Analysis of the Relationship Between Urinary JC Virus and Renal Function in HIV-infected Patients with Five-year Follow-up
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 an-tiretroviral 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 posi-tive 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,ser-um 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±14.45 μmol/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 can be used as an early indicator of renal damage in HIV patients.
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