Viral Origin, Clinical Course, and Renal Outcomes in Patients With BK Virus Infection After Living-Donor Renal Transplantation

Schwarz, Anke; Linnenweber-Held, Silvia; Heim, Albert; Framke, Theodor; Haller, Hermann; Schmitt, Corinna

doi:10.1097/tp.0000000000001066

Cited by 75 publications

(76 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the viremia group genotype IV was more prevalent after genotype I. This outcome differs from the one recently published by Schwarz et al where genotype IV was more prevalent in the BKPyVAN group [32]. This discrepancy could possibly be explained to the different distribution of BKPyV genotypes in the population throughout the world, as described by others [33–35].…”

Section: Discussioncontrasting

confidence: 61%

A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients

et al. 2017

View full text Add to dashboard Cite

BackgroundThe immunosuppressive agents mycophenolate acid (MPA) and tacrolimus (Tac) are associated with a higher incidence of BK polyomavirus nephropathy (BKPyVAN).In this observational retrospective cohort study, the frequency of BK polyomavirus (BKPyV) complications over a 24-month period was studied.Methods358 renal transplant recipients (RTR) treated with MPA, with either cyclosporine A (CsA) (CsAM group) or Tac (TacM group) and mostly prednisolone, were included.ResultsIncidence of BKPyV-viremia was not significantly different between the CsAM (n = 42/191) (22.0%) and the TacM (n = 36/167) (21.6%) group. Biopsy proven BKPyVAN occurred more often in the TacM group (6.6%) versus the CsAM group (2.1%) (p = 0.03). Longitudinal data analysis showed a significant earlier decline of viral load in plasma in the CsAM group compared to the TacM group (p = 0.005).The incidence of biopsy proven acute rejection (BPAR) was significantly higher in the CsAM (19.9%) compared to the TacM (10.8%) (p = 0.02) group. Graft loss, estimated glomerular filtration rate and mortality rate did not differ in both treatment groups.ConclusionIn conclusion, this study shows that immunosuppressive treatment with Tac and MPA compared to CsA and MPA is associated with a lower incidence of BPAR, but at the cost of an increased risk of developing BKPyVAN in the first two years post-transplant.

show abstract

Section: Discussioncontrasting

confidence: 61%

A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A German study comparing 20 donor recipient pairs through VP1 typing region also concluded that the virus shed by recipients most likely come from the donor . And, more recently, Schwarz et al also demonstrated the donor‐origin of the virus in 24 of 28 living donor‐recipient pairs.…”

Section: Discussionmentioning

confidence: 72%

Variable sources of Bk virus in renal allograft recipients

Urbano

Nali

Oliveira

et al. 2019

Journal of Medical Virology

View full text Add to dashboard Cite

BK virus is the causative agent of polyomavirus‐associated nephropathy, a major cause of kidney transplant failure affecting 1%‐10% of recipients. Previous studies that investigated the viral source on the kidney recipient pointed that the donor is implicated in the origin of human polyomavirus BK (BKPyV) infection in recipients, but giving the low genetic variability of BKPyV this subject is still controversial. The aim of this study was to determine if BKPyV replicating in kidney recipients after transplantation is always originated from the donor. Urine and blood samples from 68 pairs of living donors and kidney recipients who underwent renal transplantation from August 2010‐September 2011 were screened for BKPyV by real time polymerase chain reaction. Only three recipients presented viremia. When both donors and recipients were BKPyV positive, a larger fragment of VP1 region was obtained and sequenced to determine the level of similarity between them. A phylogenetic tree was built for the 12 pairs of sequences obtained from urine and high level of similarity among all sequences was observed, indicating that homology inferences for donor and recipient viruses must be cautiously interpreted. However, a close inspection on the donor‐recipient pairs sequences revealed that 3 of 12 pairs presented considerably different viruses and 4 of 12 presented mixed infection, indicating that the source of BKPyV infection is not exclusively derived from the donor. We report that about 60% of the renal recipients shed BKPyV genetically distinct from the donor, confronting the accepted concept that the donor is the main source of recipients’ infection.

show abstract

“…In addition to potent immunosuppression, risk factors for BKVAN after KTx include treatment for allograft rejection, ureteral stent indwelling time, and pretransplantation donor‐recipient pair seroreactivity . These reports have raised awareness that BK infection after KTx could be from reactivation of recipient's BKV or donor‐derived transmission . A better understanding of the epidemiology of BKV genotypes among KTx recipients may advance future studies to prevent BKVAN or to help develop a vaccine for BK virus among KTx recipients …”

Section: Introductionmentioning

confidence: 99%

BK polyomavirus genotypes in renal transplant recipients in the United States: A meta‐analysis

Khoury

Aeddula

Boonpheng

et al. 2019

J Evidence Based Medicine

View full text Add to dashboard Cite

Background In the United States, increasing ethnic diversity has been apparent. However, the epidemiology and trends of BKV genotypes remain unclear. This meta‐analysis was conducted with the aim to assess the prevalence of BKV genotypes among kidney transplant (KTx) recipients in the United States. Methods A comprehensive literature review was conducted through October 2018 utilizing MEDLINE, Embase, and Cochrane Database to identify studies that reported the prevalence of BKV subtypes and/or subgroups in KTx recipients in the United States. Pooled prevalence rates were combined using random effects, generic inverse variance method. The protocol for this study is registered with PROSPERO (no. CRD42019134582). Results A total of eight observational studies with a total of 193 samples (urine, blood, and kidney tissues) from 188 BKV‐infected KTX recipients were enrolled. Overall, the pooled estimated prevalence rates of BKV subtypes were 72.2% (95% confidence of interval [CI]: 62.7‐80.0%) for subtype I, 6.8% (95% CI: 2.5‐16.9%) for subtype II, 8.3% (95% CI: 4.4‐15.1%) for subtype III, and 16.1% (95% CI: 10.4‐24.2%) for subtype IV, respectively. While metaregression analysis demonstrated a significant positive correlation between year of study and the prevalence of BKV subtype I (slopes = +0.1023, P = .01), there were no significant correlations between year of study and percentages of BKV subtype II‐IV (P > .05). Among KTx recipients with BKV subtype I, the pooled estimated percentages of BKV subgroups were 22.4% (95% CI: 13.7‐34.5%) for subgroup Ia, 30.6% (95% CI: 17.7‐47.5%) for subgroup Ib1, 47.7% (95% CI: 35.8‐59.9%) for subgroup Ib2, and 4.1% (95% CI:1.2‐13.3%) for subgroup Ic, respectively. Conclusion BKV subtype I is the most prevalent subtype among KTx recipients in the United States and its prevalence seems to increasing overtime. Subgroup Ib2 is the most common subgroup among BKV subtype I.

show abstract

Viral Origin, Clinical Course, and Renal Outcomes in Patients With BK Virus Infection After Living-Donor Renal Transplantation

Cited by 75 publications

References 42 publications

A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients

A delicate balance between rejection and BK polyomavirus associated nephropathy; A retrospective cohort study in renal transplant recipients

Variable sources of Bk virus in renal allograft recipients

BK polyomavirus genotypes in renal transplant recipients in the United States: A meta‐analysis

Contact Info

Product

Resources

About