Частота и динамика полиомавирусной инфекции после трансплантации почек

ЦЕЛЬ ИССЛЕДОВАНИЯ. Определение частоты детекции полиомавирусов BK и JC в моче и крови у больных после трансплантации почки (ТП) в зависимости от возраста и сроков после трансплантации. ПАЦИЕНТЫ И МЕТОДЫ. В исследование были включены 52 больных после ТП, в том числе 23 - с хроническим гломерулонефритом/нефросклерозом, 14 - с диабетической нефропатией, 8 - с IgA-нефропатией. Все больные получали стандартную иммуносупрессивную терапию. ДНК выделяли из клеток мочевого осадка и лейкоцитов периферической крови. Наличие вирусов BK и JC определяли методом геноспецифической ПЦР РЕЗУЛЬТАТЫ. Частота выявления полиомавирусов в клетках мочи составила, соответственно, 25 и 14% для вирусов ВК и JC. Полиомавирусы в периферической крови обнаружены в 33% (вирус ВК) и 28% проб (вирус JC). Вирурия и виремия для каждого типа полиомавирусов не были связаны друг с другом при отчетливой тенденции к сочетанному выявлению вирусов ВК и JC и в клетках мочи, и в лейкоцитах крови. Отмечена тенденция к повышению JC-позитивности в моче у больных старше 50 лет. Ко-инфекция вирусами ВК и JC определяется в 8% образцов мочи и 13% проб лейкоцитов. Частота JC-позитивных образцов мочи у больных с исходной диабетической нефропатией была достоверно выше, чем у остальных пациентов (33 против 23%, р=0,04), будучи особенно выраженной на 2-м году после ТП. ЗАКЛЮЧЕНИЕ. Полученные данные указывают на относительно высокую частоту выявления вирусов ВК и JC, включая ко-инфекцию, в клетках мочи и лейкоцитах крови и ее вероятную связь с возрастом, сроками после ТП и диабетом. Уточнение клинического и биологического значения полученных данных требует проведения дальнейших исследований.

трансплантация почки , иммуносупрессия , полиомавирус , вирус ВК , вирус JC , моча , кровь , ПЦР-диагностика

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