BKV Reactivation in Renal Transplant Recipients: Diagnostic and Therapeutic Strategy—Case Reports

Sessa, A.; Esposito, A.; Giliberti, A.; Bergallo, Massimiliano; Costa, Cristina; Rossano, R.; Lettieri, E.; Capuano, M.

doi:10.1016/j.transproceed.2008.05.007

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…However, it has been shown that the PVAN in renal transplant recipients was more correlated with the degree of immunosuppression than with the use of particular drugs [17,23]. In this study, the distribution values of viruria/viremia was also not related to immunosuppressive therapy although the combinaison [Tac + prednisolone + MMF] was more but not statistically significant prescribed in all groups.…”

Section: Discussioncontrasting

confidence: 49%

The Monitoring Interest of BK Virus Load in Renal Allograft Tunisian Recipients: Prospective Study

Gorgi¹,

Bacha²,

Sfar³

et al. 2012

OJOTS

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BK virus (BKV) may cause nephropathy in renal transplant recipients receiving immunosuppressive therapy, resulting in renal dysfunction and, possibly graft loss. However, the positive and negative predictive values of BK viral load are still controversial. In this prospective, single-center study, BKV DNA was measured 1, 3 and 6 months after transplantation. The viral load in urine and plasma was quantified with the real-time Q-PCR (Argen kit) in 73 renal allograft recipients Three of them showed acute rejection. To determine the cutoff value of viral load, 60 sera samples of healthy blood donors, matched for age and sex, were tested. The mean plasmatic viral load one month posttransplantation was statistically higher in renal transplant recipients (17.23 copies/ml) compared to that in controls (2 copies/ml) (p: 0.06). This difference of the distribution of viremia values is more evident in the third and sixth month (p: 0.002 and 0.010 respectively). Furthermore, analysis of the kinetic of viral load revealed an average rise of viremia at 3 months (1589.14 copies/ml) followed by its decrease at 6 months (249.75 copies/ml). However, the difference was not statistically significant. The same is true for the distribution of values of viruria and in all cases the average viral load was statistically higher in urine than in plasma. In addition, this study did not shown significant relationsheep between viremia/viruria and the occurrence of acute rejection, the renal function deterioration, the source of allograft or immunosuppressive therapy protocol. If the results of this study demonstrate the importance of the replication of BKV in renal transplant patients from the first month compared to that in immunocompetent subjects, the screening of the DNA of this virus does not appear to have a prognostic value in the occurrence of acute rejection. However, the plasma and urine monitoring of BKV load beyond 6 months, not appear to exclude the relationsheep between these two biomarkers and the occurrence of chronic graft dysfunction.

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Section: Discussioncontrasting

confidence: 49%

The Monitoring Interest of BK Virus Load in Renal Allograft Tunisian Recipients: Prospective Study

Gorgi¹,

Bacha²,

Sfar³

et al. 2012

OJOTS

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“…In addition, there has been some limited success with leflunomide, an immunosuppressive drug (Faguer et al, 2007; Josephson et al, 2006; Williams et al, 2005). Other antiviral treatments that have been used in clinical trials include intravenous immunoglobulin (IVIG) and fluoroquinolone antibiotics (Bonvoisin et al, 2008; Rinaldo and Hirsch, 2007; Sener et al, 2006; Sessa et al, 2008). However, more systematic studies are warranted to evaluate the efficacies of these treatments.…”

Section: Polyomavirus-associated Diseasesmentioning

confidence: 99%

The role of polyomaviruses in human disease

et al. 2009

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The human polyomaviruses, BK virus and JC virus, have long been associated with serious diseases including polyomavirus nephropathy and progressive multifocal leukoencephalopathy. Both viruses establish ubiquitous, persistent infections in healthy individuals. Reactivation can occur when the immune system is impaired, leading to disease progression. Recently, the human polyomavirus family has expanded with the identification of three new viruses (KI, WU and Merkel cell polyomavirus), all of which may prove to be involved in human disease. This review describes the general aspects of human polyomavirus infections and pathogenicity. Current topics of investigation and future directions in the field are also discussed.

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“…Tyrosine kinase (29), cyclooxygenase (18), and NF-B signaling (15) may also be affected at higher concentrations. Leflunomide has demonstrated antiviral activity toward human immunodeficiency virus 1 (HIV-1) (38) and herpesviruses (25,44) and is now also used in treatment of PVAN (2,3,6,9,12,13,24,26,30,34,39,41,47), although its clinical efficacy has not been formally tested in controlled trials. For herpesviruses, the antiviral effect is attributed to impaired nucleocapsid tegumentation (25,44).…”

mentioning

confidence: 99%

Leflunomide Inhibition of BK Virus Replication in Renal Tubular Epithelial Cells

Bernhoff

Tylden

Kjerpeseth

et al. 2010

J Virol

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The immunomodulatory drug leflunomide is frequently used for treating polyomavirus-associated nephropathy, yet its antiviral mechanism is unclear. We characterized the effects of the active leflunomide metabolite A771726 (LEF-A) on the polyomavirus BK (BKV) life cycle in human renal tubular epithelial cells. LEF-A at 10 g/ml reduced the extracellular BKV load by 90% (IC 90 ) but with significant host cytostatic effects. BKV genome replication, late protein expression, and virion assembly and release were inhibited with visible disruption of the nuclear replication architecture. Both host cell and antiviral effects were largely reversed by uridine addition, implicating nonspecific pyrimidine depletion as the major anti-BKV mechanism of leflunomide.

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BKV Reactivation in Renal Transplant Recipients: Diagnostic and Therapeutic Strategy—Case Reports

Cited by 12 publications

References 16 publications

The Monitoring Interest of BK Virus Load in Renal Allograft Tunisian Recipients: Prospective Study

The Monitoring Interest of BK Virus Load in Renal Allograft Tunisian Recipients: Prospective Study

The role of polyomaviruses in human disease

Leflunomide Inhibition of BK Virus Replication in Renal Tubular Epithelial Cells

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