PDF(Pubmed)
Abstract：
Infection with BK polyomavirus (BKPyV) is a common opportunistic infection after kidney transplantation (KT) and may affect graft function. We aimed to determine the incidence, risk factors, and clinical outcomes of BKPyV DNAemia in a prospective cohort of 601 KT recipients transplanted from 2012 to 2020. BKPyV PCR on plasma was performed at days 60, 90, 180, 270, and 360 post-KT. Any BKPyV DNAemia was defined as a single BKPyV DNA of ≥1000 copies/mL. Severe BKPyV DNAemia was defined as two consecutive BKPyV DNA of ≥10,000 copies/mL. Cumulative incidences were investigated using the Aalen-Johansen estimator, and the risk factors were investigated in Cox proportional hazard models. The incidence of any BKPyV DNAemia and severe BKPyV DNAemia was 21% (18-25) and 13% (10-16) at one year post-KT, respectively. Recipient age > 50 years (aHR, 1.72; 95% CI 1.00-2.94; p = 0.049), male sex (aHR, 1.96; 95% CI 1.17-3.29; p = 0.011), living donors (aHR, 1.65; 95% CI 1.03-2.74; p = 0.045), and >3 HLA-ABDR mismatches (aHR, 1.72; 95% CI 1.01-2.94; p = 0.046) increased the risk of severe BKPyV DNAemia. Any BKPyV DNAemia was associated with an increased risk of graft function decline (aHR, 2.26; 95% CI 1.00-5.12; p = 0.049), and severe BKPyV DNAemia was associated with an increased risk of graft loss (aHR, 3.18; 95% CI 1.06-9.58; p = 0.039). These findings highlight the importance of BKPyV monitoring post-KT.
摘要：
BK多瘤病毒（BKPyV）感染是肾移植（KT）后常见的机会性感染，可能会影响移植物功能。我们的目的是确定发病率，危险因素，和BKPyVDNA血症的临床结果在2012年至2020年601KT移植受者的前瞻性队列中。在KT后第60、90、180、270和360天对血浆进行BKPyVPCR。任何BKPyVDNA血症被定义为≥1000拷贝/mL的单个BKPyVDNA。重度BKPyVDNA血症定义为两个连续的BKPyVDNA≥10,000拷贝/mL。使用Aalen-Johansen估计法对累积发病率进行了调查，并在Cox比例风险模型中调查危险因素。KT后一年，任何BKPyVDNA血症和严重BKPyVDNA血症的发生率分别为21％（18-25）和13％（10-16），分别。收件人年龄>50岁(AHR，1.72；95%CI1.00-2.94；p=0.049），男性(AHR,1.96；95%CI1.17-3.29；p=0.011），活着的捐赠者(AHR，1.65；95%CI1.03-2.74；p=0.045），和>3个HLA-ABDR错配(AHR，1.72；95％CI1.01-2.94；p=0.046）增加了严重BKPyVDNA血症的风险。任何BKPyVDNA血症都与移植物功能下降的风险增加相关(aHR，2.26；95%CI1.00-5.12；p=0.049），严重的BKPyVDNA血症与移植物丢失的风险增加相关(aHR，3.18；95%CI1.06-9.58；p=0.039）。这些发现强调了KT后BKPyV监测的重要性。
