Urinary excretion of poliomavirus in children and adolescents infected with Human Immunodeficiency Virus (HIV)

• Grant number: 07/06687-7
• Support type: Regular Research Grants
• Duration: March 01, 2008 - August 31, 2009
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal researcher: Daisy Maria Machado
• Grantee: Daisy Maria Machado
• Home Institution: Instituto de Medicina Tropical de São Paulo (IMT). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

The human being is the natural host of two viruses classified within the Poliomaviridae family, JC vírus (JCV) and BK vírus (BKV). Both viruses are able to cause persistent and asymptomatic infection in renal tissue and blood in about 35-85% of the world population. The viruses are usually nonpathogenic for nonimmunocompromised individuals, although reactivation in immunocompromised patients with relative or absolute cellular immunodeficiency has been associated with serious complications. The best-known site of KBV latency in humans is the urogenital tract, and viral sequences can be detected in up to 50% of human kidneys. Peripheral blood mononuclear cells are the second important potential site of BKV latency. Compared to healthy subjects, there is an increased incidence of viruria in HIV-infected individuals, ranging from 20% to 44% in most studies. The level of BKV, but not JCV viruria, seems to show an inverse correlation with the circulating T cell count. BKV reactivation is associated with interstitial nephritis and ureteral stenosis in allograft recipients, and late onset haemorrhagic cystitis in bone marrow transplat patients. JCV is neurotropic, and in immunocompromized individuals the reactivation produces progressive multifocal leucoencephalopathy, a fatal demyelinating neurological disease. Reactivation of HpyVs may also accur in otherwise healthy people, leading to asymptomatic viruria. Many questions concerning the pathogenesis and natural history of infection remain unanswered, especially in children and adolescents exposed to HIV-infection. The present study focuses on this issue by analysing the urine samples from a cohort of HIV-infected children and adolescents followed at the Pediatric Infectious Diseases Division, Department of Pediatrics, Federal University of São Paulo. In total, 200 urine samples will be obtained from 100 children and adolescents (aged 5-20 years), the first sample during the inclusion visit and the second sample with a six-month interval. Detection of BKV and JCV will be carried out with a real time PCR, wich amplifies a specific region of T-large antigen, common for BKV and JCV. (AU)