Analysis of diagnostic methods as a screening test to detect BK virus nephropathy in kidney transplant patients

Nihei, Camila Hitomi; Pierrotti, Lı́gia Camera; David‐Neto, Elias

doi:10.5935/0101-2800.20160042

Cited by 2 publications

(4 citation statements)

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“…Quantitative PCR tests to asses BK viremia are not standardized and viral loads to define PyVAN varies among centers. In another study, we have established a viremia cutoff value (4 × 10 4 copies/mL) for the diagnosis of presumptive PyVAN, with a sensitivity of 100% and a specificity of 94% . The AST guidelines suggest a reduction in immunosuppression once viremia reaches 10 4 copies/mL .…”

Section: Methodsmentioning

confidence: 99%

“…In another study, we have established a viremia cutoff value (4 × 10 4 copies/ mL) for the diagnosis of presumptive PyVAN, with a sensitivity of 100% and a specificity of 94%. 13 The AST guidelines suggest a reduction in immunosuppression once viremia reaches 10 4 copies/ mL. 12 Based on these findings, patients were grouped according to the following definitions:…”

Section: Me Thodsmentioning

confidence: 99%

“…On the other side, higher levels of viremia are already considered as a diagnosis of PyVAN. In our center, a viremia of 4 × 10 4 copies/mL, defined using our in‐house PCR assay, has been defined as a presumptive diagnosis of PyVAN …”

Section: Introductionmentioning

confidence: 99%

“…In our center, a viremia of 4 × 10 4 copies/mL, defined using our in-house PCR assay, has been defined as a presumptive diagnosis of PyVAN. 13 Increasing levels of viremia are related to significant kidney tissue damage. 14 showing no differences in serum creatinine (SCr) whether patients presented definitive, presumptive, or low BK viremia 15…”

Section: Introductionmentioning

confidence: 99%

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Effect of polyoma viremia on 3‐year allograft kidney function

David‐Neto

Agena

David

et al. 2019

Transplant Infectious Dis

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Background Polyoma viremia is associated with damage to renal tubular and urothelial cells. This may imply that a certain level of viremia, even cleared thereafter, could be associated with long‐term renal dysfunction. Methods We, retrospectively, analyzed 390 first renal transplants adult recipients (≥18 years) who were monitored for BK viremia in the first 12 months and evaluated estimated GFR (MDRD‐4 equation) at 1 month and at the last follow‐up (959 ± 392 days). Results One hundred and ninety‐nine patients (51%) developed at least one positive viremia: 105 (53%) low viremia (<104 copies/mL), 36 (18%) high viremia (4 × 104 > viremia ≥ 104 copies/mL) and 58 (15%) viremia (≥4 × 104 copies/mL) consistent with polyoma virus associated nephropathy (PyVAN). Out of these 58 patients, 24 (6%) developed bx‐proven (SV40+) PyVAN and 34(8.7%) presumptive PyVAN (SV40−). Baseline characteristics, immunosuppression, KDRI, rejection episodes, etc., did not differ among groups but there were more deceased donors and ATG induction therapy in the high viremia group. At last follow‐up, all patients in the low, high viremia and presumptive PyVAN (except 2) had cleared BK viremia. Bx‐proven PyVAN led to 14 graft losses, 10 due to PyVAN. In the presumptive PyVAN there was only one graft loss registered as due to PyVAN. eGFR, at 1 month after KTx, did not differ among groups (51 ± 22 vs 48 ± 24 vs 45 ± 27 vs 43 ± 18 vs 46 ± 22 mL/min/1.73 m2), for no, low and high viremia as well for presumptive PyVAN and bx‐proven PyVAN groups, respectively. At the last follow‐up, eGFR did not differ between the no, low, and high viremia compared to baseline and to each other but was statistically lower in the presumptive and bx‐proven PyVAN (38 ± 15 and 17 ± 7 mL/min/1.73 m2) either compared to baseline or to the other groups. Conclusions This study shows that low and high levels of BK viremia do not lead to GFR changes although very high viremia levels, compatible with presumptive or bx‐proven PyVAN, even if cleared thereafter, lead to allograft damage and decreased GFR.

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Section: Methodsmentioning

confidence: 99%

Section: Me Thodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%