Correlation Between BK,JC Virus Infection And Renal Function In Patients After Renal Transplantation

Objective Renal transplantation is an important clinical method for the treatment of end-stage renal disease,but the application of various immunosuppressants can easily lead to the reactivation and infection of polyomavirus BK and JC in the recipient.Because transplant recipients are in a state of long-term immunosuppression,the probability of developing viremia and viremia is greatly increased,and in severe cases,it further develops into polyomavirus-associated nephropathy(PVAN)with poor prognosis,and nearly half of PVAN patients gradually develop into renal allograft failure.Previous studies have mainly focused on PVAN caused by BK virus,but there are few studies on the relationship between JC virus or two kinds of virus infection and renal function changes after transplantation.In recent years,some confirmed cases of PVAN with only JC viuria have been found,so the report of JC virus has been paid more and more attention.Methods From April 2018 to November 2021,97 patients with renal transplantation were selected as the research object through the convenient sampling method,the patients were followed up for 3 months.The BK virus and JC virus load in blood and urine were measured by real-time fluorescence quantitative PCR,the number and classification of lymphocytes were analyzed by flow cytometry,and the renal function index was detected by automatic biochemical analyzer.Observe the incidence of BK virus and JC virus infection,compare the renal function of patients with BK virus and JC virus infection,and analyze the correlation between BK virus and JC virus load and renal function indexes by linear correlation analysis.Results(1)The incidence of BK virus and JC virus infection in the renal transplantation group was29.90%,which was significantly higher than that in the healthy control group(4.00%).The incidence of abnormal renal function in patients with positive BK virus and JC virus infection was 62.07%,which was significantly higher than that in patients with negative BK virus and JC virus(P<0.05).(2)Logistic regression analysis showed that tacrolimus+mycophenolate mofetil+corticosteroid immunosuppressive regimen and lymphocyte level were factors affecting BK virus and JC virus infection.The virus positive rate in tacrolimus+mycophenolate mofetil+corticosteroid immunosuppressive regimen was higher than that in cyclosporine+mycophenolate mofetil+corticosteroid immunosuppressive regimen(P<0.05).(3)The lymphocyte counts of CD3~+,CD4~+and CD8~+T in patients with renal transplantation were lower than those in healthy people(P<0.05),and the number of CD3+T lymphocytes in patients with virus positive kidney transplantation was lower than that in patients with virus negative kidney transplantation(P<0.05).(4)The levels of serum creatinine,blood urea nitrogen and serum cystatin C in BK virus and JC virus positive patients were significantly higher than those in BK virus and JC virus negative patients,while complement C1q was significantly lower than that in BK virus and JC virus negative patients(P<0.05).The viral loads of BK and JC were positively correlated with serum creatinine,blood urea nitrogen and serum cystatin C levels(r>0,P<0.05),and negatively correlated with complement C1q(r<0,P<0.05).Conclusion Immunosuppression in patients after renal transplantation may lead to BK virus and JC virus infection;immunosuppression regimen and lymphocyte level may be high risk factors for virus reactivation;BK virus and JC virus infection may affect the host renal function,so renal function or virus infection should be monitored regularly in order to take timely intervention measures.