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首页> 外文期刊>Transplantation: Official Journal of the Transplantation Society >Polyomavirus BK infection in pediatric kidney-allograft recipients: a single-center analysis of incidence, risk factors, and novel therapeutic approaches.
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Polyomavirus BK infection in pediatric kidney-allograft recipients: a single-center analysis of incidence, risk factors, and novel therapeutic approaches.

机译：小儿肾移植患者的多瘤病毒BK感染：发病率，危险因素和新颖治疗方法的单中心分析。

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BACKGROUNDAlthough a growing body of literature regarding polyoma BK virus (BKV) infection and associated interstitial nephritis in kidney-allograft recipients is becoming available, the impact of BKV infection in the pediatric population has not been fully evaluated.METHODSIn a retrospective analysis, we performed polymerase chain reaction (PCR) assays for BKV DNA in serum and urine samples from 100 pediatric kidney-allograft recipients referred to our institution in the last 5 years.RESULTSBKV viruria was observed in 26 of 100 patients, whereas BKV viremia was demonstrated in 5 patients. Serum creatinine was significantly higher in recipients with positive BK viremia compared with BKV DNA-negative patients (mean 2.66 vs. 1.14 mg/100 mL). Renal biopsy performed in 3 of 5 patients showed graft damage consistent with interstitial nephropathy. In the univariate analysis, negative antibody status of the recipient and the presence of mycophenolate mofetil in baseline immunosuppression were the two factors predictive of active BKV infection.CONCLUSIONSOur study shows that BKV-associated nephropathy is a relevant complication in the pediatric kidney transplantation setting also. Identification of patients at risk of developing virus-associated nephropathy, through prospective quantification of viral load, could improve clinical outcome by allowing the use of timely preemptive therapy guided by BKV DNA levels.
机译：背景技术尽管越来越多的文献报道了肾移植患者中多瘤BK病毒（BKV）感染和相关性间质性肾炎的文献，但尚未完全评估BKV感染对小儿人群的影响。方法在回顾性分析中，我们进行了聚合酶在最近5年中，我们的100名儿科肾脏移植患者接受了血清和尿液样本中BKV DNA的链反应（PCR）分析.100名患者中有26名发现了RESULTSBKV病毒血症，而5名患者中发现了BKV病毒血症。与BKV DNA阴性的患者相比，BK病毒血症阳性的患者的血清肌酐明显更高（平均2.66 vs. 1.14 mg / 100 mL）。 5名患者中有3名进行的肾脏活检显示出与间质性肾病相一致的移植物损害。在单变量分析中，受体的阴性抗体状态和基线免疫抑制中霉酚酸酯的存在是预测活动性BKV感染的两个因素。结论我们的研究表明，BKV相关性肾病也是小儿肾脏移植环境中的相关并发症。通过对病毒载量进行前瞻性定量鉴定，确定有发展为病毒相关肾病风险的患者，可以通过使用以BKV DNA水平为指导的及时抢先治疗来改善临床结果。

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