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黄病毒与肾脏疾病

Flaviviruses and Kidney Diseases.

机构信息

Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.

出版信息

Adv Chronic Kidney Dis. 2019 May;26(3):198-206. doi: 10.1053/j.ackd.2019.01.002.

Abstract

The genus Flavivirus comprises approximately 73 viruses, which share several common aspects, such as dimension, structure, nucleic acid properties, and shape in electronic microscopy. Global incidence of flavivirus infection increased dramatically over the last decades, causing large outbreaks in several areas of the world. These viruses are expanding from endemic tropical and subtropical areas to previously nonendemic areas, affecting and causing diseases in millions of individuals worldwide and posing a formidable challenge to public health in several countries. The majority of clinically significant flavivirus-associated infections are mosquito borne (arboviruses-acronym for ARthropod-BOrne VIRUSES), such as dengue, yellow fever, Japanese encephalitis, Zika, and West Nile fever. Most diseases caused by flaviviruses are asymptomatic or manifest as self-limited, mild, undifferentiated febrile diseases. In a limited number of cases, these diseases may evolve to severe inflammatory, multisystem diseases, causing high morbidity and mortality. Some flaviviruses have been consistently identified in kidney tissue and urine and have been clinically associated with kidney diseases. In this review, we will provide an overview of the epidemiology, risk factors, kidney pathology, etiopathogenesis, and outcomes of acute and chronic kidney syndromes associated with dengue, yellow fever, Zika, and West Nile virus disease.

摘要

黄病毒属包含约 73 种病毒,这些病毒在尺寸、结构、核酸特性和电子显微镜下的形状等方面具有一些共同特征。在过去几十年中,全球黄病毒感染的发病率显著上升,在世界多个地区引发了大规模疫情。这些病毒从地方性热带和亚热带地区扩展到以前非地方性地区,影响并导致全球数百万人患病,对多个国家的公共卫生构成了严峻挑战。大多数具有临床意义的黄病毒相关感染是由蚊子传播的(虫媒病毒——节肢动物传播的病毒的缩写),如登革热、黄热病、日本脑炎、寨卡和西尼罗河热。大多数由黄病毒引起的疾病是无症状的,或表现为自限性、轻微、非特异性发热疾病。在少数情况下,这些疾病可能发展为严重的炎症性、多系统疾病,导致高发病率和死亡率。一些黄病毒一直被发现在肾脏组织和尿液中,并与肾脏疾病有临床关联。在这篇综述中,我们将概述与登革热、黄热病、寨卡和西尼罗河病毒病相关的急性和慢性肾脏综合征的流行病学、危险因素、肾脏病理学、病因发病机制和结局。

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