A Prospective Longitudinal Study of Polyomavirus Shedding in Lung‐Transplant Recipients

Thomas, Lora D.; Vilchez, Regis A.; White, Zoe S.; Zanwar, Preeti; Butel, Janet S.; Dummer, Stephen

doi:10.1086/510625

Cited by 35 publications

(33 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At these high rates of urinary BKV replication, sloughing of altered epithelial cells with nuclear inclusions ('decoy cells') appear in urine cytology preparations, and virions can be visualized by negative staining electron microscopy (42)(43)(44). In nonkidney SOT recipients, BKV viruria is thought to result from reactivating the endogenous BKV which only exceptionally progresses to clinical disease (40,(45)(46)(47)(48). In kidney transplant recipients, BKV reactivation most likely results from reactivating BKV in tubular epithelial cells of the donor kidney (49) which is then amplified in the urothelial cell layer (41,42).…”

Section: Primary Infection With Bkv Occurs Mostly Without Specific Symentioning

confidence: 99%

See 1 more Smart Citation

BK Virus in Solid Organ Transplant Recipients

Hirsch

Randhawa

2009

American Journal of Transplantation

202

163

View full text Add to dashboard Cite

Section: Primary Infection With Bkv Occurs Mostly Without Specific Symentioning

confidence: 99%

“…In heart, liver and lung transplant recipients have a 5%-25% incidence of viruria, but viremia is uncommon and PyVAN extremely rare (45,46,(120)(121)(122)(123)(124) (47,48). In most cases, treatment with cidofovir was not effective (48).…”

Section: Screening Of Nonrenal Transplant Recipients For Bkv Replicatmentioning

confidence: 99%

BK Virus in Solid Organ Transplant Recipients

Hirsch

Randhawa

2009

American Journal of Transplantation

202

163

View full text Add to dashboard Cite

“…Primers PYVfor/PYVrev directed at a conserved sequence in the amino (N)-terminus of the large T-antigen (T-ag) gene of BKV, JCV, and SV40 were used for viral analysis (Bergsagel et al, 1992;Lednicky et al, 1995). Our laboratory has established the use of these primers to detect BKV and JCV in clinical samples (Thomas et al, 2007;Vanchiere et al, 2005aVanchiere et al, , 2005b as well as SV40 (Meneses et al, 2005;Thomas et al, 2007;Vilchez et al, 2002b). Primers TP1Q3/TP1Q5 were used to detect EBV latent membrane protein 2a (LMP2a) gene sequences (Vilchez et al, 2002a).…”

Section: Pcr Amplification and Dna Sequence Analysismentioning

confidence: 99%

Detection of polyomavirus SV40 in tonsils from immunocompetent children

Patel

Vilchez

Killen

et al. 2008

Journal of Clinical Virology

Self Cite

View full text Add to dashboard Cite

Background-BK virus (BKV), JC virus (JCV) and simian virus 40 (SV40) are nonenveloped DNA viruses, members of the family Polyomaviridae. BK and JC viruses establish persistent infections in humans, and evidence suggests that SV40 can infect humans, as well. Whether persistence occurs in the lymphoid system is unknown.Methods-Paraffin-embedded tonsils from 220 immunocompetent children (mean age 9.3 years) were examined by polymerase chain reaction (PCR) to detect viral DNA of BKV, JCV, SV40, and Epstein-Barr virus (EBV).Results-Polyomavirus-specific DNA sequences were detected in 8.3% (29/351) of specimens collected from 220 children. Twenty-one (9.5%) children had polyomavirus DNA present in at least one tonsil, with sequences identified as SV40 (n=20) and BKV (n=1). Polyomavirus JCV was not detected. Among patients positive for SV40, 8 of 14 (57%) contained viral DNA in both available tonsils. EBV DNA was detected in 99 (28.2%) samples from 67 (30.5%) patients. Eleven samples (3.1%) from 8 (3.6%) children were positive for both polyomavirus and EBV. SV40-positive children were significantly older than the SV40-negative subjects (P < 0.001). T-antigen expression was detected in an SV40 DNA-positive tonsil by immunohistochemistry.Conclusions-These results suggest that SV40 can infect tonsils, that lymphoid tissue may represent a site for polyomavirus persistence, and that immunohistochemistry is not a useful detection assay when there are very few virus-infected cells in a tissue.

show abstract

“…In fact, biopsy-confirmed PyVAN is confined to single case reports (14,15) (8,17 (11)(12)(13)20,21) (Table 1). [13][14][15][16][17][18][19][20][21][22][23][24][25]. In one patient, PyVAN occurred earlier, but only after a second heart transplant, the first having lasted for 4.5 years (27).…”

Section: The Polyomavirus Bk (Bkv) Seroprevalence Reaches 80-90% In Tmentioning

confidence: 99%

Renal Failure Five Years After Lung Transplantation Due to Polyomavirus BK‐Associated Nephropathy

Egli

Helmersen²,

Taub

et al. 2010

American Journal of Transplantation

View full text Add to dashboard Cite

Polyomavirus-associated nephropathy (PyVAN) is rare in nonrenal solid organ transplantation and only limited information is available from single cases. We describe a 67-year-old female presenting with hypertension and progressive kidney failure due to Py-VAN 60 months after lung transplantation. Plasma BK virus (BKV) loads were 4.85 log 10 copies/mL at diagnosis and cleared slowly over 14 months after switching from tacrolimus, mycophenolate and prednisone to low-dose tacrolimus, sirolimus and leflunomide, the latter being discontinued for anemia and diarrhea. BKV-and JC virus-specific immunoglobulins were detectable prior to transplantation. Only BKV-specific IgG and IgM increased during follow-up. BKV-specific T cells were detectable in blood following in vitro expansion, but cleared with reincreased sirolimus, yet BKV viremia remained undetectable. We identified eight other cases of PyVAN in nonrenal solid organ transplantation including lung (n = 1), heart (n = 6) and pancreas (n = 1). Overall, diagnosis was later than commonly seen in kidney transplants (median 18 months, interquartile range 10-29). Seven patients were male, five received triple immunosuppression consisting of tacrolimus, mycophenolate, prednisone. Immunosuppression was reduced in four cases and cidofovir and/or leflunomide administered in five and two cases, respectively. Renal function deteriorated in five requiring hemodialysis in four. We discuss mTOR inhibitors versus cidofovir and leflunomide as potential PyVAN rescue therapy.

show abstract

A Prospective Longitudinal Study of Polyomavirus Shedding in Lung‐Transplant Recipients

Abstract: Polyomaviruses BKV and JCV were commonly detected in urine from lung-transplant recipients. SV40 was found in 12% of patients but was shed at a lower frequency and with lower viral loads than the other viruses. Polyomavirus infection was not associated with renal dysfunction.

Cited by 35 publications

References 50 publications

BK Virus in Solid Organ Transplant Recipients

BK Virus in Solid Organ Transplant Recipients

Detection of polyomavirus SV40 in tonsils from immunocompetent children

Renal Failure Five Years After Lung Transplantation Due to Polyomavirus BK‐Associated Nephropathy

Contact Info

Product

Resources

About