Detection of JCV or BKV viruria and viremia after kidney transplantation is not associated with unfavorable outcomes

Querido, Sara; Weigert, André; Pinto, Iola; Papoila, Ana Luísa; Pessanha, Maria Ana; Gómes, Perpétua; Adragão, Teresa; Paixão, Paulo

doi:10.1002/jmv.28800

Cited by 5 publications

(11 citation statements)

References 28 publications

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“…The prevalence of BKPyV viruria among our recipients was lower than expected [ 34 ]. Furthermore, the median time from transplant surgery to the first recorded episode of viruria was longer than those described by previously published studies [ 37 , 42 ], but in line with the one recently reported by Querido and colleagues [ 35 ]. The prevalence of BKPyV viruria and BKPyV urinary load were highest around T4, with a steady decrease during the rest of the follow-up.…”

Section: Discussionsupporting

confidence: 90%

“…The pattern of JCPyV urinary replication during the post-transplant follow-up was similar to those described in other prospective studies on KT recipients or healthy subjects and overall suggests that the virus can remain latent in renal tubular epithelial cells, easily reactivating in case of transient or persistent states of immunosuppression [ 32 , 35 , 38 – 41 ].…”

Section: Discussionsupporting

confidence: 83%

“…These results are overall in line with previously published data [ 29 – 31 ]. However, some authors have reported an higher prevalence of BKPyV viruria, particularly among recipients [ 32 – 35 ]. Such discrepancy may be due to several reasons including different geographical or ethnic characteristics or it may reflect the fact that BKPyV is more frequently associated with clinical manifestations than JCPyV.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal study of human polyomaviruses viruria in kidney transplant recipients

Dolci,

Colico,

Ambrogi

et al. 2024

Clin Exp Med

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Introduction Immunosuppression after kidney transplantation (KTx) exposes recipients to Human Polyomaviruses (HPyVs) infections, whose natural history is still misunderstood. Methods Allograft biopsies, and urine from 58 donor-recipient pairs were collected before KTx (T0) and 1 (T1), 15 (T2), 30 (T3), 60 (T4), 90 (T5), 180 (T6), 270 (T7), 360 (T8), and 540 (T9) days after transplant. Specimens were tested for JC (JCPyV) and BK (BKPyV), by quantitative Real-Time PCR. The course of post-KTx HPyVs viruria, and the association between JCPyV viruria in recipients and donors, were evaluated. Results HPyVs were detected in 3/58 (5.2%) allograft biopsies. HPyVs viruria was present in 29/58 (50%) donors and 41/58 (70.7%) recipients. JCPyV DNA was detected in 26/58 (44.8%) donors and 25/58 recipients (43.1%), 19 of whom received kidney from JCPyV positive donor, whereas BKPyV genome was detected in 3 (5.2%) donors and 22 (37.9%) recipients. The median time of JCPyV, and BKPyV first episode of replication was 1, and 171 days post KTx, respectively. At T0, JCPyV viruria of donors was associated with increased risk of JCPyV replication post-KTx; recipients with JCPyV positive donors showed lower risk of BKPyV replication post-KTx. Conclusions The results suggested that JCPyV may be transmitted by allograft, and that its replication post KTx might prevent BKPyV reactivation. Future investigation regarding correlation between chronic exposure to immunosuppressive agents and HPyVs urinary replication are warranted.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Longitudinal study of human polyomaviruses viruria in kidney transplant recipients

Dolci,

Colico,

Ambrogi

et al. 2024

Clin Exp Med

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“…We noted a progressive increase in TTV viral load from baseline to a peak at month 3 and a slight decrease after month 6, when immunosuppression reaches a lower plateau dose. It is already established that, once immunosuppression is initiated, TTV DNA viral loads rise during the first weeks to months and a peak is observed in most cases by month 3 [ 18 , 19 ], thereafter reaching a steady-state phase with stabilization at levels higher than baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Detection of BKPyV viremia in two consecutive analyses, triggered discontinuation of the antimetabolite and initiation of mTOR inhibitor (everolimus; target 12-h trough levels of 3–7 ng/mL), as previously published by our group [ 19 ]. Calcineurin inhibitor target trough levels were also reduced (tacrolimus target 12-h trough levels of 3–5 ng/mL), in accordance to clinical practice in our center.…”

Section: Methodsmentioning

confidence: 99%

Kinetics of Torque Teno Virus Viral Load Is Associated with Infection and De Novo Donor Specific Antibodies in the First Year after Kidney Transplantation: A Prospective Cohort Study

Querido

Martins

Gómes

et al. 2023

Viruses

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Torque teno virus (TTV) was recently identified as a potential biomarker for the degree of immunosuppression, and potentially as a predictor of rejection and infection in solid organ transplant patients. We evaluated TTV viral load in kidney transplant (KT) patients during the first year post-transplant to examine overall kinetics and their relationships with deleterious events, including episodes of infection and the formation of de novo donor-specific antibodies (DSAs). In a single-center, prospective observational cohort study, 81 KT patients were monitored at baseline, week 1, and month 1, 3, 6, 9 and 12, post-KT, and whenever required by clinical events. Kidney function, plasma TTV load, immunoglobulins and lymphocyte subpopulations were assessed at each time point. Twenty-six patients (32.1%) presented a total of 38 infection episodes post-KT. Induction immunosuppression with thymoglobulin, compared to basiliximab, was not associated with more infections (p = 0.8093). Patients with infectious events had lower T-cells (p = 0.0500), CD8+ T-cells (p = 0.0313) and B-cells (p = 0.0009) 1 month post-KT, compared to infection-free patients. Patients with infection also showed higher increases in TTV viral loads between week 1- month 1, post-KT, with TTV viral load variations >2.65 log10 cp/mL predicting the development of infectious events during the 12-month study period (p < 0.0001; sensitivity 99.73%; specificity 83.67%). Patients who developed de novo DSAs had lower TTV DNA viral loads at month 12 after KT, compared to patients who did not develop DSA (3.7 vs. 5.3 log10 cp/mL, p = 0.0023). Briefly, evaluating early TTV viremia is a promising strategy for defining infectious risk in the 1st year post-KT. The availability of standardized commercial real-time PCR assays is crucial to further validate this as an effective tool guiding immunosuppression prescription.

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Molecular epidemiology and risk factors associated with BK and JC polyomavirus urinary shedding after kidney allograft

Demey,

Aubry,

Descamps

et al. 2024

Journal of Medical Virology

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Polyomaviruses BK (BKPyV) and JC (JCPyV), belonging to the Polyomaviridae, are responsible for human pathologies. In kidney transplant recipients, BKPyV replication can lead to irreversible nephron damage whereas JCPyV replication remains asymptomatic. Concomitant replication is rare and potential competition between the infections has been described. The aim of this retrospective case‐control study was to describe the molecular epidemiology and risk factors associated with BKPyV and JCPyV replication in a cohort of kidney transplant recipients. In total, 655 urine samples from 460 patients were tested for BKPyV and JCPyV DNA. Positive samples were submitted to strain genotyping. Demographic and clinical characteristics were also compared. Isolated JCPyV and BKPyV was found in 16.5% and 23.3% of patients, respectively; co‐replication was rare (3.9%). BKPyV strains Ib‐2, Ib‐1, and IVc‐2 were the most prevalent. JCPyV strains mostly belonged to genotypes 4 and 1B. During follow‐up, JCPyV shedding significantly reduced the risk of BKPyV DNAuria, with an odds ratio of 0.57 (95% confidence interval: 0.35–0.99), and was associated with better prognosis than BKPyV replication, based on the estimated glomerular filtration rate. Molecular epidemiology of BKPyV and JCPyV strains in our region was similar to previous studies. This study suggests that JCPyV is benign and appears to limit damaging BKPyV replication. JCPyV DNAuria screening could thus be a useful strategy to predict BKPyV‐related outcomes.

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Detection of JCV or BKV viruria and viremia after kidney transplantation is not associated with unfavorable outcomes

Cited by 5 publications

References 28 publications

Longitudinal study of human polyomaviruses viruria in kidney transplant recipients

Longitudinal study of human polyomaviruses viruria in kidney transplant recipients

Kinetics of Torque Teno Virus Viral Load Is Associated with Infection and De Novo Donor Specific Antibodies in the First Year after Kidney Transplantation: A Prospective Cohort Study

Molecular epidemiology and risk factors associated with BK and JC polyomavirus urinary shedding after kidney allograft

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