多瘤病毒感染在造血干细胞移植受者中的发病率、危险因素及影响
Incidence, risk factors and the effect of polyomavirus infection in hematopoietic stem cell transplant recipients.
作者信息
Hu Jianhua, Li Siying, Yang Meifang, Xu Lichen, Zhang Xuan, Zhao Hong, Dong Huihui, Huang Yaping, Fan Jun, Li Lanjuan
机构信息
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.
出版信息
J Int Med Res. 2017 Apr;45(2):762-770. doi: 10.1177/0300060517691795. Epub 2017 Mar 7.
Objective The effect of polyomavirus infection in HSCT recipients is poorly understood. Methods We evaluated 38 HSCT recipients. Polyomavirus was detected by nested qualitative polymerase chain reaction (PCR) assays of urine. The risk factors for BK virus and JC virus were analysed. The kidney and liver functions of infected and uninfected patients were compared. Results BK virus, JC virus, and simian virus 40 were detected in 21%, 42%, and 0% of HSCT recipients respectively. HCMV infection was found to be an independent risk factor for JC virus infection (odds ratio (OR): 8.528), while transplants with mismatched HLA are more susceptible to BK virus infection (OR: 12.000). Liver function of JC virus-infected subjects was worse than that of uninfected subjects. Conclusion We must be vigilant for opportunistic polyomavirus infections in HSCT recipients, especially those with HCMV co-infection or a mismatched HLA transplant. When unexplained liver function deterioration is observed, JC virus infection should be considered.
目的 对异基因造血干细胞移植（HSCT）受者多瘤病毒感染的影响了解甚少。方法 我们评估了38例HSCT受者。通过尿液巢式定性聚合酶链反应（PCR）检测多瘤病毒。分析BK病毒和JC病毒的危险因素。比较感染和未感染患者的肾和肝功能。结果 HSCT受者中BK病毒、JC病毒和猿猴病毒40的检出率分别为21%、42%和0%。发现人巨细胞病毒（HCMV）感染是JC病毒感染的独立危险因素（优势比（OR）：8.528），而HLA配型不合的移植受者更易感染BK病毒（OR：12.000）。JC病毒感染受试者的肝功能比未感染受试者差。结论 我们必须警惕HSCT受者中的机会性多瘤病毒感染，尤其是那些合并HCMV感染或HLA配型不合移植的患者。当观察到无法解释的肝功能恶化时，应考虑JC病毒感染。
Zotero 插件