title: Donor and recipient BKV-specific IgG antibody and posttransplantation BKV infection: a prospective single-center study.
abstract: BACKGROUND
  The study evaluated the relationship of pretransplantation BK virus (BKV)-specific donor and recipient serostatus to posttransplantation BKV infection.
  
  
  METHODS
  Two hundred forty adult de novo kidney-only recipients and 15 pediatric recipients were prospectively enrolled and followed for a minimum of 18 months. Pretransplantation BKV serostatus was available for 192 adult and 11 pediatric donor-recipient pairs. Based on BKV-specific IgG enzyme immunoassay ≥8 units, subjects were divided into four groups: D+R+, D+R-, D-R+, and D-R-. BKV DNA surveillance was performed at 1, 3, 6, 12, and 24 months. The outcomes studied were development of any BKV infection, viremia, and significant viremia (≥10,000 copies/mL plasma).
  
  
  RESULTS
  Of the 192 adult subjects (D+R- [n=41], D+R+ [n=42], D-R+ [n=41], and D-R- [n=68]), 89 of 192 developed any BKV infection and 62 of 89 developed BK insignificant viremia (n=33) and significant viremia (n=29). Any BKV infection developed in 25 of 41, 22 of 42, 17 of 41, and 25 of 68 in the D+R-, D+R+, D-R+, and D-R- groups, respectively. Any viremia (20 of 41) and significant viremia (10 of 41) seen in the D+R- group was significantly higher than other groups (P=0.014). In 11 pediatric recipients, infection was seen only in the D+R- group. Overall, infection was highest in the D+R- group and lowest in the D-R- group.
  
  
  CONCLUSIONS
  BKV serostatus can be used to risk stratify patients for posttransplantation infection.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, 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: Scott K
authors.initials: SK
authors.lastname: Van-Why
authors.forename: David C
authors.initials: DC
authors.lastname: Cronin
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Johnson
authors.forename: Sundaram
authors.initials: S
authors.lastname: Hariharan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000737:chemistry*; D001739:BK Virus / Q000235:genetics* / Q000276:immunology*; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D011183:Postoperative Complications; D011446:Prospective Studies; D014180:Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000453:epidemiology; D014766:Viremia / Q000821:virology
chemical_list: D000906:Antibodies; D007074:Immunoglobulin G