在艾滋病毒感染的脏移植接受者中管理BK病毒感染的挑战
Dante A Puntiel1, Jayalakshmi N Alagar1, Julienne Jeong1
1Department of Surgery, Temple University Hospital, Philadelphia, PA.
Transplantation proceedings
|November 13, 2025
概括
艾滋病毒阳性移植接受者面临着由BK病毒病 (BKVN) 引起的移植损失的更高风险. 关键的风险因素包括延迟的移植功能,HLA不匹配,较老的捐赠者/接受者年龄,以及糖尿病史.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
- 病毒学 病毒学
背景情况:
- 在免疫抑制下BK病毒 (BKV) 的重新激活威胁到移植,导致BK病毒病 (BKVN).
- 由于平衡免疫抑制,抗逆转录病毒疗法和药物相互作用,在HIV阳性患者中管理BKVN是复杂的.
研究的目的:
- 调查BKVN发病率,风险因素和艾滋病毒阳性移植接受者的结局.
- 为了将这些发现与HIV阴性脏移植接受者进行比较.
主要方法:
- 使用了联合器官共享网络数据库 (2009年8月至2022年2月).
- 包括已知艾滋病毒状况的移植接受者,但不包括年龄在18岁以下或曾经接受过移植的人.
- 采用参数和非参数测试来确定HIV阳性个体中BKVN的风险因素.
主要成果:
- 艾滋病毒阳性接受者有较高的BKVN相关的移植损失发病率 (0.8%对0.3%,P<.001).
- 艾滋病毒阳性接受者中BKVN的显著风险因素包括延迟的移植功能,更大的HLA不匹配,较老的捐赠者/接受者年龄和糖尿病史.
- 艾滋病毒阳性BKVN患者的移植存活时间较短 (P = .044).
结论:
- 艾滋病毒阳性移植接受者由于BKVN而增加了移植损失的风险.
- 延迟的移植功能,HLA不匹配,先进的捐赠者/接受者年龄和糖尿病是该人群中BKVN的关键风险因素.
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