Investigating Risk Factors for the Development of BK Virus Infection in Kidney Transplant Recipients in Guilan Province during 2007-2015
Vol. 17 No. 6 (2020),
9 January 2021
Purpose: Polyomavirus nephropathy has been recognized as an important cause of silent loss of kidney transplant function in up to 50% of kidney recipients (1). The present study aimed to evaluate the risk factors associated with BK virus infection in kidney transplant recipients.
Materials and Methods: Clinical information, urinary Decoy cells, and blood polymerase chain reaction (PCR) tests were collected for polyomavirus infection in 223 kidney transplant recipients undergoing surgery at Razi hospital at Guilan University of Medical Sciences between 2007 and 2015. Kidney biopsies were performed in patients with BKPyV- DNAemia more than 10,000 Copies/ml or increased plasma creatinine.
Results: Among 223 patients, 116 (52%) were male. The mean age of participants was 49.57±13.48 years. Out of 223 participants, 41 (18.4%) had Decoy cells in their urine, and 182 (81.6%) did not, 15 of whom (6.7%) had viral genome in their blood. Only did 3 patients out of 10 have BK Virus nephropathy in their kidney biopsy. Among risk factors, it was found that post-transplant duration (P< 0.001) and the use of anti-thymocyte globulin (P= 0.001) were the most significant risk factors for finding decoy cells in patients’ urine.
Conclusions: Post-transplant time, particularly the first 6 months, was found as the most important risk factor for the reactivation of polyomavirus infection in our patients because of strong immunosuppression and use of anti-thymocyte globulin (for prophylaxis or rejection treatment). It is concluded that kidney transplant recipients should be monitored in episodically after transplantation.
- BK virus
- Decoy cell
- JC virus
- polyomavirus infection
- renal transplantation
- risk factors
How to Cite
- Stolt A, Sasnauskas K, Koskela P, et al. Seroepidemiology of the human polyomaviruses. J Gen Virol. 2003; 84:1499- 504.
- Hirsch HH, Knowles W, Dickenmann M, et al. Prospective study of polyomavirus type BK replication and nephropathy in renal transplant recipients. N Engl J Med. 2002; 347:488-496.
- Wiseman AC. Polyomavirus nephropathy: a current perspective and clinical considerations. Am J Kidney Dis. 2009; 54:131-42.
- Hirsch HH, Steiger J. Polyomavirus BK. Lancet Infect Dis. 2003;3:611-23
- Boubenider S, Hiesse C, Marchand S. Post transplantationpolyomavirus infection. J Nephrol 1999; 12:24-9.
- Brennan DC, Agha I, Bohl DL, et al. Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction. Am J Transplant 2005; 5:58-94.
- Bressollette-Bodin C, Coste-Burel M, Hourmant M, et al. A prospective longitudinal study of BK virus infection in 104 renal transplant recipients. Am J Transplant 2005; 5:1926-33.
- Deirdre Sawinski and Simin Goral. BK virus infection: an update on diagnosis and treatment. Nephrol Dial Transplant. 2015; 30: 209-217. doi: 10.1093/ndt/gfu023.
- D.Pai, D.M. Mann, A. Malik, D. R. Hoover, B. Fyfe, and R.A. Mann. Risk Factors for the Development of BK Virus Nephropathy in Renal Transplant Recipients. Transplantation Proceedings 2015; 47:2465-2469.
- H.H. Hirsch, P. Randhawa and the AST Infectious Diseases Community of Practice. BK Polyoma Virus in Solid Organ Transplantation. American Journal of Transplantation 2013; 13: 179-188. doi:10.1111/ajt.12110
- Ramos E, Drachenberg CB, Portocarrero M, et al. BK virus nephropathy diagnosis and treatment: Experience at the University of Maryland Renal Transplant Program. Clin Transpl 2002; 143-153.
- Hirsch HH. Polyoma and Papilloma Virus Infections after Hematopoietic Stem Cell or Solid Organ Transplantation. In: Bowden P, Ljungman P, Snydman DR, eds. Transplant infections. 3rdEd. Philadelphia: Lippincott Williams & Wilkins; 2010, pp. 465-482.
- Boldorini R, Veggiani C, Barco D, Monga G: Kidney and urinary tract polyomavirus infection and distribution: Molecular biology investigation of 10 consecutive autopsies. Arch Pathol Lab Med. 2005; 129: 69-73.
- Randhawa P, Uhrmacher J, Pasculle W, Vats A, Shapiro R, Eghtsead B, Weck K: A comparative study of BK and JC virus infections in organ transplant recipients. J Med Virol. 2005;77: 238–243.
- Wen MC, Wang CL, Wang M, Cheng CH, Wu MJ, ChenCH, Shu KH, Chang D: Association of JC virus with tubulointerstitial nephritis in a renal allograft recipient. J MedVirol. 2004; 72: 675–678.
- Daniel L. Bohl, Daniel C. Brennan: BK Virus Nephropathy and Kidney Transplantation. Clin J Am Soc Nephrol. 2007; 2: S36-S46. doi: 10.2215/CJN.00920207.
- Vera-sempere FJ, Rubio L, Moremo-Garcia A, et al. Polyomavirus Chain Reaction Detection of BK Virus and Monitoring of BK Nephropathy in Renal Transplant Recipients at the University Hospital La Fe. Transplantation Proceedings 2005; 37:3770-3.
- Prince O, Savic S, Dickenmann M, Steiger J, Bubendorf L, Mihatsch MJ. Risk factors for polyoma virus nephropathy. Nephrol Dial Transplant 2009; 24:1024-33.
- Nevo S, Swan V, Enger C et al. Acute Bleeding after bone marrow transplantation (BMT), incidence and effect on survival. A quantitative analysis in 1402 patients. Blood 1998; 91: 1469-1477.
- Ramos E, Drachenberg CB, Papadimitrious JC et al. Clinical course of Polyoma virus nephropathy in 67 renal transplant patients. J Am Soc Nephrol 2002; 13: 2145-2151.
- Theodoropoulos N, Wang E, Penugonda S, et al, BK virus replication and nephropathy after alemtuzumab induced kidney transplantation. American journal of transplantation 2013; 13: 197-206
- D. Perez-Torres, J. Bertran-Pasarell, E. Santiago-Delpín, M. Gonzalez Ramos, et al. Factors and outcome in BK virus nephropathy in a Hispanic kidney transplant population. Transpl Infect Dis 2010; 12: 16-22.
- Hasegawa M, Ito T, Saigo K et al. Association of DNA amplification in Renal transplant recipients. Transplantation Proceedings 2014; 46: 556-559.
- Dheir H, Sahin S, Uyar M et al. Intensive polyomavirus nephropathy Treatment as a preferable approach for graft surveillance. Transplantation proceedings 2011; 43: 867-870.
- Saundh BK, Tibble S, Baker R, Sasnauskas K, Harris M, Hale A. Different pattern of BK and JC polyomavirus reactivation following renal Transplantation. J Clin Pathol. 2010; 63(8):714-8. doi:10.1136/jcp.2009.074864.
- V. Lopez, C. Gutierrez, E. Sola, I, et al. Does JC polyomavirus cause nephropathy in renal transplant patients. Transplantation Proceedings, 2010;42: 2889-2891.
- Christopher K. Buehrig, Donna J. Lager, Mark D. Stegall, et al. Influence of surveillance renal allograft biopsy on diagnosis and prognosis of polyomavirus associated nephropathy. Kidney International, 2003; 64:665-673.
- G. Huanga, L. Zhangb, X. Liangc, J. Qiua, et al. Risk Factors for BK Virus Infection and BK Virus associated Nephropathy under the Impact of Intensive Monitoring and Pre-emptive Immunosuppression Reduction Transplantation Proceedings, 2014; 46: 3448-3454.
- Eva Girmanova, Irena Brabcova, Stepan Bandur, Petra Hribova, et al. A Prospective Longitudinal Study of BK Virus Infection in 120 Czech Renal Transplant Recipients. Journal of Medical Virology, 2011; 83:1395-1400.
- Caroline Lamarche, Julie Orio, Suzon Collette, Lynne Senécal, et al. BK Polyomavirus and the Transplanted Kidney: Immunopathology and Therapeutic Approaches. Transplantation 2016; 100: 2276-2287.
- Abstract Viewed: 0 times
- Pdf/5972 Downloaded: 0 times