肾移植术后BK病毒感染研究进展

摘要

BK病毒是一种隶属于多瘤病毒种属的DNA病毒,在正常人群中的感染率高达90%。然而,仅在免疫功能受损的个体中引发相关疾病,以接受移植手术后服用免疫抑制药物的患者最为显著。 BK病毒的持续复制被认为是导致肾移植受者移植肾功能受损的重要因素,而由其引发的BK病毒性肾病( BKVN)则已成为肾移植失败的重要原因之一。应用尿细胞学染色和检测尿液或血液中BK病毒DNA载量等方法可对BK病毒感染和BKVN进行监测并早期诊断,增加了早期治疗的成功率。然而,由于缺乏特异性的抗病毒药物,BKVN的治疗仍然是非常困难。该文即针对肾移植术后BK病毒感染的流行病学、发病机制、实验室检测方法以及治疗策略的研究予以综述。%The BK virus,a DNA virus from the polyomavirus group,infects up to 90% of the general population. However,significant clinical manifestations are rare and limited to individuals with impaired im-mune functions,especially in the renal transplant recipients who recepted immunosuppressor. Persistent BK virus replication in patients with renal allografts was identified as an important cause of progressive graft dys-function,and the BK virus nephritis ( BKVN) has emerged as an important cause of renal transplant failure. Diagnostic strategies using urine cytology and BKV load measurements in urine or plasma have led to earlier diagnosis of BKV infection and BKVN,which increased the success rate of intervention. But due to the lack of specific antiviral drugs,the treatment of BKVN is difficult. In this review,we discuss the epidemiology,patho-genesis,detction method and current treatment protocols.