Fluoroquinolones for BK viral complication after transplantation: Meta‐analysis

Ito, Yusuke; Hino, T.; Honda, Akira; Kurokawa, Mineo

doi:10.1111/tid.13433

Cited by 7 publications

(5 citation statements)

References 30 publications

(88 reference statements)

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“…Fluoroquinolones like ciprofloxacin have been used with some effect. 107 The use of intravenous immunoglobulin is a supportive strategy that can help provide humoral immunity. 108 Leflunomide has been studied but the current data are not very convincing.…”

Section: Bk Virusmentioning

confidence: 99%

Post-allogeneic hematopoietic stem cell transplantation viral reactivations and viremias: a focused review on human herpesvirus-6, BK virus and adenovirus

Wang

Patel

Haddadin

et al. 2021

Therapeutic Advances in Infection

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Human cytomegalovirus and Epstein–Barr virus have been recognized as potential drivers of morbidity and mortality of patients undergoing allogeneic stem cell transplantation for years. Specific protocols for monitoring, prophylaxis and pre-emptive therapy are in place in many transplant settings. In this review, we focus on the next three most frequent viruses, human herpesvirus-6, BK virus and adenovirus, causing reactivation and/or viremia after allogeneic transplant, which are increasingly detected in patients in the post-transplant period owing to emerging techniques of molecular biology, recipients’ characteristics, treatment modalities used for conditioning and factors related donors or stem cell source. Given the less frequent detection of an illness related to these viruses, there are often no specific protocols in place for the management of affected patients. While some patients develop significant morbidity (generally older), others may not need therapy at all (generally younger or children). Furthermore, some of the antiviral therapies used are potentially toxic. With the addition of increased risk of secondary infections, risk of graft failure or increased risk of graft- versus-host disease as well as the relationship with other post-transplant complications, the outcomes of patients with these viremias remain unsatisfactory and even long-term survivors experience increased morbidity.

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Section: Bk Virusmentioning

confidence: 99%

Post-allogeneic hematopoietic stem cell transplantation viral reactivations and viremias: a focused review on human herpesvirus-6, BK virus and adenovirus

Wang

Patel

Haddadin

et al. 2021

Therapeutic Advances in Infection

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“…1 BKV can cause serious complications, such as hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) and BKV-associated nephropathy due to allograft loss after renal transplantation. [1][2][3][4] The frequency of BKV-associated HC (BKV-HC) after HSCT is ∼10%. 1,2 BKV-HC reduces patients' quality of life and may lead to decreased overall survival.…”

Section: Introductionmentioning

confidence: 99%

“…BK polyomavirus (BKV) infects most of the general population during childhood and persists in renal tubular cells and urothelial cells 1 . BKV can cause serious complications, such as hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) and BKV‐associated nephropathy due to allograft loss after renal transplantation 1–4 . The frequency of BKV‐associated HC (BKV‐HC) after HSCT is ∼10% 1,2 .…”

Section: Introductionmentioning

confidence: 99%

A cluster of BK polyomavirus‐associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Hosoi

Murata

Suzuki

et al. 2021

Transplant Infectious Dis

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Background BK polyomavirus (BKV) can cause hemorrhagic cystitis (HC) in immunocompromised patients after hematopoietic stem cell transplantation (HSCT). It remains unclear whether nosocomial BKV infections occur. During a 9‐month period, an increase in BKV‐associated HC (BKV‐HC) cases was observed at our institution. Aim The BKV‐HC cluster population was compared with populations of HSCT patients from before and after the BKV‐HC cluster to evaluate whether nosocomial BKV transmission had occurred. Methods A retrospective analysis was carried out to assess the risk of patients developing BKV‐HC after HSCT. The background data of the cluster patients were compared with those of the patients who underwent HSCT before or after the cluster, and the collected BKV isolates were serotyped. Results BKV‐HC involving grade ≥2 hematuria occurred in six of 15 HSCT recipients during a 9‐month period. The incidence of BKV‐HC was significantly higher in this period than in the other periods (p = 0.0014). There were no significant differences in the patients’ background data between the cluster and non‐cluster periods, including in terms of risk factors for BKV‐HC. Serotype analyses of BKV revealed that the BKV detected in the urine samples from four of the six BKV‐HC patients belonged to subtype Ic. The gene sequences of these four BKV exhibited >99.5% homology. Conclusion Our study suggests that nosocomial BKV infections may occur after HSCT. Although many cases of BKV‐HC are caused by the reactivation of a latent virus, it is necessary to employ appropriate hygiene measures when cases of BKV‐HC occur.

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“…There is a limited number of studies examining its effectiveness in BKVN treatment. A meta-analysis showed that fluoroquinolones did not prevent the development of BKVN after transplantation [21]. Fluoroquinolones may reduce the rate of the BK virus to some extent but may not have sufficient clinical effects [22].…”

Section: Discussionmentioning

confidence: 99%

Biopsy proven BK virus nephropathy in kidney transplant recepients: A multi-central study from Turkey (BK-TURK STUDY)

İslam

Gungor

Dheir

et al. 2023

Preprint

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Background: Polyomavirus BK virus infection is a significant complication of renal transplantation and is an important cause of allograft loss. Today, despite the innovations in the pharmaceutical industry, a curative treatment against the BK virus has not been developed. The management is not standardized and is generally based on reported experience from transplantation centers. However, the literature on the subject with large samples is limited. Therefore, we designed a study to present our countrywide experience with BK virus nephropathy (BKVN) in renal transplant recipients. Methods: Our study was conducted with thirty kidney transplant centers from all provinces of Turkey. Only cases with BKVN proven by allograft biopsy were included in our study. Demographic characteristics and laboratory values of the patients were obtained from the archives and electronic databases of the centers. Results: A total of 13.857 patients from 30 transplantation centers were screened. 207 BKVN cases proven by allograft biopsy were identified and included in the study. The mean age was 46.4±13.1, and 146 (70.5%) patients were male. Twenty-six patients did not receive any induction therapy, 144 patients received anti-T lymphocyte globulin (ATLG), and 37 patients received basiliximab after transplantation. 23.6% of the patients had acute rejection history in the first six months of renal transplantation. all were treated with pulse steroids, and 46 were also treated with ATLG. The mean time to diagnosis of BKVN was 15.8±22.2 months after transplantation. At the time of diagnosis, the patients’ mean creatinine level was 1.8±0.7 mg/dl, and the mean estimated glomerular filtration rate was 45.8±19.6 ml/min. While BKVN was solely reported in 181 cases, there were cellular rejection findings in 21 biopsy specimens and humoral rejection in 4 biopsy specimens. In addition of dose reduction or discontinuation of immunosuppressive drugs, eighteen patients were treated with cidofovir, 11 patients with leflunomide, 17 patients with quinolones, 15 patients with intravenous immunoglobulin (IVIG), five patients with cidofovir+IVIG, and 12 patients with leflunomide+IVIG. None of the patients who received leflunomide and leflunomide+IVIG had allograft loss. Allograft loss was observed in 12 (15%) of 78 patients treated with antivirals or immunomodulators. Allograft loss occurred in 32 patients (15%) during follow-up out of 207 patients with BKVN. Five patients were retransplanted, and none developed BKVN during the follow-up. Conclusions: BKVN is still a significant cause of allograft loss in kidney transplantation, which has not been fully elucidated. Leflunomide appears to be an effective treatment in these patients.

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Fluoroquinolones for BK viral complication after transplantation: Meta‐analysis

Cited by 7 publications

References 30 publications

Post-allogeneic hematopoietic stem cell transplantation viral reactivations and viremias: a focused review on human herpesvirus-6, BK virus and adenovirus

Post-allogeneic hematopoietic stem cell transplantation viral reactivations and viremias: a focused review on human herpesvirus-6, BK virus and adenovirus

A cluster of BK polyomavirus‐associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Biopsy proven BK virus nephropathy in kidney transplant recepients: A multi-central study from Turkey (BK-TURK STUDY)

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