title: Role of BK virus infection in end-stage renal disease patients waiting for kidney transplantation--viral replication dynamics from pre- to post-transplant.
abstract: We report the prevalence of BK virus (BKV) infection before renal transplantation and the dynamics of BKV viremia from pre- to post-transplantation. We assessed 60 kidney transplanted patients from a single cohort in Italy, treated with identical immunosuppressive therapy, for BK viremia at pre-transplantation, 12 h, and three and six months post-transplantation. Polymerase chain reaction showed that the prevalence of plasma BKV replication--considered a marker of infection--was 20% in pre-transplant patients. All pre-transplant-positive patients remained positive post-transplant, whereas the majority of pre-transplant-negative patients remained negative. Viremia dynamics classification revealed three clusters of patients: Cluster A++, pre-transplant-positive patients (20%) who tested positive at least once post-transplant; Cluster B-+, pre-transplant-negative patients (28%) who tested positive at least once post-transplant; and Cluster C- -, pre-transplant-negative patients (52%) who remained negative throughout. These clusters presented significant differences related to the prevalence of substantially positive patients with high plasma viral load (>10(3) copies/mL) in cluster A, but not in donors' or grafts' characteristics. We suggest that pre-transplant viral status should be considered as an additional risk factor for post-transplant BKV replication. Therefore, pre-transplant BKV infection screening in kidney transplant patients should be performed for improving planning of personalized immunosuppressant schemes and specific post-transplant surveillance.
authors: Nephrology and Dialysis Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
authors: Anna Paola
authors: AP
authors: Mitterhofer
authors: Francesca
authors: F
authors: Tinti
authors: Valeria
authors: V
authors: Pietropaolo
authors: Ilaria
authors: I
authors: Umbro
authors: Elena
authors: E
authors: Anzivino
authors: Anna
authors: A
authors: Bellizzi
authors: Assunta
authors: A
authors: Zavatto
authors: Luca
authors: L
authors: Poli
authors: Pasquale Bartolomeo
authors: PB
authors: Berloco
authors: Gloria
authors: G
authors: Taliani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001739:BK Virus / Q000502:physiology*; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D027601:Polyomavirus Infections / Q000601:surgery / Q000821:virology*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D014412:Tumor Virus Infections / Q000601:surgery / Q000821:virology*; D019562:Viral Load; D014766:Viremia / Q000821:virology; D014779:Virus Replication; D014850:Waiting Lists; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents
keywords: BK infection risk factor; BK replication dynamics; BK virus; PCR; kidney transplantation; pre-transplant BK infection