Prevalence and Risk Factors of BK Viremia in Patients With Kidney Transplantation: A Single-Center Experience From Turkey

Doğan, Serdar; Çelebi, Zeynep Kendi; Aktürk, Serkan; Kutlay, Sim; Tüzüner, Acar; Keven, Kenan; Şengül, Şule

doi:10.1016/j.transproceed.2017.01.009

Cited by 18 publications

(10 citation statements)

References 18 publications

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“…Recipient age was identified as a risk factor for BKPyV viremia with borderline significance (HR [per decade]: 1.40; P ‐value = .059). Previous studies have also found a weak, and often not significant, association between BKPyV infection and recipient age 21‐23 . Quite unexpectedly, the pre‐transplant diagnosis of coronary heart disease was associated with the occurrence of BKPyVAN (HR: 4.14; P ‐value = .040), although caution must be applied in drawing causal inference.…”

Section: Discussionmentioning

confidence: 94%

CMV infection, valganciclovir exposure, and the risk of BK viremia and associated nephropathy after kidney transplantation: Is there a link?

Rodríguez‐Goncer

Ruiz-Ruigómez

López‐Medrano

et al. 2021

Transplant Infectious Dis

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Background Immunomodulatory effects attributable to cytomegalovirus (CMV) would predispose to BK polyomavirus (BKPyV) infection after kidney transplantation (KT), although available evidence is conflicting. It has been suggested that (val)ganciclovir therapy may increase the risk of BKPyV viremia and BKPyV‐associated nephropathy (BKPyVAN) as a result of drug‐induced T‐cell impairment. Methods We investigated whether CMV replication and/or (val)ganciclovir exposure (either as prophylaxis or treatment) were associated with the development of BKPyV viremia or BKPyVAN in a prospective cohort of 399 KT recipients. CMV infection (any level or high‐level viremia and area under the curve of DNAemia) and (val)ganciclovir exposure (any duration of therapy and cumulative days of treatment) during the first post‐transplant year were explored through separate landmark survival analyses. Results Cumulative incidence of BKPyV viremia and BKPyVAN after a median follow‐up of 551 days was 23.1% and 2.5%, respectively. One‐year rates of CMV infection and (val)ganciclovir therapy were 47.4% and 54.1%, respectively. No differences were observed in BKPyV viremia‐ or BKPyVAN‐free survival according to previous CMV infection or (val)ganciclovir exposure in any of the landmark analyses. Adjusted Cox models confirmed this lack of association. Conclusion Our findings do not confirm the existence of a relevant impact of CMV infection or (val)ganciclovir therapy on the risk of post‐transplant BKPyV events.

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Section: Discussionmentioning

confidence: 94%

CMV infection, valganciclovir exposure, and the risk of BK viremia and associated nephropathy after kidney transplantation: Is there a link?

Rodríguez‐Goncer

Ruiz-Ruigómez

López‐Medrano

et al. 2021

Transplant Infectious Dis

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“…Plenty of studies had identified the importance of recipient male gender [62,65,67,68,87,124] and older recipient age [57,68,87,113] in the development of BKVN, though such findings have not been consistently observed in all analyses [55,76,114]. Similarly, Obesity (BMI over 30 kg/m 2 ) was an independent predictor for BK viremia in a single study [125], but not in others [68,78].…”

Section: Recipient Age Gender and Weightmentioning

confidence: 99%

“…On the other hand, tacrolimus therapy was only classified as a risk factor for BK viremia in 7 multivariate analyses , [62][63][64][65][66][67][68] (Table 2) and a risk factor for BKVN in other two multivariate analyses [53,54] . The rest of studies which correlated tacrolimus with BK viremia and showed clearance of viremia upon reducing or withdrawing tacrolimus had small sample size (11 to 60 patients) and did not have control groups [95][96][97][98].…”

Section: Bk Association With Maintenance Immunosuppressant Therapymentioning

confidence: 99%

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BK Virus Infection in Adult Renal Transplant Recipients; Risk Factors and their Impact on Allograft Survival

Alalawi¹,

Alnour²,

Kossi³

et al. 2020

Trends in Transplant

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Background: Since the discovery of BK Virus (BKV) in 1971, it became a growing challenge in the renal transplant field. Many hypotheses over the latest years have been made to justify the increased risk of acquiring BKV infection post-renal transplantation. Excessive immunosuppression remains the primary risk factor. Risk factors such as older recipients, male gender, prolonged cold ischemia time, ureteric stent insertion, degree of HLA mismatching and others have all been linked as additional risks for acquiring BKV infection. Nevertheless, the current literature on risk factors are inconclusive and no single identifiable risk factor can determine recipients who at risk. Objective:The objective of this review is to delineate and contemplate the potential risk factors published in the literature and leads to BKV nephropathy.Methodology: For this review, a variety of sources were utilised including EMBASE, Scopus, PubMed/Medline database and Google Scholar for observational studies on probable risk factors predisposing to BK viremia and/or nephropathy.Results: almost 22 distinctive risk factors were identified.Discussion: Over immunosuppression remains the major risk factor for acquiring BKV infection post-renal transplant, though it is uncertain whether the occurrence of BKVN (BKV Nephropathy) is owing to quantitative and/or qualitative differences in immune suppressants.Besides immunosuppression, other probable risk factors for BKV infection were recognized. Whilst some of them were reproducible in many of these studies, they were denied by others. For instance, ureteric stents, recipient's age, race, deceased-donor type and acute rejection episodes, were inconsistently recognised as significant risk factors for BKV infection. Conclusions:Over immunosuppression remained the reproducible risk factor for BKV infection in all studies, never the less published data on other risks factors varies. This may mirror the patient's geographical area, genetic vulnerability and probably a different BK gene variant with different risk susceptibility, these warrant further investigation.

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“…This has corresponded to dramatic increases in BKV detection rates. Rates of viraemia amongst renal transplant recipients vary widely in the reported literature, with prevalence ranging between 1.5% and 33% and peak incidence in the first year following transplantation . The development of BKVN occurs in approximately 1% to 10% of cases and was historically associated with rates of graft loss approaching 50% .…”

Section: Epidemiologymentioning

confidence: 99%

BK virus: Current understanding of pathogenicity and clinical disease in transplantation

Chong

Antoni

Macdonald

et al. 2019

Reviews in Medical Virology

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BK polyomavirus (BKV) is an important cause of graft loss in renal transplant recipients that continues to pose a significant challenge to clinicians due to its frequently unpredictable onset, persistence, and the lack of effective antiviral agents or prevention strategies. This review covers our current understanding of epidemiology, viral transmission and disease progression, and treatment and prevention strategies that have been used to manage this disease.

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Prevalence and Risk Factors of BK Viremia in Patients With Kidney Transplantation: A Single-Center Experience From Turkey

Cited by 18 publications

References 18 publications

CMV infection, valganciclovir exposure, and the risk of BK viremia and associated nephropathy after kidney transplantation: Is there a link?

CMV infection, valganciclovir exposure, and the risk of BK viremia and associated nephropathy after kidney transplantation: Is there a link?

BK Virus Infection in Adult Renal Transplant Recipients; Risk Factors and their Impact on Allograft Survival

BK virus: Current understanding of pathogenicity and clinical disease in transplantation

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