Human Polyomavirus Infections with JC Virus and BK Virus in Renal Transplant Patients

Abstract

Infection with the human polyomaviruses JC virus and BK virus was studied in 61 immunosuppressed renal transplant patients. Urine cytologic studies, indirect immunofluorescence microscopy, electron microscopy, and serologic studies were used to assess viral activity. Patients records were abstracted for events associated with polyomavirus infections. Polyomavirus excretion in urine was detected in 12 of 61 patients (20%). Eleven excreted JC virus and nine, BK virus. Fourfold hemagglutination-inhibition antibody titer rises occurred in 25 of 61 patients (41%). The serologic data suggested that most JC virus infections were primary, whereas most BK virus infections resulted from virus reactivation. During this 2-year study, 32 of 61 patients (52%) had evidence of active viral replication. Urinary tract excretion was associated with drug-requiring diabetes mellitus (P = 0.001), arterial occlusive disease (P = 0.03), and ureteral stricture with loss of renal function (P = 0.02). Antibody increases to BK virus were associated with a rising seurum creatinine (P = 0.02) and need for transplant biopsy (P = 0.02). Polyomavirus replication was therefore associated with an increased frequency of transplant related complications.

Interferon β1-a and selective anti-5HT2a receptor antagonists inhibit infection of human glial cells by JC virus

“…Seroepidemiological studies indicate that 70% of the human population worldwide are infected with JCV (Bofill-Mas et al, 2001;Bofill-Mas, Pina, and Girones, 2000;Gardner, 1973;Gardner et al, 1971;Hogan et al, 1980;Imperiale, 2000;Shah, Daniel, and Warszawski, 1973). The mode of virus transmission is unknown, and no clinical illness has been associated with primary infection.…”

JC polyomavirus infection in candidates for kidney transplantation living in the Brazilian Amazon Region

“…At the site of entry, which is normally the respiratory tract, these viruses replicate and traffic to the tissues of the kidneys (Heritage et al 1981, McCance 1983) and the central nervous system, where they sustain a long-term infection (Elsner & Dörries 1992, Quinlivan et al 1992. A recurrence of the infection may be induced by significant immunosuppression, as in the case of kidney (Hogan et al 1980, Kahan et al 1980, Gardner et al 1984) and bone marrow transplants (O'Reilly et al 1981, Arthur et al 1988) and other factors such as immunodeficiency diseases, diabetes, other chronic diseases, immunosuppressive chemotherapy, pregnancy ) and old age (Tajima et al 1990). …”

Histologic versus Molecular Diagnosis of BK Polyomavirus–Associated Nephropathy

“…The association between renal transplantation and shedding of polyomavirus in the urine was established firmly by subsequent studies (10,(12)(13)(14). The reported incidence of viruria in patients who received azathioprine and prednisone ranged from 14 to 68%, depending on the method used to demonstrate the infection (10,(12)(13)(14)(15)(16).…”