Pathogenesis and management of polyomavirus infection in transplant recipients.
Polyomaviruses (JC virus [JCV], BK virus [BKV], and simian virus 40 [SV40]) establish subclinical and persistent infections and share the capacity for reactivation from latency in their host under immunosuppression. JCV establishes latency mainly in the kidney, and its reactivation results in the development of progressive multifocal leukoencephalopathy. BKV causes infection in the kidney and the urinary tract, and its activation causes a number of disorders, including nephropathy and hemorrhagic cystitis. Recent studies have reported SV40 in the allografts of children who received renal transplants and in the urine, blood, and kidneys of adults with focal segmental glomerulosclerosis, which is a cause of end-stage renal disease and an indication for kidney transplantation. Clinical syndromes related to polyomavirus infection are summarized in the present review, and strategies for the management of patients who receive transplants are discussed.
Kwak
Eun Jeong
EJ
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Vilchez
Regis A
RA
Randhawa
Parmjeet
P
Shapiro
Ron
R
Butel
Janet S
JS
Kusne
Shimon
S
D003556:Cystitis / Q000175:diagnosis / Q000209:etiology; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D009393:Nephritis / Q000175:diagnosis / Q000209:etiology; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D013577:Syndrome; D019737:Transplants / Q000009:adverse effects*