title: High-level JCPyV viruria after kidney transplantation-Clinical and histopathological findings.
abstract: The significance of JC polyomavirus (JCPyV) after kidney transplantation ranges from irrelevant to full-blown nephropathy or PML.
  
  
  
  To investigate the clinical significance of high-level JCPyV viruria and JCPyV primary infections after kidney transplantation.
  
  
  
  JCPyV viruria was detected in routine screening by quantitative real-time PCR in 40/238 kidney transplant recipients and was high-level (>107copies/ml) in 17 patients. A protocol biopsy at the time of JCPyV viruria was available from 10 patients.
  
  
  
  Peak urine viral loads were 1.0×107-2.5×109copies/ml in the 17 high-level viruria patients. 6/15 (40%) patients with high-level JCPyV viruria with pretransplant sera available were JCPyV IgG negative suggesting that JCPyV viruria resulted from the donor graft in most cases. No acute graft dysfunction was associated with JCPyV viruria. No positive SV40 staining was detected in protocol biopsies, and no specific histopathology was associated with high-level viruria; JCPyV nephropathy was not found. No differences were seen in histopathology or graft function at 3 years in patients with high-level viruria compared to non-JCPyV viruric patients transplanted during the same time period, and outcome was similar in patients with presumably primary and reactivated JCPyV. The mean estimated GFR at last follow-up was 44ml/min (range 12-60ml/min). One graft with high-level viruria was lost 9 years posttransplant due to recurrent IgA nephropathy CONCLUSIONS: High-level JCPyV viruria seems to be associated with primary JCPyV infection reflecting the average seroprevalence of 60%, but is not stringently associated with inferior graft function or survival, or histopathological changes.
authors.affiliation: Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland. Electronic address: Ilkka.helantera@helsinki.fi.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Helanterä
authors.affiliation: Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Hirsch
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
authors.forename: Eeva
authors.initials: E
authors.lastname: Auvinen
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Mannonen
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
authors.forename: Maaret
authors.initials: M
authors.lastname: Nummi
authors.affiliation: Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland.
authors.forename: Marion
authors.initials: M
authors.lastname: Wernli
authors.affiliation: Department of Nephrology, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Ortiz
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Räisänen-Sokolowski
authors.affiliation: Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Lempinen
authors.affiliation: Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
authors.forename: Irmeli
authors.initials: I
authors.lastname: Lautenschlager
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification*; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000473:pathology* / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D066027:Transplant Recipients; D016896:Treatment Outcome; D014556:Urine / Q000821:virology*; D019562:Viral Load
keywords: JC polyomavirus; Kidney transplantation; Polyomavirus-associated nephropathy