接受定期查的移植患者的BKPyVDNAemia:一个单中心队列研究
Daniel B Rasmussen1, Dina L Møller1, Sebastian R Hamm1
1Viro-Immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark.
Microorganisms
|January 23, 2024
概括
经过移植后,BK多瘤病毒 (BKPyV) 感染很常见,并可能损害移植功能. 监测BKPyVDNAemia对于预测移植受体的移植衰退和损失至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 病毒学 病毒学
- 移植免疫学 移植免疫学
背景情况:
- 乙基多瘤病毒 (BKPyV) 是一种机会性感染,在移植 (KT) 后经常遇到.
- BKPyV感染可能会对移植功能和存活产生负面影响.
- 了解BKPyVDNAemia的发病率,风险因素和结果对于患者管理至关重要.
研究的目的:
- 为了前性地确定BKPyVDNAemia在移植接受者的发病率.
- 确定与BKPyVDNAemia发展和严重程度相关的风险因素.
- 评估与BKPyVDNAemia相关的临床结果,包括与BCPyVDNAemia相关的移植功能和损失.
主要方法:
- 一项前性队列研究,涉及2012年至2020年601名脏移植接受者.
- 在KT后的多个时间点 (60日,90日,180日,270日,360日) 使用血PCR量化了BKPyVDNA水平.
- 确定了任何BKPyVDNAemia (≥1000副本/毫升) 和严重的BKPyVDNAemia (≥10,000副本/毫升) 的定义.
- 统计分析包括Aalen-Johansen累积发病率估计器和Cox比例危险模型用于风险因素评估.
主要成果:
- 任何BKPyVDNAemia和严重的BKPyVDNAemia的一年累积发病率分别为21%和13%.
- 严重BKPyVDNAemia的危险因素包括接受者年龄>50岁,男性性别,活体捐赠者和>3个HLA-ABDR不匹配.
- 任何BKPyVDNAemia都与移植功能下降的风险增加有关 (aHR, 2.26),以及严重的BKPyVDNAemia导致移植损失 (aHR, 3.18).
结论:
- BKPyV DNAemia 是移植后的一种严重并发症,具有显著的发病率和风险因素.
- BKPyVDNAemia的存在和严重程度与不良的移植结果有关,包括功能下降和损失.
- 定期监测BKPyVDNAemia后KT对于早期检测和管理至关重要,以保持移植的生存.
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