title: BK virus-specific antibodies and BKV DNA in renal transplant recipients with BKV nephritis.
abstract: We evaluated twenty renal transplant subjects at various stages of BKV nephritis (BKVN) for BKV-specific IgG and IgM antibodies using ELISA technique and BKV-DNA using PCR. They were divided as early onset (n = 7), stabilizing (n = 3), resolved (n = 8) and late onset (n = 2) BKVN. BKV-specific antibodies and BKV-DNA were simultaneously determined. The mean BKV-specific IgG level in early onset and stabilizing BKVN were 64 and 39 EIA units, and were significantly lower than 138 EIA units seen in resolved BKVN, P = 0.007, P = 0.008. The mean BKV-specific IgM levels in stabilizing BKVN was higher than resolved BKVN (130 vs 51 EIA units), P = 0.006. Mean plasma BKV loads for each group were 955,925, 5642 and 42 copies/mL of plasma, respectively. Prospective study in six BKVN cases revealed mean IgG, IgM levels and BKV-DNA at the time of diagnosis of BKVN as 39, 110 EIA units and 586,758 copies/mL of plasma, respectively. After a mean period of 5.2 months, IgG level increased to 120 EIA units (p = 0.0058) and had no detectable viral copies in circulation. Recovery from BKVN and elimination of BKV is associated with the development of BKV-specific IgG antibodies and this provides insight into the role of humoral immunity to BKV in the pathogenesis of BKVN.
authors.affiliation: The Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA. hari@mcw.edu
authors.forename: Sundaram
authors.initials: S
authors.lastname: Hariharan
authors.forename: Eric P
authors.initials: EP
authors.lastname: Cohen
authors.forename: Brahm
authors.initials: B
authors.lastname: Vasudev
authors.forename: Rimas
authors.initials: R
authors.lastname: Orentas
authors.forename: Raphael P
authors.initials: RP
authors.lastname: Viscidi
authors.forename: Justin
authors.initials: J
authors.lastname: Kakela
authors.forename: Brian
authors.initials: B
authors.lastname: DuChateau
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D001739:BK Virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood* / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000821:virology*; D016035:Pancreas Transplantation / Q000009:adverse effects; D027601:Polyomavirus Infections / Q000276:immunology / Q000635:transmission*; D013997:Time Factors; D014412:Tumor Virus Infections / Q000276:immunology / Q000635:transmission*; D014766:Viremia / Q000097:blood / Q000188:drug therapy
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D003404:Creatinine