Dynamics of pregnancy‐associated polyomavirus urinary excretion: A prospective longitudinal study

Abstract

Asymptomatic polyomaviruria of pregnancy has been documented in point prevalence studies, but little attention has been given to the dynamics of polyomavirus excretion during pregnancy because of its benign course. We tested the hypothesis that the frequency and/or magnitude of polyomavirus excretion would increase as pregnancy progresses. Urine specimens were obtained prospectively from 179 healthy women during uncomplicated pregnancies and 37 healthy non‐pregnant women. Real‐time polymerase chain reaction was used to determine BK virus (BKV) and JC virus (JCV) viral loads in urine, blood, and rectal and vaginal swabs collected during routine obstetric and gynecologic clinic visits. Asymptomatic urinary shedding of BKV and/or JCV was observed in 384 (48.0%) of 800 specimens from 100 (55.8%) pregnant women. BKV excretion was more common in pregnant than non‐pregnant women (41.3% vs. 13.5%, P = 0.0026). The frequency of JCV excretion was no different in pregnant compared to non‐pregnant women. The frequency and magnitude of polyomavirus shedding did not vary with gestational age. Post‐partum shedding of BKV, but not JCV, rapidly decreased to undetectable levels. Pregnancy‐associated BKV excretion begins early in pregnancy and terminates rapidly post‐partum. Neither the frequency nor magnitude of BKV or JCV shedding increased with pregnancy progression. Further study into the host factors that regulate pregnancy‐associated BKV excretion may allow identification of the host factors that predict susceptibility to BKV‐associated diseases in immune compromised patients. J. Med. Virol. 84: 1312–1322, 2012. © 2012 Wiley Periodicals, Inc.

Polyomavirus detection in multiple sclerosis patients under natalizumab therapy: Profile and frequency of urinary shedding

“…In this work, the overall proportion of MS patients who shed JCV (21.7% considering at least one time‐point) was similar to that observed for healthy individuals, which is around 18.9–27% [Markowitz et al, ; Egli et al, ; McClure et al, ; Urbano et al, ]. Our data were also similar to immunocompromised groups, such as renal and liver recipients [Drachenberg et al, ; Kusne et al, ] and HIV‐infected population, which range from 25% to 28% [Markowitz et al, ; Behzad‐Behbahani et al, ].…”

The Rapidly Expanding Family of Human Polyomaviruses: Recent Developments in Understanding Their Life Cycle and Role in Human Pathology

“…Unlike JCPyV in the kidney, this may be considered to be true latency—that is, virus production at even a low level has ceased. Similarly, BKPyV may reside as a persistent low-level infection in the kidney in the absence of PVAN since it can also be detected in urine [33]—for example, asymptomatic BK polyomaviruria is well documented in pregnancy [34]. In contrast to JCPyV and BKPyV, KIPyV and WUPyV are not found in urine but are found in nasophayngeal aspirates, bronchoalveolar lavages, and feces of pediatric patients [35], indicating an apparent tissue tropism of these viruses for respiratory epithelia.…”

The polyomavirus puzzle: is host immune response beneficial in controlling BK virus after adult hematopoietic cell transplantion?

“…Although no BKV polymerase chain reaction (PCR) assays are approved by the US Food and Drug Administration, and no standardization exists among current BKV PCR assays, BKV has been detected in blood and urine by PCR assays targeting different regions of the BKV genome, including those that encode the T antigen and the capsid proteins VP1 and VP2 . BKV has been detected by PCR of the urine in 5–44% of asymptomatic, immunocompetent adults from ages 20–89 years , in 41% of pregnant women , and in 8–58% of human immunodeficiency virus‐positive patients . Asymptomatic detection of BKV in the urine could be a consequence of periodic viral reactivation in the setting of physiologic triggers, such as a concurrent systemic illness or waning cellular immunity against BKV during pregnancy or human immunodeficiency virus infection.…”