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一项观察性队列研究,用于在血中病毒复制后BK多重瘤病毒瘤病的组织学查

Evert Cleenders¹, Priyanka Koshy², Elisabet Van Loon³

¹Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Leuven Biostatistics and Statistical Bioinformatics Centre, KU Leuven, Leuven, Belgium.

Kidney international

|August 20, 2023

概括

对BKPyV-DNAemia进行系统查对于预防多重瘤病毒相关性病 (PyVAN) 至关重要. 血病毒载量有效预测PyVAN,使得活检对诊断和管理决策的必要性降低.

科学领域:

腎臟病學 (nephrology) 是一種醫學.
病毒学病毒学
移植免疫学移植免疫学

背景情况:

多重瘤病毒相关性病 (PyVAN) 是移植失败的重要原因.
建议对BKPyV-DNAemia进行系统查,以预防和治疗PyVAN.
在BCPyV-DNAemia期间通过活检区分假定 (SV40阴性) 和已证明 (SV40阳性) PyVAN的临床实用性尚未得到充分证实.

研究的目的:

在检测BKPyV-DNAemia时评估使用SV40免疫组织化学检查的脏活检的附加值.
为了评估血BKPyV病毒载荷和PyVAN的pvl分数的诊断性能.
为了确定SV40状态和病毒载量的预后值,用于移植后的病毒清除.

主要方法:

对2008-2017年间进行的950次移植进行了回顾性分析.
在并发活检中检测BKPyV-DNAemia和SV40免疫组织化学.
对血病毒载量和pvl评分进行诊断和预后价值的分析.

主要成果:

在26.3%的接受者中检测到BKPyV-DNAemia;9.6%的人呈阳性SV40.
血病毒载量显示高精度 (ROC-AUC 0.950) 预测SV40阳性.
血病毒载量低于4log10副本/毫升具有高负预测值 (0.989),用于排除SV40阳性.

结论:

基于SV40免疫组织化学的假定和已证实的PyVAN之间的区别具有有限的临床价值.
血BKPyV病毒载量是指导脏活检的必要性的可靠指标.
对于BKPyV-DNAemia的管理决策应该平衡病毒控制与排斥风险.

关键词:

活组织活检移植脏移植移植脏聚马病毒性腎病症 (polyomavirus nephropathy) 是一種多元病毒性腎病.查检查查检查查检查查检查

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