High-level JCPyV viruria after kidney transplantation—Clinical and histopathological findings

Helanterä, Ilkka; Hirsch, Hans H.; Auvinen, Eeva; Mannonen, Laura; Nummi, Maaret; Wernli, Marion; Ortiz, Fernanda; Räisänen-Sokolowski, Anne; Lempinen, Marko; Lautenschlager, Irmeli

doi:10.1016/j.jcv.2016.10.018

Cited by 8 publications

(5 citation statements)

References 28 publications

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“…In 1 patient (jns976), the JCPyV sequences of the donor and recipient did not cluster. Here, we initially suspected a recent infection of the recipient, as the individual was IgG negative at the time of transplant but, at the same time, JCPyV reads could be detected, which has been reported before in cases of primary JCPyV infection in kidney transplant patients [22,24,25]. Surprisingly, the patient was already IgG positive before transplantation, as well as 1 year thereafter, while IgG levels were undetectable around the time of transplantation.…”

Section: Parameters Of Renal Function and Jc Polyomavirus Infectionmentioning

confidence: 61%

Metagenomic Virome Sequencing in Living Donor and Recipient Kidney Transplant Pairs Revealed JC Polyomavirus Transmission

Schreiber

Kufner

Hübel

et al. 2018

Clinical Infectious Diseases

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Background. Before kidney transplantation, donors and recipients are routinely screened for viral pathogens using specific tests. Little is known about unrecognized viruses of the urinary tract that potentially result in transmission. Using an open metagenomic approach, we aimed to comprehensively assess virus transmission in living-donor kidney transplantation.Methods. Living kidney donors and their corresponding recipients were enrolled at the time of transplantation. Follow-up study visits for recipients were scheduled 4-6 weeks and 1 year thereafter. At each visit, plasma and urine samples were collected and transplant recipients were evaluated for signs of infection or other transplant-related complications. For metagenomic analysis, samples were enriched for viruses, amplified by anchored random polymerase chain reaction (PCR), and sequenced using high-throughput metagenomic sequencing. Viruses detected by sequencing were confirmed using real-time PCR.Results. We analyzed a total of 30 living kidney donor and recipient pairs, with a follow-up of at least 1 year. In addition to viruses commonly detected during routine post-transplant virus monitoring, metagenomic sequencing detected JC polyomavirus (JCPyV) in the urine of 7 donors and their corresponding recipients. Phylogenetic analysis confirmed infection with the donor strain in 6 cases, suggesting transmission from the transplant donor to the recipient, despite recipient seropositivity for JCPyV at the time of transplantation.Conclusions. Metagenomic sequencing identified frequent transmission of JCPyV from kidney transplant donors to recipients. Considering the high incidence rate, future studies within larger cohorts are needed to define the relevance of JCPyV infection and the donor's virome for transplant outcomes.

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Section: Parameters Of Renal Function and Jc Polyomavirus Infectionmentioning

confidence: 61%

Metagenomic Virome Sequencing in Living Donor and Recipient Kidney Transplant Pairs Revealed JC Polyomavirus Transmission

Schreiber

Kufner

Hübel

et al. 2018

Clinical Infectious Diseases

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“…The median JCPyV and BKPyV DNAuria levels observed here concorded with those reported in the literature. Even with high JCPyV DNAuria, almost 6 log10 copies/mL, patients appeared asymptomatic 34,43 . Interestingly, in patients where co‐replication was observed, BKPyV DNAuria was lower than in BKPyV‐only cases, supporting the hypothesis that the two viruses compete in some way.…”

Section: Discussionmentioning

confidence: 80%

Molecular epidemiology and risk factors associated with BK and JC polyomavirus urinary shedding after kidney allograft

Demey,

Aubry,

Descamps

et al. 2024

Journal of Medical Virology

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Polyomaviruses BK (BKPyV) and JC (JCPyV), belonging to the Polyomaviridae, are responsible for human pathologies. In kidney transplant recipients, BKPyV replication can lead to irreversible nephron damage whereas JCPyV replication remains asymptomatic. Concomitant replication is rare and potential competition between the infections has been described. The aim of this retrospective case‐control study was to describe the molecular epidemiology and risk factors associated with BKPyV and JCPyV replication in a cohort of kidney transplant recipients. In total, 655 urine samples from 460 patients were tested for BKPyV and JCPyV DNA. Positive samples were submitted to strain genotyping. Demographic and clinical characteristics were also compared. Isolated JCPyV and BKPyV was found in 16.5% and 23.3% of patients, respectively; co‐replication was rare (3.9%). BKPyV strains Ib‐2, Ib‐1, and IVc‐2 were the most prevalent. JCPyV strains mostly belonged to genotypes 4 and 1B. During follow‐up, JCPyV shedding significantly reduced the risk of BKPyV DNAuria, with an odds ratio of 0.57 (95% confidence interval: 0.35–0.99), and was associated with better prognosis than BKPyV replication, based on the estimated glomerular filtration rate. Molecular epidemiology of BKPyV and JCPyV strains in our region was similar to previous studies. This study suggests that JCPyV is benign and appears to limit damaging BKPyV replication. JCPyV DNAuria screening could thus be a useful strategy to predict BKPyV‐related outcomes.

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“…A previous study screened 238 kidney transplant recipients and observed that a high-level of JCPyV-DNAuria in 17 patients was not associated with inferior graft function or survival. 34 However, the study did not observe patients with JCPyV-DNAemia. Our study demonstrated that JCPyV-DNAemia significantly increases the risk of allograft failure in kidney transplant recipients with PyVAN.…”

Section: Discussionmentioning

confidence: 81%

“… 33 If BKPyV-DNAuria is present, a blood PCR test for BKPyV is recommended. 34 The relation between JCPyV-DNAemia and renal allograft dysfunction is not well established. Accordingly, routine screening for JCPyV after kidney transplantation is not recommended; thus, co-infection with JCPyV can be missed.…”

Section: Discussionmentioning

confidence: 99%

Concurrent JCPyV-DNAemia Is Correlated With Poor Graft Outcome in Kidney Transplant Recipients with Polyomavirus-associated Nephropathy

Zhang,

Luo,

Zhao

et al. 2024

Transplantation

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Background. Co-infection of JC polyomavirus (JCPyV) and BK polyomavirus (BKPyV) is uncommon in kidney transplant recipients, and the prognosis is unclear. This study aimed to investigate the effect of concurrent JCPyV-DNAemia on graft outcomes in BKPyV-infected kidney transplant recipients with polyomavirus-associated nephropathy (PyVAN). Methods. A total of 140 kidney transplant recipients with BKPyV replication and PyVAN, 122 without concurrent JCPyV-DNAemia and 18 with JCPyV-DNAemia were included in the analysis. Least absolute shrinkage and selection operator regression analysis and multivariate Cox regression analysis were used to identify prognostic factors for graft survival. A nomogram for predicting graft survival was created and evaluated. Results. The median tubulitis score in the JCPyV-DNAemia-positive group was higher than in JCPyV-DNAemia-negative group (P = 0.048). At last follow-up, the graft loss rate in the JCPyV-DNAemia-positive group was higher than in the JCPyV-DNAemia-negative group (50% versus 25.4%; P = 0.031). Kaplan–Meier analysis showed that the graft survival rate in the JCPyV-DNAemia-positive group was lower than in the JCPyV-DNAemia-negative group (P = 0.003). Least absolute shrinkage and selection operator regression and multivariate Cox regression analysis demonstrated that concurrent JCPyV-DNAemia was an independent risk factor for graft survival (hazard ratio = 4.808; 95% confidence interval: 2.096-11.03; P < 0.001). The nomogram displayed favorable discrimination (C-index = 0.839), concordance, and clinical applicability in predicting graft survival. Conclusions. Concurrent JCPyV-DNAemia is associated with a worse graft outcome in BKPyV-infected kidney transplant recipients with PyVAN.

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High-level JCPyV viruria after kidney transplantation—Clinical and histopathological findings

Cited by 8 publications

References 28 publications

Metagenomic Virome Sequencing in Living Donor and Recipient Kidney Transplant Pairs Revealed JC Polyomavirus Transmission

Metagenomic Virome Sequencing in Living Donor and Recipient Kidney Transplant Pairs Revealed JC Polyomavirus Transmission

Molecular epidemiology and risk factors associated with BK and JC polyomavirus urinary shedding after kidney allograft

Concurrent JCPyV-DNAemia Is Correlated With Poor Graft Outcome in Kidney Transplant Recipients with Polyomavirus-associated Nephropathy

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