the infection in renal transplant recipients. Sixty consecutive adult patients, transplanted less than a year before, were included in this study. B19V and other opportunistic viral infections were detected retrospectively in plasma samples collected every 15 days during the first 3 months and every month from 3 months to 1 year following the kidney transplant. Demographic characteristics, immunosuppressive treatment and biological findings were recorded on each sampling date. Six patients (10%) presented B19V viremia, while eight CMV (13.3%), seven EBV (11.7%), five HHV-6 (8.3%), five BKV (8.3%), and two adenovirus (3.3%) infections were detected. The mean value of B19V viral load was 149 UI/ml. B19V infections were either reactivation or reinfection due to genotype two in five cases, while one case of primary infection with genotype 1 was observed. Neither risk factors nor biological consequences of B19V infection have been identified. These results rank B19V third among opportunistic viral infections occurring during the first year after a kidney transplant. With regard to this high incidence, and even if the risk factors and biological consequences of the infection should be assessed in larger studies, the question of systematic screening and follow-up of B19V infection in kidney transplant recipients is relevant.

摘要

1986 年首次描述的肾移植受者细小病毒 B19(B19V)感染仍然鲜为人知,可能被低估。本研究的目的是确定肾移植后 1 年内 B19V 感染的频率,并确定肾移植受者感染的易患因素和表现。本研究纳入了 60 例在肾移植前不到 1 年接受移植的成年患者。回顾性检测了血浆样本中的 B19V 和其他机会性病毒感染,这些样本在肾移植后第 1 个月的前 3 个月内每 15 天采集一次,第 3 个月至第 1 年内每月采集一次。在每个采样日期记录了人口统计学特征、免疫抑制治疗和生物学发现。6 名患者(10%)出现 B19V 血症,8 名患者(13.3%)出现 CMV 感染,7 名患者(11.7%)出现 EBV 感染,5 名患者(8.3%)出现 HHV-6 感染,5 名患者(8.3%)出现 BKV 感染,2 名患者(3.3%)出现腺病毒感染。B19V 病毒载量的平均值为 149 UI/ml。由于基因型 2,5 例为再激活感染,1 例为原发性感染,其余 8 例 CMV、7 例 EBV、5 例 HHV-6、5 例 BKV 和 2 例腺病毒感染均为再感染。未发现 B19V 感染的危险因素或生物学后果。这些结果表明,B19V 在肾移植后 1 年内发生的机会性病毒感染中排名第三。鉴于这种高发病率,即使需要在更大的研究中评估感染的危险因素和生物学后果,但对肾移植受者进行 B19V 感染的系统筛查和随访的问题仍然值得关注。

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