ABSTRACT
BK virus-(BKV) associated nephropathy (BKVN) is a major cause of allograft injury in kidney transplant recipients. In such patients, subclinical reactivation of latent BKV infection can occur in the pre-transplant period. The purpose of this study was to determine whether urinary BKV shedding in the immediate pre-transplant period is associated with a higher incidence of viruria and viremia during the first year after kidney transplantation. We examined urine samples from 34 kidney transplant recipients, using real-time quantitative polymerase chain reaction to detect BKV. Urine samples were obtained in the immediate pre-transplant period and during the first year after transplant on a monthly basis. If BKV viruria was detected, blood samples were collected and screened for BKV viremia. In the immediate pre-transplant period, we detected BKV viruria in 11 (32.3%) of the 34 recipients. During the first year after transplantation, we detected BKV viruria in all 34 patients and viremia in eight (23.5%). We found no correlation between pre-transplant viruria and post-transplant viruria or viremia (p = 0.2). Although reactivation of latent BKV infection in the pre-transplant period is fairly common among kidney transplant recipients, it is not a risk factor for post-transplant BKV viruria or viremia.
Subject(s)
BK Virus/genetics , DNA, Viral/biosynthesis , DNA, Viral/urine , Kidney Transplantation/adverse effects , Polyomavirus Infections/metabolism , Tumor Virus Infections/metabolism , Viremia/metabolism , Adolescent , Adult , Brazil/epidemiology , Female , Follow-Up Studies , Graft Survival , Humans , Incidence , Male , Middle Aged , Polyomavirus Infections/epidemiology , Polyomavirus Infections/virology , Prospective Studies , Real-Time Polymerase Chain Reaction , Risk Factors , Transplant Recipients , Tumor Virus Infections/epidemiology , Tumor Virus Infections/virology , Urinalysis , Viremia/epidemiology , Viremia/virology , Virus Shedding , Young AdultABSTRACT
OBJECTIVE: To evaluate the presence of JC virus DNA in CSF samples from Brazilian AIDS patients with focal lesions of CNS white matter without mass effect compatible with progressive multifocal leukoencephalopathy (PML). METHODS: CSF samples from AIDS patients with neurological symptoms and a CT scan showing focal lesions of CNS white matter without mass effect suggestive of PML, and from AIDS and non-AIDS patients with non-PML neurological diseases were tested for JC virus DNA by PCR. The primers used to amplify the T antigen region of the JC virus resulted in a 173-bp fragment. The presence of the JC virus was confirmed by digestion of the PCR product using BamH1. RESULTS: The PCR for JCV DNA was negative in 119/120 non-PML CSF samples (specificity =99.2%). Of 56 CSF samples from AIDS patients with focal lesions of CNS white matter without mass effect, JCV DNA was positive in 48.2% (27/56). In 23/29 (79.3%) JCV DNA-negative cases, other causes for the encephalitic lesions were found. No JCV DNA-positive cases showed other diagnoses. CONCLUSIONS: The prevalence of JCV DNA by PCR in CSF samples from Brazilian AIDS patients with focal brain lesions, without mass effect was 48.2%. In these patients, a negative JCV PCR is highly suggestive of other neurological conditions.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , DNA, Viral/cerebrospinal fluid , JC Virus/isolation & purification , Leukoencephalopathy, Progressive Multifocal/pathology , Leukoencephalopathy, Progressive Multifocal/virology , Acquired Immunodeficiency Syndrome/cerebrospinal fluid , Acquired Immunodeficiency Syndrome/virology , Adolescent , Adult , Brain/pathology , Brazil , Child , Female , Humans , JC Virus/genetics , Leukoencephalopathy, Progressive Multifocal/complications , Leukoencephalopathy, Progressive Multifocal/physiopathology , Male , Middle Aged , Polymerase Chain Reaction/methodsABSTRACT
Com o objetivo de se avaliar a magnitude da infeccao perinatal pelo citomegalovirus em hospital publico do municipio de Sao Paulo, os autores acompanharam prospectivamente 98 recem-nascidos ete o quarto mes de vida. Amostras de urina foram coletadas ao nascimento e posteriormente a cada mes, para inoculacao em tubos contendo fibroblastos humanos. Amostras de sangue foram coletadas ao nascimento, no segundo e quarto mes de vida para pesquisa de anticorpos IgM especificos para o CMV, pelo metodo de imunofluorescencia indireta. Dos 37 recem-nascidos que foram acompanhados ate o quarto mes de vida, 9 se infectaram neste periodo, com diagnostico feito pelo isolamento do CMV. O risco de aquisicao da infeccao pelo citomegalovirus no periodo perinatal estimado pela tabua de sobrevivencia foi de 30,9 por cento. A pesquisa de anticorpos IgM por imunofluorescencia so permitiu tal diagnostico em 2 casos (8,1 por cento). A diferenca observada entre os dois metodos foi estatisticamente significante (p = 0,015). O estudo da prevalencia de anticorpos IgG pelo ensaio imunoenzimatico nas maes das criancas mostrou taxas de 92,7 por cento. Nao se isolou CMV nas amostras de leite materno, coletadas mensalmente ate o terceiro mes de lactacao...
