title: Polyomavirus BK infection before liver transplantation in patients with chronic kidney disease.
abstract: End-stage liver disease (ESLD) and chronic kidney disease (CKD) patients are both immunocompromised populations but polyomavirus BK (BKV) replication before liver transplantation is rare. We evaluated BKV prevalence among liver transplant recipients with renal dysfunction and the possible role of CKD as a risk factor for BKV replication in ESLD. From 2010 to 2011 we selected 31 ESLD patients awaiting liver transplantation to identify, the presence of CKD: No CKD (n = 22; 18 males) and CKD group (n = 9; 5 males). BKV infection was defined on the basis of viremia evaluated using quantitative real-time polymerase chain reactions. The prevalence of viremia among the No CKD group was 14% versus 56% in the CKD group (Fisher test; P = .027). We hypothesized that the presence of CKD may represent an additional condition of immunologic dysfunction regarding antiviral surveillances other than the antibacterial one that characterizes ESLD immunodysfunction, which could have promoted BKV replication. The specific immunologic mechanisms involved in pretransplantation diseases may have a role in BKV reactivation that could become responsible for nephropathy after transplantation.
authors.affiliation: Department of Clinical Medicine, Nephrology and Dialysis Unit, 1st Faculty of Medicine and Surgery, Sapienza University of Rome, Rome, Italy. annapaola.mitter@uniromal.it
authors.forename: A P
authors.initials: AP
authors.lastname: Mitterhofer
authors.forename: F
authors.initials: F
authors.lastname: Tinti
authors.forename: I
authors.initials: I
authors.lastname: Umbro
authors.forename: V
authors.initials: V
authors.lastname: Pietropaolo
authors.forename: F
authors.initials: F
authors.lastname: Fiacco
authors.forename: A
authors.initials: A
authors.lastname: Bellizzi
authors.forename: E
authors.initials: E
authors.lastname: Anzivino
authors.forename: S
authors.initials: S
authors.lastname: Ginanni Corradini
authors.forename: L
authors.initials: L
authors.lastname: Poli
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: P B
authors.initials: PB
authors.lastname: Berloco
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.forename: F
authors.initials: F
authors.lastname: Chiarini
authors.forename: G
authors.initials: G
authors.lastname: Taliani
mesh_terms: D000328:Adult; D001739:BK Virus / Q000302:isolation & purification* / Q000502:physiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000150:complications*; D060888:Real-Time Polymerase Chain Reaction; D014779:Virus Replication