title: BK virus replication and nephropathy after alemtuzumab-induced kidney transplantation.
abstract: BK virus nephropathy (BKVN) is a recognized cause of graft failure in kidney transplant recipients. There are limited data on the epidemiology of BK virus (BKV) infection after alemtuzumab induction. By clinical protocol, the kidney transplant recipients at our center were screened with BKV plasma PCR monthly for the first 4 months posttransplant then every 2-3 months for 2 years. A single center retrospective cohort study of all kidney transplant recipients from January 2008 to August 2010 was conducted to determine incidence and outcomes of BKV infection. Descriptive statistics and Kaplan-Meier analysis was performed. Of 666 recipients, 250 (37.5%) developed viruria, 80 (12%) developed viremia and 31 (4.7%) developed BKVN at a median of 17, 21 and 30 weeks, respectively. Induction with alemtuzumab did not significantly affect incidence of BKVN. Increased recipient age, African American race, acute graft rejection and CMV infection were significantly associated with the development of BKVN in multivariate analysis. The incidence of BK viruria, viremia and nephropathy was not significantly different among kidney transplant recipients who received alemtuzumab induction compared to patients receiving less potent induction.
authors.affiliation: Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, USA.
authors.forename: N
authors.initials: N
authors.lastname: Theodoropoulos
authors.forename: E
authors.initials: E
authors.lastname: Wang
authors.forename: S
authors.initials: S
authors.lastname: Penugonda
authors.forename: D P
authors.initials: DP
authors.lastname: Ladner
authors.forename: V
authors.initials: V
authors.lastname: Stosor
authors.forename: J
authors.initials: J
authors.lastname: Leventhal
authors.forename: J
authors.initials: J
authors.lastname: Friedewald
authors.forename: M P
authors.initials: MP
authors.lastname: Angarone
authors.forename: M G
authors.initials: MG
authors.lastname: Ison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001739:BK Virus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D016019:Survival Analysis; D014779:Virus Replication; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074323:Alemtuzumab