Clinical Study On BK And JC Virus Infection In Kidney Recipients

Objective:To study BK and JC virus infection features and analyse risk factors of BK and JCvirus infection.Methods:From June to December in2013,60cases of kidney recipients in PLA309Hospitalwere collected in this study.Regularly following up for twelve months and taking urinespecimens and blood samples at the fifth day，one month，three months，six months andtwelve months, we recorded their gender, age,immunosuppressive regimen, source forkidney,renal function and asked whether they had been in the presence or absence ofdiabetes, delayed graft function recovery (DGF), steroid pulse therapy and lunginfections. According to the virus DNA load detected by detection kit and fluorescencequantitative real-time PCR technology,we divided recipients into three groups:viremia,viruria, normal control. Measurement data using t test,F test or rank sum test,count datausing the chi-square test or rank sum test,the data was analysed by SPSS16.0. Renalfunction was compared in these groups and risk factors were analysed by logisticregression.Results:(1)BK viremia and viruria incidence rates of the60recipients were5%(3/60),26.7%(16/60). JC viremia and viruria incidence rates of the60recipients were0%(0/60),16.7%(10/60).JC viruria was first positive in the fifth day after renaltransplantation, however BK viruria was first positive in a month after renaltransplantation. JC and BK virus both had a high positive rate in3to6months afterrenal transplantation.But no concomitant BK and JC virus infection recipients appear.(2)Univariate analysis showed that recipient age, gender, type of donor kidney anddiabetes mellitus had no correlation with BK virus infection. recipient age, gender, typeof donor kidney,diabetes mellitus,whether to use the ATG immune induction, with orwithout DGF, lung infection had no correlation with JC virus infection. Howevercompared to CsA,FK506administration based immunosuppressive regimen waspositively correlated with BK virus infection (r=0.288,P=0.018). ATG immuneinduction(r=0.154,P=0.033), impact of hormone therapy(r=0.186,P=0.027),DGF(r=0.19 3,P=0.040) and lung infection(r=0.201,P=0.030) were all correlated with BK virusinfection.however ATG immune induction(r=0.125,P=0.048) and impact of hormonetherapy (r=0.211,P=0.039) were both correlated with JC virus infection.(3) Multivariate analysis showed that FK506administration based immunosuppressiveregimen(OR=6.620,P=0.032)、using ATG immune induction(OR=1.126,P=0.044) andimpact of hormone therapy(OR=1.753,P=0.026) were all risk factors of BK virusinfection，however there is no obvious risk factors of JC virus infection.Conclusion:JC and BK virus both had a high positive rate in3to6months after renaltransplantation, however JC viruria was first positive in the fifth day after renaltransplantation and BK viruria was first positive in a month. early diagnosis of thesepolyomaviruses is important. BK virus infection risk factors contained FK506-basedimmunosuppressive regimen, ATG immune induction, the impact of hormone therapy,and JC virus infection may be associated with ATG induction and steroid pulse therapy.