Journal of the Pediatric Infectious Diseases Society · 2014
A Prospective Study on the Predictive Value of Plasma BK Virus-DNA Load for Hemorrhagic Cystitis in Pediatric Patients After Stem Cell Transplantation.
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Cesaro Simone, Tridello Gloria, Pillon Marta, Calore Elisabetta, Abate Davide, Tumino Manuela, Carucci Nicolina, Varotto Stefania, Cannata Elisa, Pegoraro Anna, Barzon Luisa, Palù Giorgio, Messina Chiara
Аннотация
BACKGROUND: In hematopoietic stem cell transplantation (HSCT), late hemorrhagic cystitis (HC) has been associated with BK virus (BKV) infection. We assessed the value of plasma BKV load in predicting HC.
METHODS: Plasma and urine BKV-DNA load were assessed prospectively in 107 pediatric patients.
RESULTS: Twenty patients developed grade II and III HC, with 100-day cumulative incidence of 18.8%. At diagnosis of HC, the median load of BKV DNA was 2.3 × 10(3) copies/mL. A plasma BKV-DNA load of 10(3) copies/mL had a sensitivity of 100% and a specificity of 86% with a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 39% for HC. A urine BKV-DNA load of >10(7) copies/mL had a sensitivity of 86% and a specificity of 60% with a NPV of 98% and a PPV of 14% for HC. A BKV load of 10(3) copies/mL on plasma was significantly associated with HC in multivariate analysis (hazard ratio [HR], 6.1; P = .0006). Patients with HC had a significantly higher risk of mortality than patients who did not have HC (HR, 2.6; P = .018).
CONCLUSIONS: The above values were used to monitor plasma BKV-DNA load, and they provided a better prediction of patients at risk of HC than urine BKV-DNA load.
METHODS: Plasma and urine BKV-DNA load were assessed prospectively in 107 pediatric patients.
RESULTS: Twenty patients developed grade II and III HC, with 100-day cumulative incidence of 18.8%. At diagnosis of HC, the median load of BKV DNA was 2.3 × 10(3) copies/mL. A plasma BKV-DNA load of 10(3) copies/mL had a sensitivity of 100% and a specificity of 86% with a negative predictive value (NPV) of 100% and a positive predictive value (PPV) of 39% for HC. A urine BKV-DNA load of >10(7) copies/mL had a sensitivity of 86% and a specificity of 60% with a NPV of 98% and a PPV of 14% for HC. A BKV load of 10(3) copies/mL on plasma was significantly associated with HC in multivariate analysis (hazard ratio [HR], 6.1; P = .0006). Patients with HC had a significantly higher risk of mortality than patients who did not have HC (HR, 2.6; P = .018).
CONCLUSIONS: The above values were used to monitor plasma BKV-DNA load, and they provided a better prediction of patients at risk of HC than urine BKV-DNA load.
Предметные рубрики MeSH
Abdominal PainAdolescentBK VirusChildChild, PreschoolCystitisFemaleHematopoietic Stem Cell TransplantationHemorrhageHumansIncidenceInfantMalePolyomavirus InfectionsPredictive Value of TestsProspective StudiesRisk FactorsSensitivity and SpecificityTumor Virus InfectionsUrination DisordersViral LoadViremia