Evaluation of the predisposition and clinical impact of BK virus replication in kidney transplant patients
An. acad. bras. ciênc
;
89(1,supl): 675-684, May. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-886657
ABSTRACT
ABSTRACT The BK virus (BKV) produces a subclinical kidney infection in immunocompetent individuals. However, viremia may occur in kidney transplant patients with ongoing immunosuppression. BKV-associated nephropathy (BKVN) has no specific treatment and is a leading cause of organ transplant loss. In this study, we evaluated the predisposition and the clinical impact of BKV replication in kidney transplant patients during post-transplant monitoring in a reference institution in Brazil. Demographic, clinical and laboratory data generated during routine outpatient follow-up were retrospectively collected. BK viremia was investigated using real-time polymerase chain reaction. Of the 553 participants, 7.4% (n = 41) presented BKV replication. Of these, 16 (39%) lost their kidney graft and interstitial nephritis was identified on kidney biopsy in 50% of the cases. Among the evaluated variables, only the use of the immunosuppressant mycophenolate sodium was identified as a risk factor for viremia (OR 7.96; 95% CI 2.35 to 26.98). The graft survival estimate in BKV-positive patients was significantly reduced (24.8% vs. 85.6%) after 10 years of transplantation. We concluded that defining predisposing factors remains an important challenge for the prevention and control of BKV activity following kidney transplantation, especially considering the development of BKVN and its strong effect on graft maintenance.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Tumor Virus Infections
/
Viremia
/
Virus Replication
/
Kidney Transplantation
/
BK Virus
/
Polyomavirus Infections
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
An. acad. bras. ciênc
Journal subject:
Science
Year:
2017
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade da Região de Joinville/BR
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