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一项针对肾移植受者的前瞻性研究显示,不存在原发性JC多瘤病毒感染。

A prospective study of renal transplant recipients reveals an absence of primary JC polyomavirus infections.

作者信息

Saundh Baljit K, Baker Richard, Harris Mark, Hale Antony

机构信息

Leeds Teaching Hospital NHS Trust, Microbiology and Renal Unit, Leeds, United Kingdom.

Leeds Teaching Hospital NHS Trust, Microbiology and Renal Unit, Leeds, United Kingdom.

出版信息

J Clin Virol. 2016 Apr;77:101-5. doi: 10.1016/j.jcv.2016.02.015. Epub 2016 Feb 18.

Abstract

BACKGROUND

Both JC polyomavirus (JCPyV) and BK polyomavirus (BKPyV) are acquired at an early age. JCPyV causes progressive multifocal leukoencephalopathy and has been described in association with nephropathy.

OBJECTIVES

Urine and plasma samples from renal transplant recipients (RTRs) were examined for JCPyV to determine its involvement in causing infection and disease.

STUDY DESIGN

JCPyV testing was performed on 112 RTRs included in a randomised controlled study of steroid-sparing immunosuppressive regimens [1]. Urine and EDTA blood samples were collected pre- and post-transplantation and analysed for JCPyV using real-time PCR and sequencing to determine genotype and viral variation. Donor and recipient IgG antibody status to JCPyV was also determined.

RESULTS

Overall, 13.3% of RTRs were positive for JCPyV of which one patient developed viraemia without viruria. JCPyV DNA was detected early following transplantation (defined as five days post transplantation) from recipients with donors that were positive for JCPyV IgG antibodies. No dual cases of JCPyV and BKPyV were observed. One patient sample had sequence duplication in the non-coding control region.

CONCLUSIONS

Like BKPyV, JCPyV tends to occur early post transplantation but did not result in sustained viraemia. There was no deterioration of renal function in patients positive for JCPyV. As with other viruses, JCPyV donor serostatus was a risk factor for detection of JCPyV DNA. JCPyV appears to protect individuals from BKPyV infection, as recipients were twice as likely to develop BKPyV with a negative JCPyV donor.

摘要

背景

JC多瘤病毒(JCPyV)和BK多瘤病毒(BKPyV)均在幼年时获得感染。JCPyV可引起进行性多灶性白质脑病,且已被描述与肾病相关。

目的

检测肾移植受者(RTR)的尿液和血浆样本中的JCPyV,以确定其在引起感染和疾病中的作用。

研究设计

对112名纳入类固醇节省免疫抑制方案随机对照研究的RTR进行JCPyV检测[1]。在移植前后收集尿液和乙二胺四乙酸(EDTA)抗凝血样本,并使用实时聚合酶链反应(PCR)和测序分析JCPyV,以确定基因型和病毒变异。还确定了供体和受体针对JCPyV的IgG抗体状态。

结果

总体而言,13.3%的RTR的JCPyV呈阳性,其中1例患者出现病毒血症但无病毒尿。在移植后早期(定义为移植后5天),从供体JCPyV IgG抗体呈阳性的受体中检测到JCPyV DNA。未观察到JCPyV和BKPyV的双重感染病例。1例患者样本在非编码控制区存在序列重复。

结论

与BKPyV一样,JCPyV往往在移植后早期出现,但未导致持续性病毒血症。JCPyV阳性患者的肾功能没有恶化。与其他病毒一样,供体JCPyV血清状态是检测JCPyV DNA的一个危险因素。JCPyV似乎可保护个体免受BKPyV感染,因为JCPyV供体阴性的受体发生BKPyV感染的可能性是前者的两倍。

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