title: High incidence of malignancy in polyomavirus-associated nephropathy in renal transplant recipients.
abstract: Human polyomaviruses (PV), including JC and BK virus, have been reported to cause polyomavirus-associated nephropathy (PVAN), in renal transplant patients. PV infection has been demonstrated to be associated with malignancies in animals; however, the association between malignancy and viral infections in humans is not clear. We retrospectively reviewed our 864 (M:F=502:362) kidney transplant patients over the past 25 years. We identified PVAN in 6 patients (0.69%), including BK nephropathy (n=5) and JC nephropathy (n=1). Three patients (50%) improved after reducing the immunosuppression, but 3 (50%) progressed to graft loss despite this reduction. Malignancy occurred in 5 out of the 6 patients (83%; P<.0001 compared with patients without PVAN), including transitional cell carcinoma (n=2), renal cell carcinoma (n=1), squamous cell carcinoma of skin (n=1) and Kaposi sarcoma (n=1). We concluded that kidney transplant patients with PVAN are at a significantly greater risk to develop malignancy. Whether this is due to a direct effect of PV infection or the result of overimmunosuppression remains to be determined in a future study.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, and Department of Life Science, Tunghai University, Taichung, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: M-C
authors.initials: MC
authors.lastname: Wen
authors.forename: M
authors.initials: M
authors.lastname: Wang
authors.forename: J-D
authors.initials: JD
authors.lastname: Lian
authors.forename: C-H
authors.initials: CH
authors.lastname: Cheng
authors.forename: M-J
authors.initials: MJ
authors.lastname: Wu
authors.forename: T-M
authors.initials: TM
authors.lastname: Yu
authors.forename: Y-W
authors.initials: YW
authors.lastname: Chuang
authors.forename: D
authors.initials: D
authors.lastname: Chang
authors.forename: K-H
authors.initials: KH
authors.lastname: Shu
mesh_terms: D000818:Animals; D001739:BK Virus / Q000302:isolation & purification; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification; D007674:Kidney Diseases / Q000453:epidemiology / Q000235:genetics / Q000628:therapy / Q000821:virology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008499:Medical Records; D009369:Neoplasms / Q000453:epidemiology / Q000821:virology; D027601:Polyomavirus Infections / Q000453:epidemiology / Q000473:pathology*; D015995:Prevalence; D012189:Retrospective Studies; D014412:Tumor Virus Infections / Q000453:epidemiology / Q000473:pathology