title: Prevalence and risk factors of polyomavirus BK replication in simultaneous pancreas/kidney transplant recipients from a single transplant center.
abstract: BACKGROUND
  BK virus (BKV) replication is considered as a marker of risk for polyomavirus BK-associated nephropathy (PVAN). We evaluated the occurrence and risk factors for BKV DNA positivity following simultaneous pancreas/kidney transplantation (SPK).
  
  
  METHODS
  Point prevalence of BK viruria and viremia was assessed in 183 SPK recipients. Real-time polymerase chain reaction was used with a detection threshold of 10(3) copies/mL. High-level BKV positivity was defined as viruria and/or viremia >10(7) and >10(4) copies/mL, respectively. BKV-positive patients were retested after 4-13 months and underwent an additional six-month clinical follow-up.
  
  
  RESULTS
  Urine and serum BKV positivity was detected in 28 (17.3% of available samples) and 7 (3.8%) patients, with high-level viruria and viremia occurring in 6 (3.7%) and 3 (1.6%) patients, respectively. PVAN was biopsy-confirmed in 1 and suspected as a cause of progressive renal failure in another SPK recipient. Patients with single low-level viruria did not progress to high-level positivity or PVAN at follow-up. In multivariate analysis, pre-transplant diabetes duration and delayed graft function were independently associated with BKV positivity.
  
  
  CONCLUSIONS
  Point prevalence of high-level BKV positivity and PVAN was low in SPK recipients from a single center. Diabetes duration and delayed graft function were independent risk factors for BKV replication.
authors.affiliation: Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Mindlova
authors.forename: Petr
authors.initials: P
authors.lastname: Boucek
authors.forename: Frantisek
authors.initials: F
authors.lastname: Saudek
authors.forename: Jelena
authors.initials: J
authors.lastname: Skibova
authors.forename: Teodora
authors.initials: T
authors.lastname: Jedinakova
authors.forename: Kvetoslav
authors.initials: K
authors.lastname: Lipar
authors.forename: Milos
authors.initials: M
authors.lastname: Adamec
authors.forename: Hans H
authors.initials: HH
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D001739:BK Virus / Q000302:isolation & purification* / Q000502:physiology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D027601:Polyomavirus Infections / Q000175:diagnosis*; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000175:diagnosis*; D019562:Viral Load; D014766:Viremia / Q000175:diagnosis; D014779:Virus Replication
chemical_list: D004279:DNA, Viral