Quantitation of BK virus load in serum for the diagnosis of BK virus-associated nephropathy in renal transplant recipients.
BK virus-associated nephropathy is an increasingly recognized cause of graft dysfunction among kidney transplant recipients, and definitive diagnosis requires renal biopsy. By using a newly developed, quantitative, real-time polymerase chain reaction (PCR) assay for BK virus DNA, a retrospective analysis was done of sequential serum samples (n=28) from 4 transplant recipients with histopathologically documented BK virus nephropathy and from samples (n=76) from 16 transplant recipient control patients. BK virus DNA was detected in serum samples from all 4 case patients versus 0 of 16 control patients (P< .0001, Fisher's exact test) at a median of 32 weeks (range, 17-61 weeks) before the diagnosis of BK virus nephropathy. BK virus load decreased in 3 of 3 patients after the reduction of immunosuppression and/or nephrectomy. It is concluded that quantitative PCR for BK virus DNA in serum is useful both for identifying transplant recipients at risk for BK virus nephropathy and for monitoring the response to therapy.
Limaye
A P
AP
Department of Laboratory Medicine, University of Washington, Seattle, USA. limaye@u.washington.edu
Jerome
K R
KR
Kuhr
C S
CS
Ferrenberg
J
J
Huang
M L
ML
Davis
C L
CL
Corey
L
L
Marsh
C L
CL
D000328:Adult; D001739:BK Virus / Q000235:genetics / Q000302:isolation & purification*; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000097:blood / Q000628:therapy / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000097:blood / Q000821:virology*; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D014412:Tumor Virus Infections / Q000097:blood / Q000821:virology*; D019562:Viral Load
D004279:DNA, Viral; D007166:Immunosuppressive Agents