Microbiology and Virology Unit, University Hospital City of Health and Science of Turin, Corso Bramante 88, 10126 Turin, Italy.
Nephrology Unit, University Hospital City of Health and Science of Turin, Corso Bramante 88, 10126 Turin, Italy.
Viruses. 2020 Sep 20;12(9):1047. doi: 10.3390/v12091047.
In kidney transplant patients, polyomavirus-associated nephropathy (PVAN) represents a serious complication; the key factor for the development of PVAN is immunosuppression level and modulation of anti-rejection treatment represents the first line of intervention. Allograft biopsy and histology remain the criterion standard for diagnosing PVAN.
All consecutive renal biopsies with the diagnosis of PVAN carried out at the University Hospital City of Health and Science of Turin over a five-years period were studied. Renal allograft biopsy was performed due to renal function alterations associated to medium-high polyomavirus BK (BKV)-DNA levels on plasma specimen.
A total of 21 patients underwent a first biopsy to diagnose a possible BKV nephropathy, in 18, a second biopsy was made, in eight, a third biopsy, and finally, three underwent the fourth renal biopsy; following the results of each biopsies, immunosuppressant agents dosages were modified in order to reduce the effect of PVAN.
In this study, the clinical and histological features of 21 kidney transplant recipients with BKV reactivation and development of PVAN are described. To date, the only treatment for PVAN consists in the reduction of immunosuppressive agents, constantly monitoring viral load.
在肾移植患者中，多瘤病毒相关性肾病（PVAN）是一种严重的并发症；PVAN 发展的关键因素是免疫抑制水平，而抗排斥治疗的调节代表了干预的第一线。同种异体移植活检和组织学仍然是诊断 PVAN 的标准。
在都灵城市健康与科学大学医院进行了为期五年的多瘤病毒相关性肾病（PVAN）的连续肾活检研究。由于血浆标本中存在中等至高水平的多瘤病毒 BK（BKV）-DNA，肾功能发生改变，因此进行了肾同种异体移植活检。
共有 21 名患者进行了首次活检以诊断可能的 BKV 肾病，其中 18 名患者进行了第二次活检，8 名患者进行了第三次活检，最终有 3 名患者进行了第四次肾活检；根据每次活检的结果，调整了免疫抑制剂的剂量，以减轻 PVAN 的影响。
在这项研究中，描述了 21 名接受 BKV 再激活和发展为 PVAN 的肾移植受者的临床和组织学特征。迄今为止，PVAN 的唯一治疗方法是减少免疫抑制剂，同时持续监测病毒载量。
