BK virus infection: an update on diagnosis and treatment

Sawinski, Deirdre; Goral, Simin

doi:10.1093/ndt/gfu023

Cited by 203 publications

(247 citation statements)

References 60 publications

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“…Risk factors for BKVN after renal transplantation can be donor-related including BK seropositivity, HLA mismatch and HLAC7; recipient-related including the male gender, advanced age and the presence of diabetes; and transplant-related including ATG use, tacrolimus and/or MMF-based immunosuppressive therapy, prolonged ischemia, delayed graft function, previous rejection episodes and ureteral stents (12). Although most of the patients with BKVN are renal transplant recipients, it has been reported in the literature that BKVN develops in the native kidney.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Renal Biopsies for BK Virus Nephropathy in Non-Renal Transplant Immunosuppressed Patients

Merhametsiz¹,

Yıldırım²,

Oğuz³

et al. 2016

Turk Neph Dial Transpl

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OBJeCtIVe: Although BK virus nephropathy (BKVN) has mostly been reported to occur in transplanted kidneys, there has been a gradual increase in cases of BKVN in the native kidney. This study was directed towards investigating the incidence of BKVN in patients undergoing renal biopsy due to acute kidney injury (AKI) who were also immunosuppressed due to a condition other than organ transplantation. MAterIAl and MethOds:Out of the 1223 patients undergoing renal biopsy for various conditions between January 2001 and January 2013, 52 patients who underwent a biopsy for AKI and were immunosuppressed at the time of the biopsy were included into the study. After renal biopsies of all patients were reevaluated, all biopsy specimens were exposed to immunohistochemical staining for SV40 antibody. results:Of the 52 patients, 29 had primary glomerulonephritis, 18 had secondary glomerulonephritis and 5 had a malignancy. All patients except one case of acute lymphoblastic leukemia and one case of non-Hodgkin lymphoma were immunosuppressed due to immunosuppressive therapy. None of the patients had any signs of BKVN on immunohistochemical staining of renal biopsy specimens.COnClusIOn: Failure to detect BKVN in this study may be because BKV causes gradual impairment of renal functions and the sample did not include patients frequently observed to have BKVN in the native kidney.keY wOrds: Acute kidney injury, BK virus nephropathy, Immunosuppression, Renal biopsy, Renal transplantation, SV40 antibody Öz AMAÇ: BK virüs nefropatisi (BKVN) çoğunluğu böbrek nakli olgularında tanımlansa da, öz böbreklerde de giderek artan oranda BKVN olguları tanımlanmaktadır. Çalışmada, akut böbrek yetmezliği nedeniyle böbrek biyopsisi yapılan organ nakli dışında bir nedene bağlı immünsüpresif hastaların renal biyopsi örneklerinde BKVN sıklığını araştırmayı amaçladık. GereÇ ve YÖnteMler:Ocak 2001-Ocak 2013 tarihleri arasında çeşitli nedenlerle böbrek biyopsisi yapılmış 1223 hastadan akut böbrek hasarı nedeniyle biyopsi yapılmış ve biyopsi esnasında immünsüpresif olup çalışmaya uygun olan 52 hasta çalışmaya dahil edildi. Çalışmaya alınan hastaların böbrek biyopsileri tekrar değerlendirilerek ışık mikroskopisinde BKV'ye ait olabilecek değişiklikler arandıktan sonra tüm biyopsi materyallerine SV40 immünhistokimyasal antikor boyaması yapıldı.BulGulAr: Olguların tanısal dağılımı şu şekildeydi; 29 hasta primer glomerülonefrit (GN), 18 hasta sekonder GN ve 5 hasta malignite. Hastaların ikisi (ALL ve NHL olguları) hariç hepsi immünsüpresif tedavi nedeniyle immünsüpresiftiler. Böbrek biyopsilerinde yapılan immün histokimyasal boyamada 52 olgunun hiçbirinde BKVN'ye ait bulguya rastlanmadı ve tüm olgularda SV40 negatif saptandı.sOnuÇ: Sonuç olarak çalışmamızda, akut böbrek hasarı nedeniyle böbrek biyopsisi yapılmış olgularda BKVN'yi saptayamamış olmamız, BKVN'nin böbrek fonksiyonlarında yavaş seyirli bir bozulmaya sebep olmasından veya bu çalışmanın BKV'nin öz böbrek nefropatisinin daha çok izlendiği hastaları içermemesinden kaynaklanmış olabilir.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Renal Biopsies for BK Virus Nephropathy in Non-Renal Transplant Immunosuppressed Patients

Merhametsiz¹,

Yıldırım²,

Oğuz³

et al. 2016

Turk Neph Dial Transpl

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“…203 The T-cell IFN-γ enzyme-linked immunospot (ELISPOT) assay quantifies memory T-cells in peripheral blood that respond to donor HLAs or CMV antigens. 204 The clinical utility of both these biomarker assays in clinical practice is yet to be determined.…”

Section: Strategies For Prevention Of Underimmunosuppressionmentioning

confidence: 99%

“…205 Viral infections, which occur more frequently during the first few months after transplantation, are most likely in the context of greater immunosuppression. 195,204,[206][207][208] Furthermore, recipient age is often a significant risk factor for bacterial infections, but not viral/fungal infections. 209 Type of immunosuppressive agent such as use of induction therapy with antithymocyte globulin is also associated with viral infections.…”

Section: Overimmunosuppression and Infectionmentioning

confidence: 99%

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

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“…[5,6] JC and BK viruses typically are asymptomatic infections that predominately present in immune suppressed individuals. Disease states from polyomavirus infections are broad and range from BK virus-related nephropathy [7] to JC virusrelated progressive multifocal leukoencephalopathy. [8] The propensity for the CNS characteristic of these viruses has led to attempts to develop better screening methods to clarify this relationship.…”

Section: Environmental Etiologies Of Gbmmentioning

confidence: 99%

The association between human cytomegalovirus and glioblastomas: a review

Hochhalter¹,

Carr²,

O’Neill³

et al. 2017

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Human cytomegalovirus (HCMV) was reported in glioblastoma multiforme (GBM) over a decade ago and this finding has the potential to increase our understanding of the disease and it offers an alternative tumor-specific therapeutic target. Due of this promise, there is a fair amount of time, energy and money being directed towards understanding and utilizing this connection for eventual therapeutic purposes. Nevertheless, the association between GBM and HCMV remains controversial. Several studies have reported conflicting results, further undermining the potential clinical value of this association. In this review, the authors will discuss the latest developments on this evolving issue. Specifically, the results of the latest studies, both positive and negative, will be discussed. Furthermore, potential theories to explain discrepancies reported in the literature will be proposed. Clinical implications including potential targets for anti-HCMV therapy and the latest developments in anti-HCMV therapy will be presented. Finally, solutions to remedy this controversial issue in neuro-oncology will be offered. ReviewThis is an open access article distributed under the terms of the Creative Commons AttributionNonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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BK virus infection: an update on diagnosis and treatment

Cited by 203 publications

References 60 publications

Evaluation of Renal Biopsies for BK Virus Nephropathy in Non-Renal Transplant Immunosuppressed Patients

Evaluation of Renal Biopsies for BK Virus Nephropathy in Non-Renal Transplant Immunosuppressed Patients

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

The association between human cytomegalovirus and glioblastomas: a review

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