Prospective monitoring of BK virus replication in renal transplant recipients

Background. BK virus‐associated nephropathy (BKVAN) can be diagnosed only with renal graft biopsy. Definitive diagnosis of BKVAN requires demonstration of BK virus (BKV) replication in renal allograft tissues. Non‐invasive analysis of urine and blood is considered essential in screening renal transp...

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Bibliographic Details
Published in:Transplant infectious disease 2009-02, Vol.11 (1), p.1-10
Main Authors: Koukoulaki, M., Grispou, E., Pistolas, D., Balaska, K., Apostolou, T., Anagnostopoulou, M., Tseleni-Kotsovili, A., Hadjiconstantinou, V., Paniara, O., Saroglou, G., Legakis, N., Drakopoulos, S.
Format: Article
Language:English
Subjects:
Adult
Aged
BK disease
BK infection
BK reactivation
BK replication
BK virus
BK Virus - genetics
BK Virus - isolation & purification
BK Virus - physiology
de novo
Female
Graft Survival
Humans
immune suppression
Immunosuppression
Incidence
Kidney Transplantation - adverse effects
Male
Middle Aged
polymerase chain reaction
polyoma virus
Polyomavirus Infections - blood
Polyomavirus Infections - epidemiology
Polyomavirus Infections - urine
Polyomavirus Infections - virology
renal graft function
renal transplantation
Tumor Virus Infections - blood
Tumor Virus Infections - epidemiology
Tumor Virus Infections - urine
Tumor Virus Infections - virology
viremia
Viremia - blood
Viremia - epidemiology
Viremia - urine
Viremia - virology
viruria
Virus Activation
Virus Replication
Young Adult
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Summary:Background. BK virus‐associated nephropathy (BKVAN) can be diagnosed only with renal graft biopsy. Definitive diagnosis of BKVAN requires demonstration of BK virus (BKV) replication in renal allograft tissues. Non‐invasive analysis of urine and blood is considered essential in screening renal transplant recipients. Patients and methods. This study evaluated prospectively the replication of BKV in plasma and urine with qualitative and quantitative real‐time polymerase chain reaction in 32 de novo (group A) and 34 chronic (group B) renal transplant recipients and the long‐term impact on graft function. Results. In group A, 456 samples (228 plasma, 228 urine) were examined and BKV was detected in 31 (31/228, 14%) samples of plasma and 57 (57/228, 25%) samples of urine in 20 (20/32, 62.5%) and 23 (23/32, 72%) recipients, respectively. Incidence of viremia and viruria increased during the first 6 months presenting a peak the third postoperative month (viremia: 28% and viruria: 31%). Immune suppressive treatment with tacrolimus showed significant relation with viremia. Renal graft function in de novo renal transplant recipients remained stable throughout the follow‐up period without influence of BKV replication. In group B, incidence of viremia and viruria were 3% (1/34) and 9% (3/34) correspondingly, indicating that after the first post‐transplant year the risk of BKV re‐activation is diminished. Conclusion. The highest incidence of BK viremia and viruria is observed the third post‐transplantation month, confirming previously published studies in Europe and the United States, and long‐term follow up shows that BKV replication decreases significantly after the third post‐transplant month and even transient viremia or viruria does not have an impact on renal function.
ISSN:1398-2273
1399-3062
DOI:10.1111/j.1399-3062.2008.00342.x