TY - JOUR
T1 - Longitudinal study of BK Polyomavirus outcomes, risk factors, and kinetics in renal transplantation patients
AU - Chan, Brandon Dow
AU - Wong, Gabriella
AU - Jiang, Qing
AU - Lee, Magnolia Muk Lan
AU - Wong, Wing Yan
AU - Chen, Feifei
AU - Wong, Wing Tak
AU - Zhu, Lixing
AU - Wong, Francis Kim Ming
AU - Tai, William C S
N1 - Funding Information:
WCST was supported in part by the Hong Kong University Grants Committee, Research Grants Council, General Research Fund (Project #12103515 ). LXZ was supported by the Hong Kong University Grants Committee, Research Grants Council, General Research Fund ( HKBU12301717 ).
PY - 2020/5
Y1 - 2020/5
N2 - Background: In the immunocompromised conditions following renal transplantation, BK virus can reactivate and cause BK virus associated nephropathy (BKVN). Increased BK viral loads and extended duration of infection have been linked to development of BKVN. The aim of this study was to observe the incidence of BKV infection and BKVN, and kinetics of infection and disease in renal transplantation recipients. Methods: From 2014 to 2018, we conducted a longitudinal cohort observational study of 139 renal transplantation patients treated at a single clinic. Quantitative PCR assay was conducted to assess longitudinal BK viral loads. Analysis of patient clinical characteristics was performed to determine risk factors for BKV infection and associated disease. Results: Of our cohort, 29 (20.9%) patients developed high BK viremia, and 7 (5.0%) developed biopsy-confirmed BKVN. Clinical parameters associated with diabetes (FBS, HbA1c) and hyperlipidemia (TG, TC, LDL-C) were found to be correlated with development of high BK viremia or BKVN. In 3 of 4 patients receiving intravenous immunoglobulin (IVIG) treatment, BK viral loads were reduced by at least 1 log within 2–3 months of administration. Significant differences were measured in BK viral loads and kidney function between BK viremic patients and BKVN patients by 3–9 months post-transplantation. Conclusions: We identified diabetes and hyperlipidemia as potential risk factors for development of high BK viremia and/or BKVN. IVIG was seen to be effective in reducing viral titers. The period 3–9 months post-transplantation was identified as important for development of BKVN from high BK viremia.
AB - Background: In the immunocompromised conditions following renal transplantation, BK virus can reactivate and cause BK virus associated nephropathy (BKVN). Increased BK viral loads and extended duration of infection have been linked to development of BKVN. The aim of this study was to observe the incidence of BKV infection and BKVN, and kinetics of infection and disease in renal transplantation recipients. Methods: From 2014 to 2018, we conducted a longitudinal cohort observational study of 139 renal transplantation patients treated at a single clinic. Quantitative PCR assay was conducted to assess longitudinal BK viral loads. Analysis of patient clinical characteristics was performed to determine risk factors for BKV infection and associated disease. Results: Of our cohort, 29 (20.9%) patients developed high BK viremia, and 7 (5.0%) developed biopsy-confirmed BKVN. Clinical parameters associated with diabetes (FBS, HbA1c) and hyperlipidemia (TG, TC, LDL-C) were found to be correlated with development of high BK viremia or BKVN. In 3 of 4 patients receiving intravenous immunoglobulin (IVIG) treatment, BK viral loads were reduced by at least 1 log within 2–3 months of administration. Significant differences were measured in BK viral loads and kidney function between BK viremic patients and BKVN patients by 3–9 months post-transplantation. Conclusions: We identified diabetes and hyperlipidemia as potential risk factors for development of high BK viremia and/or BKVN. IVIG was seen to be effective in reducing viral titers. The period 3–9 months post-transplantation was identified as important for development of BKVN from high BK viremia.
KW - BK virus
KW - BK virus associated nephropathy
KW - Intravenous immunoglobulin
KW - Kinetics
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85079688044&partnerID=8YFLogxK
U2 - 10.1016/j.micpath.2020.104036
DO - 10.1016/j.micpath.2020.104036
M3 - Journal article
C2 - 32017958
AN - SCOPUS:85079688044
SN - 0882-4010
VL - 142
JO - Microbial Pathogenesis
JF - Microbial Pathogenesis
M1 - 104036
ER -
