title: Quantification of BK viral load in asymptomatic renal allograft recipients.
abstract: BACKGROUND
  Polyoma BK virus (BKV) has recently been identified to cause renal allograft dysfunction, which manifests as polyomavirus-associated nephropathy (PVAN). However, the presence and level of BKV DNA in renal allograft patients with good and stable renal function have remained undetermined.
  
  
  METHODS
  In this prospective study, serum samples were collected from a total of 45 renal allograft recipients with serum creatinine <155 μmol/L. In 17 patients, whose duration of transplantation was under 2 years, samples were collected at 3-4-month intervals for up to 2 years after transplantation. BK viral load was quantified using quantitative polymerase chain reaction (Q-PCR).
  
  
  RESULTS
  The BK viral load in asymptomatic renal allograft recipients was independent of the duration of transplantation and did not correlate with allograft function. The mean (± SD) level of viremia was 552.80 ± 1931.00 genome copies/mL, with 92.9% of patients having low levels of viremia corresponding to <1 × 10(3) copies/mL. In contrast, patients with proven PVAN had levels in the range of 10(6) copies/mL.
  
  
  CONCLUSIONS
  The prevailing BK viral load in asymptomatic renal allograft patients is quantifiably low. Our findings may guide optimal immunosuppressive modulation in PVAN cases, where judicious manipulation of immunosuppression is required without inciting allograft rejection.
authors.affiliation: Division of Nephrology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Gary C W
authors.initials: GC
authors.lastname: Chan
authors.forename: Anskar Y H
authors.initials: AY
authors.lastname: Leung
authors.forename: Anders S Y
authors.initials: AS
authors.lastname: Wong
authors.forename: Kwok Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Yok Lam
authors.initials: YL
authors.lastname: Kwong
authors.forename: Kar Neng
authors.initials: KN
authors.lastname: Lai
authors.forename: Sydney C W
authors.initials: SC
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D001739:BK Virus / Q000235:genetics / Q000302:isolation & purification*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000821:virology*; D006801:Humans; D007674:Kidney Diseases / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D027601:Polyomavirus Infections / Q000821:virology*; D011183:Postoperative Complications; D011446:Prospective Studies; D014184:Transplantation, Homologous; D014412:Tumor Virus Infections / Q000821:virology*; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral