HIV感染者尿JC多瘤病毒与肾功能关系5年随访分析  

Analysis of the Relationship Between Urinary JC Virus and Renal Function in HIV-infected Patients with Five-year Follow-up

作　　者：闫俊 王梦嫣 张忠东 李峰 郑融融 孙岩 师金川 YAN Jun;WANG Mengyan;ZHANG Zhongdong(The Second Department of Infection,Xixi Hospital of Hangzhou,Zhejiang 310023,China)

机构地区：[1]杭州市西溪医院感染二科,310023

出　　处：《医学研究杂志》2024年第6期84-88,共5页Journal of Medical Research

基　　金：浙江省医药卫生科技计划面上项目(2021KY940);浙江省杭州市卫生科技计划一般(A)类项目(A20200172)。

摘　　要：目的探讨HIV感染者尿液中JC多瘤病毒(JC polyomavirus,JCV)和BK多瘤病毒(BK polyomavirus,BKV)的阳性率,评估长期随访尿JCV阳性与肾功能及淋巴细胞计数的关系。方法纳入杭州市西溪医院感染二科门诊随访的HIV-1阳性的感染者共180例。收集其尿液标本,进行JCV和BKV检测。回顾性并持续性随访收集患者抗病毒治疗(antiretroviral therapy,ART)前基线及随访1、2、3、4、5年的肾功能及CD4^(+)细胞计数等。结果180例HIV-1阳性感染者尿液中JCV的检出率为25.55%(46/180),BKV的检出率为1.67%(3/180)。患者ART前基线尿JCV阳性组总淋巴细胞数为1699.62±790.44个/微升,小于尿JCV阴性组总淋巴细胞数(2113.59±832.73个/微升),差异有统计学意义(P=0.022)。在启动ART随访中,尿JCV阳性组血肌酐水平低于尿JCV阴性组。随访第2年时,尿JCV阳性组血肌酐水平为70.00(64.00,77.00)μmol/L,小于尿JCV阴性组[76.00(67.00,85.00)μmol/L],差异有统计学意义(P=0.023)。随访第2年时,尿JCV阳性组肾小球滤过率(glomerular filtration rate,GFR)为118.00(106.25,133.75)ml/min,大于尿JCV阴性组[113.00(97.00,128.00)ml/min],差异有统计学意义(P=0.045)。随访第4年时,尿JCV阳性组血肌酐水平为70.34±14.98μmol/L,小于尿JCV阴性组(76.6±14.45μmol/L),差异有统计学意义(P=0.023)。结论HIV-1感染者中尿液中JCV和JCV的检出率与总淋巴细胞水平呈负相关。在HIV-1感染者中,尿JCV阳性对肾脏有保护性作用,尿JCV阴性可作为早期预判HIV患者肾功能损害的指标。Objective To investigate the positive rate of urine JC polyomavirus(JCV)and urine BK polyomavirus(BKV)in HIV patients,and to evaluate the relationship between urine JCV positive and renal function and lymphocyte count during long-term follow-up.Methods A total of 180 HIV-1 positive patients were enrolled in the Second Department of Infection,Xixi Hospital of Hangzhou,urine samples were collected for JCV and BKV detection.Renal function and CD4^(+)cell count were collected at baseline before taking antiretroviral therapy(ART)and at 1,2,3,4,and 5 years of follow-up.Results The detection rates of JCV and BKV in urine of 180 HIV-1 positive patients were 25.55%(46/180)and 1.67%(3/180),respectively.Before ART,the total number of lymphocytes in urine JCV positive group was 1699.62±790.44/μl,which was lower than that in urine JCV negative group(2113.59±832.73/μl),and the difference was statistically significant(P=0.022).During ART initiation follow-up,serum creatinine levels in urine JCV positive group were lower than those in urine JCV negative group.At the second year of follow-up,the serum creatinine level in urine JCV positive group was 70.00(64.00,77.00)μmol/L,which was lower than that in urine JCV negative group[76.00(67.00,85.00)μmol/L],and the difference was statistically significant(P=0.023).At the second year of follow-up,the glomerular filtration rate(GFR)of the urine JCV positive group was 118.00(106.25,133.75)ml/min,which was higher than that of urine JCV negative group[113.00(97.00,128.00)ml/min],and the difference was statistically significant(P=0.045).At the fourth year of follow-up,serum creatinine level in urine JCV positive group was 70.34±14.98μmol/L,which was lower than that in urine JCV negative group(76.6±14.45μmol/L),and the difference was statistically significant(P=0.023).Conclusion The detection rates of JCV and BKV in urine of HIV-1 positive patients are negatively correlated with total lymphocyte levels.Urine JCV positive has a protective effect on the kidney,and urine JCV negative

关 键 词：HIV JC多瘤病毒 BK多瘤病毒 肾功能 

分 类 号：R512.91[医药卫生—内科学]