A prospective longitudinal study of BK virus infection in 104 renal transplant recipients.
BK virus (BKV) infection during the first year after renal transplantation was studied prospectively in 104 unselected consecutive patients. Viral DNA in urine (DNAuria) and plasma (DNAemia) samples was detected and quantified by real-time PCR. The noncoding control region (NCCR) of BKV isolates was sequenced. DNAuria and DNAemia occurred in 57% and 29% of patients, respectively. Three groups were defined, uninfected patients (group 1, n=45), patients with DNAuria (group 2, n=29) and patients with positive DNAemia (group 3, n=30). Active infection started within the first 3 months in 80% of patients. Cold ischemia duration over 24 h and the administration of tacrolimus were identified as significant risks factors for DNAuria, whereas it remains more frequently negative in patients receiving cyclosporine A. The risk for positive DNAemia was higher in patients with DNAuria (notably for viral load (VL)>4 log/mL) or treated with tacrolimus. No relationship was found with genetic variability in the NCCR sequence. Our data highlight the high frequency of active BKV infection after renal transplantation. Although high VL was detected in some patients, none developed a BKV nephropathy. A prospective follow-up of the whole population during the first year post renal transplantation is thus not useful to predict BKV disease.
Virology Laboratory, University Hospital, Nantes and J.E 2437, Genetique des Interactions Hôte-Microorganismes, Nantes University, Nantes, France.
C
C
Bressollette-Bodin
M
M
Coste-Burel
M
M
Hourmant
V
V
Sebille
E
E
Andre-Garnier
B M
BM
Imbert-Marcille
D001739:BK Virus / Q000502:physiology*; D001483:Base Sequence; D016572:Cyclosporine / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000628:therapy / Q000821:virology*; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D027601:Polyomavirus Infections / Q000821:virology*; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012689:Sequence Homology, Nucleic Acid; D016559:Tacrolimus / Q000627:therapeutic use; D014412:Tumor Virus Infections / Q000821:virology*; D019562:Viral Load; D014779:Virus Replication
D004279:DNA, Viral; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus