Impact of low‐level BK polyomavirus viremia on intermediate‐term renal allograft function. Issue 1 (16th January 2018)

• Record Type: Journal Article
• Authors: Korth, Johannes; Widera, Marek; Dolff, Sebastian; Guberina, Hana; Bienholz, Anja; Brinkhoff, Alexandra; Anastasiou, Olympia Evdoxia; Kribben, Andreas; Dittmer, Ulf; Verheyen, Jens; Wilde, Benjamin; Witzke, Oliver
• Is Part Of: Transplant infectious disease. Volume 20:Issue 1(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-01-16
• Subjects: BK polyomavirus -- BKPyV viremia -- low‐level -- polyomavirus‐associated nephropathy -- renal transplantation; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12817
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: BK polyomavirus (BKPyV)‐associated nephropathy (PyVAN) is a significant cause of premature renal transplant failure. High‐level BKPyV viremia is predictive for PyVAN; however, low‐level BKPyV viremia does not necessarily exclude the presence of PyVAN. As data are limited regarding whether or not low‐level BKPyV viremia has an effect on intermediate‐term graft outcome, this study analyzes the impact of low‐level BKPyV viremia on intermediate‐term graft function and outcome compared with high‐level viremia and non‐viremic patients. Methods: All renal transplant patients received follow‐up examinations at the Department of Nephrology, University Hospital Essen. Patients were screened for BKPyV viremia and stratified into three groups according to their maximum BKPyV load in serum (low‐level viremia, high‐level viremia, and no viremia). Results: In 142 of 213 (67%) patients, BKPyV was never detected in serum; 42 of 213 (20%) patients were found positive for low‐level viremia (≤10 4 copies/mL); and 29 of 213 (13%) patients showed high‐level viremia (>10 4 copies/mL). No significant differences regarding transplant function and graft failure were observed between patients without BKPyV viremia (delta estimated glomerular filtration rate [eGFR] +0.1 mL/min [month 1 vs last visit at month 44]) and patients with low‐level BKPyV viremia (delta eGFR −1.7 mL/min). In patients with high‐level viremia, transplant function was significantly restricted (delta eGFR −6.5 mL/min) compared with low‐level viremia until the last visit at 44 ± 9.7 months after transplantation. Although the graft function and graft loss were worse in the high‐level viremia group compared with no viremia (eGFR 37 vs 45 mL/min), the difference was not significant. Conclusions: High‐level viremia was associated with impaired graft function. In contrast, low‐level BKPyV viremia had no significant impact on intermediate‐term graft function.