title: Lower prevalence of BK virus infection in African American renal transplant recipients: a prospective study.
abstract: BACKGROUND
  Because the occurrence of BK virus (BKV) nephritis is far less frequent than BK viremia or viruria, analysis of risk factors for BKV nephritis as an endpoint could lead to erroneous findings. We undertook a prospective study to evaluate the risk factors for the occurrence of BKV infections using BK viruria and viremia as endpoints.
  
  
  METHODS
  Two hundred forty renal only transplant recipients were prospectively enrolled into our institutional review board-approved single center study to evaluate various aspects of posttransplant BKV infection. All patients were followed up for a minimum of 6 months posttransplant.
  
  
  RESULTS
  Of the 240 subjects, 154 were whites, 61 African Americans, and 25 belonged to other races. A total of 94 developed BKV infection (any degree of BK viruria or viremia) whereas 146 developed no infection. Among these, 33 had BK viruria alone, 61 had BK viremia with viruria and 25 had significant viremia defined as BKV DNA more than 10,000 copies/mL of plasma. Lower proportion of African Americans developed BKV infection, 14 of 61 (23%), as opposed to whites, 67 of 154 (47%). Logistic regression model showed lower risk of any BKV infection in African American recipient race (OR, 0.38; 95% CI, 0.17-0.82; P=0.016) and higher risk of significant BKV infection with occurrence of acute rejection (OR, 3.9; 95% CI, 1.31-11.8; P=0.015). The Kaplan-Meier analysis shows a trend toward greater freedom from BKV infection in African Americans as opposed to other racial groups (P=0.33).
  
  
  CONCLUSIONS
  Renal transplant recipients of African American race had a lower risk of posttransplant BKV infection compared with whites, independent of other confounding risk factors.
authors.affiliation: Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Puneet
authors.initials: P
authors.lastname: Sood
authors.forename: Shamila
authors.initials: S
authors.lastname: Senanayake
authors.forename: Kumar
authors.initials: K
authors.lastname: Sujeet
authors.forename: Radhika
authors.initials: R
authors.lastname: Medipalli
authors.forename: Ehab
authors.initials: E
authors.lastname: Saad
authors.forename: Brahm
authors.initials: B
authors.lastname: Vasudev
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Bresnahan
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Johnson
authors.forename: Sundaram
authors.initials: S
authors.lastname: Hariharan
mesh_terms: D000328:Adult; D001741:Black or African American; D001739:BK Virus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D027601:Polyomavirus Infections / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000209:etiology; D044465:White People
chemical_list: D007166:Immunosuppressive Agents; D007518:Isoantibodies