A prospective longitudinal study of polyomavirus shedding in lung-transplant recipients.
BACKGROUND
Polyomavirus infection causes renal dysfunction after kidney transplantation, but it has not been thoroughly investigated in nonrenal solid-organ transplantation.


METHODS
Fifty lung-transplant recipients provided prospective urine and blood samples over the course of 17 months. Samples were analyzed for BK virus (BKV), JC virus (JCV), and simian virus 40 (SV40) using conventional polymerase chain reaction (PCR), sequence analysis, and quantitative real-time PCR.


RESULTS
Thirty-one (62%) of 50 patients had polyomavirus detected in at least 1 urine specimen, including 16 (32%) for BKV, 12 (24%) for JCV, and 6 (12%) for SV40. Mean BKV loads (5.0 log(10) copies/mL) did not differ from those of JCV (5.7 log(10) copies/mL; P=.38), but SV40 loads (2.5 log(10) copies/mL) were lower than those of BKV (P=.006) and JCV (P=.002). Blood samples were negative. Infection with individual polyomaviruses or polyomavirus infection in aggregate was not associated with reduced creatinine clearance. Patients not shedding polyomavirus had better survival than patients shedding polyomavirus (P=.049).


CONCLUSIONS
Polyomaviruses BKV and JCV were commonly detected in urine from lung-transplant recipients. SV40 was found in 12% of patients but was shed at a lower frequency and with lower viral loads than the other viruses. Polyomavirus infection was not associated with renal dysfunction.
Thomas
Lora D
LD
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Vilchez
Regis A
RA
White
Zoe S
ZS
Zanwar
Preeti
P
Milstone
Aaron P
AP
Butel
Janet S
JS
Dummer
Stephen
S
D004279:DNA, Viral / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011120:Polyomavirus / Q000235:genetics / Q000302:isolation & purification*; D027601:Polyomavirus Infections / Q000097:blood / Q000652:urine / Q000821:virology*; D011183:Postoperative Complications / Q000821:virology*; D011446:Prospective Studies; D014412:Tumor Virus Infections / Q000097:blood / Q000652:urine / Q000821:virology*
D004279:DNA, Viral