Papovavirüsler
Özet
Papovavirüsler iki ayrı ailede incelenmektedir: Papillomaviridae ve Polyomaviridae. Papovavirüsler küçük, zarfsız, ikozahedral simetrili, çift zincirli ve sirküler genoma sahip deoksiribonükleik asit (DNA) virüsleridir. Papovavirüslerin replikasyonu konak hücre çekirdeğinde gerçekleşir. İnsan papillomavirüsleri (HPV) papillom ve siğillerle seyreden epidermal lezyonlara neden olurlar. HPV, serviks kanserinin de en önemli nedenidir. Epidermal lezyonların tanısında klinik tanı esasken, asetik asitle boyama, Papanikolaou testi ve polimeraz zincir reaksiyonu (PZR) tanıda kullanılan diğer yöntemlerdir. Genital HPV enfeksiyonu aşıyla önlenebilen hastalıklar arasında yer almaktadır. Polyomavirüslerden JC virüs (JCV) ve BK virüs (BKV) klinik öneme sahiptir. Her iki virüs de bağışıklığı baskılanmış bireylerde hastalık yapmaktadır. JCV başta insan immün yetmezlik virüsü ile enfekte bireylerde progresif multifokal lökoensefalopati (PML) ile ilişkilendirilmiştir. BKV ise daha çok hematolojik ve solid organ malignitesi olan hastalarda nefropati, üretral stenoz ve hemorajik sistite neden olmaktadır. Beyin omurilik sıvısında JCV DNA’nın PZR ile gösterilmesi PML klinik tanısı için yeterlidir. İdrar ve serumda BKV DNA varlığı serum kreatinin yüksekliği olan hastalarda BKV ilişkili nefropati klinik tanısı için yeterlidir. Ancak tanıda altın standart histopatolojik incelemedir. Her iki enfeksiyonun tedavisi için de esas olan immünsupresyon düzeyinin azaltılmasıdır.
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