A Case Control Study Reveals that Polyomaviruria Is Significantly Associated with Interstitial Cystitis and Vesical Ulceration.
OBJECTIVE
To investigate whether polyomaviruses contribute to interstitial cystitis pathogenesis.


METHODS
A prospective study was performed with 50 interstitial cystitis cases compared with 50 age-matched, disease-free controls for the frequency of polyomaviruria. Associations between polyomaviruria and disease characteristics were analysed in cases. Polyomavirus in urine and bladder tissue was detected with species (JC virus vs. BK virus) specific, real-time PCR.


RESULTS
Case patients were reflective of interstitial cystitis epidemiology with age range from 26-88 years (median 58) and female predominance (41/50 F). There was a significant increase in the frequency of polyomavirus shedding between cases and controls (p<0.02). Polyomavirus shedding, in particular BK viruria, was associated with vesical ulceration, a marker of disease severity, among interstitial cystitis cases after adjustment for age and sex (OR 6.8, 95% CI 1.89-24.4). There was a significant association among cases between the presence of BK viruria and response to intravesical Clorpactin therapy (OR 4.50, 95% CI 1.17-17.4).


CONCLUSIONS
The presence of polyomaviruria was found to be associated with the ulcerative form of interstitial cystitis. Clorpactin, which has anti-DNA virus activity, was more likely to improve symptoms in the presence of BK viruria. These data from this pilot study suggest associations between polyomaviruria and interstitial cystitis warranting further investigation.
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.
Benjamin J
BJ
Winter
Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Helen E
HE
O'Connell
Victorian Infectious Diseases Reference Laboratory, Wreckyn St, North Melbourne, Victoria, Australia.
Scott
S
Bowden
Department of Urogynaecology, Royal Women's Hospital, Flemington Rd, Parkville, Victoria, Australia.
Marcus
M
Carey
Victorian Infectious Diseases Service at the Doherty Institute, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
Damon P
DP
Eisen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001739:BK Virus / Q000302:isolation & purification*; D016022:Case-Control Studies; D018856:Cystitis, Interstitial / Q000821:virology*; D005260:Female; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D014456:Ulcer / Q000821:virology*; D001743:Urinary Bladder / Q000473:pathology* / Q000821:virology; D014556:Urine / Q000821:virology*