Analysis of the current status and prognosis of BKV, JCV, CMV and EBVviruria infections in renal transplant patients within one year after surgery
10.3760/cma.j.cn114452-20240819-00465
- VernacularTitle:肾移植患者术后1年内BKV、JCV、CMV、EBV病毒尿症感染现状及预后分析
- Author:
Qian HUANG
1
;
Tianming LI
;
Xiaowei MA
;
Lin ZHAO
;
Ruoyang CHEN
;
Min LI
;
Xiaoying CHEN
Author Information
1. 上海交通大学医学院附属仁济医院检验科，上海 200125
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Infection rate;
BK virus;
JC virus;
Cytomegalovirus;
Epstein-Barr virus
- From:
Chinese Journal of Laboratory Medicine
2025;48(5):628-633
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to analyze the infection status of viral viruria within one year after kidney transplantation, its impact on renal allograft function, and associated risk factors.Methods:A retrospective case-control study was conducted, involving 370 patients who underwent allogeneic kidney transplantation at Renji Hospital, Shanghai Jiao Tong University School of Medicine, from January 1, 2020 to December 31, 2021. Urinary viral loads of BK virus (BKV), JC virus (JCV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) were detected using PCR fluorescent probe assays. Patients were categorized into infection and non-infection groups. Glomerular filtration rate (GFR) and tacrolimus trough concentration was measured during infections, and clinical data were collected. Univariate analysis was performed to identify risk factors for viral viruria.Results:The 1-year patient survival rate and graft survival rate were both 98.6%. The incidence rates of viral viruria were as follows: JCV (42.7%), BKV (29.7%), CMV (11.6%), and EBV (2.9%), with statistically significant differences among viruses ( P<0.001). Single viral infection accounted for 48% of cases, while co-infections were predominantly BKV+JCV (9%). JCV infection rates remained consistently high throughout the year (22.4%-28.9%), whereas BKV infections peaked at 3 months postoperatively (20.5%). Co-infection with low-load JCV (>2 000 copies/ml) and CMV (>6 000 copies/ml) led to a significant decline in GFR at 6 months post-transplantation [median difference: 16.7 ml/(min×1.73 m2), P=0.019]. Univariate analysis revealed that elevated tacrolimus trough concentration was independent risk factor for BKV (4.90 vs. 4.30 ng/ml, Z=4.29, P<0.001) and JCV infections (5.30 vs. 4.80 ng/ml, Z=4.25, P<0.001). Conclusion:High incidences of JCV and BKV infections were observed post-kidney transplantation. Co-infection with low-load JCV and CMV accelerates renal function impairment, highlighting the critical role of tacrolimus concentration management in reducing viral infection risks.
