Different patterns of BK and JC polyomavirus reactivation following renal transplantation.
OBJECTIVE
Reactivation of latent BK polyomavirus (BKV) infection is relatively common following renal transplantation and BKV-associated nephropathy has emerged as a significant complication. JC polyomavirus (JCV) reactivation is less well studied. The aim of the study was to determine reactivation patterns for these polyomaviruses in renal transplant recipients using an in-house quantitative real-time multiplex PCR assay and IgG serological assays using recombinant BK and JC virus-like particles.


METHODS
Retrospective analysis of urine and plasma samples collected from 30 renal transplant patients from February 2004 to May 2005 at Leeds Teaching Hospitals NHS Trust. Samples were collected at 5 days and thereafter at 1, 3, 6 and 12 months post-transplantation.


RESULTS
Eight patients (26.7%) were positive for BK viruria; three of these patients submitted plasma samples and two had BK viraemia. Five patients (16.7%) were positive for JC viruria. A corresponding rise in BKV and JCV antibody titres was seen in association with high levels of viruria.


CONCLUSIONS
Different patterns of reactivation were observed: BK viruria was detected after 3-6 months, and JC viruria was observed as early as 5 days post-transplantation. One patient had biopsy-proven BKV nephropathy. No dual infections were seen. In order to ensure better graft survival, early diagnosis of these polyomaviruses is desirable.
Saundh
Baljit K
BK
Leeds Teaching Hospitals NHS Trust, Microbiology and Renal Unit, Leeds, UK. baljit.saundh@leedsth.nhs.uk
Tibble
Stephen
S
Baker
Richard
R
Sasnauskas
Kestutis
K
Harris
Mark
M
Hale
Antony
A
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001739:BK Virus / Q000276:immunology / Q000502:physiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007577:JC Virus / Q000276:immunology / Q000502:physiology*; D007674:Kidney Diseases / Q000821:virology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D027601:Polyomavirus Infections / Q000821:virology*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000821:virology; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D014412:Tumor Virus Infections / Q000821:virology*; D019562:Viral Load; D014775:Virus Activation
D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus