Hemorrhagic cystitis may occur in a patient after a hematopoietic stem cell transplant (HSCT) due to proliferation of Polyoma BK virus (BKV). Wong et al identified risk factors for this infection. The authors are from the University of Hong Kong.
Risk factors for hemorrhagic cystitis follow HSCT:
(1) high titers of IgG antibodies to BKV
(2) acute graft-vs-host disease (GVHD)
(3) 1,000 fold or more increase in viral shedding into the urine after HSCT, with LOG10 ((viral load after) / (viral load before)) >= 3.
where:
• Most infections are believed to be reactivation of latent infections, which correlates with the presence of antibodies.
• The urine viral load is expressed in copies per mL.
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