title: The status of BK polyomavirus replication in adult renal transplant recipients in northeastern Poland.
abstract: OBJECTIVE
  BK polyomavirus (BKV) infection and BKV-associated nephropathy (BKVAN) are among the most important problems in renal transplantation. We aimed to determine the incidence of BK viruria, viremia, and BKVAN in renal transplant recipients in the northeastern part of Poland.
  
  
  METHODS
  Urine and blood samples from 126 cadaveric renal transplant recipients were analyzed for BK viruria and viremia using quantitative real-time polymerase chain reaction and the patients were followed prospectively. The diagnosis of BKVAN was established on the allograft biopsy.
  
  
  RESULTS
  Based on the BKV DNA analysis, the patients were divided into three groups: group 1 (n=89; 70.6%) without viruria or viremia, group 2 (n=24; 19.1%) with isolated viruria, and group 3 (n=13; 10.3%) with both viruria and viremia. The presence of BK viremia negatively correlated with time after the transplantation. BK viruria was associated with mycophenolate mofetil daily dose. In group 3 there were four patients (3.2%) with high viremia (>10(4) genome equivalents [gEq]/mL) and viruria (>10(7) gEq/mL) loads. Only one patient from this group developed clinical symptoms and had BKVAN in allograft biopsy. In all four cases, the maintenance immunosuppression therapy was based on tacrolimus and steroids.
  
  
  CONCLUSIONS
  Prevalence of BKV infection in renal transplant recipients in the northeastern part of Poland is similar to that reported by studies from other countries. We confirm that BK viremia could be predicted by the presence of intense viruria. Time after transplantation and the type of immunosuppression strategy are the most important predictors of BK viremia and viruria in patients after renal transplantation.
authors: Department of Nephrology and Transplantation with Dialysis Unit, Medical University, Bialystok, Poland. bnaumnik@poczta.onet.pl
authors: B
authors: B
authors: Naumnik
authors: J
authors: J
authors: Kowalewska
authors: G
authors: G
authors: Zalewski
authors: R
authors: R
authors: Charkiewicz
authors: M
authors: M
authors: Myśliwiec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001739:BK Virus / Q000472:pathogenicity* / Q000502:physiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology / Q000821:virology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D011044:Poland; D027601:Polyomavirus Infections / Q000209:etiology* / Q000473:pathology / Q000821:virology; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000209:etiology* / Q000473:pathology / Q000821:virology; D014766:Viremia / Q000209:etiology / Q000821:virology; D014779:Virus Replication; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid