Outcomes of Living Kidney Donor Candidates and Living Kidney Recipient Candidates with JC Polyomavirus and BK Polyomavirus Viruria

Abstract

Introduction. Recent data have emerged about a protective association between JCV viruria and chronic kidney disease (CKD). Material and Methods. Single-center retrospective cohort study; 230 living kidney donors (LKD) candidates and 59 potential living kidney receptors (LKR) were enrolled. Plasma and urinary JCV and BKV viral loads were measured in all LKD candidates and in nonanuric LKR candidates. Twenty-six living kidney transplant surgeries were performed. LKR were followed in order to evaluate BKV and JCV viremia and urinary viral shedding after KT. Results. In LKD candidates, JCV viruria was negatively associated with proteinuria of >200 mg/24 hours (JC viruric LKD: 12.5% vs JCV nonviruric LKD: 26.7%, p = 0.021 , OR:0.393; 95% CI: 0.181–0.854). In a multivariate analysis, LKD candidates with JCV viruria had a lower risk of proteinuria of >200 mg/24 hours ( p = 0.009 , OR: 0.342, 95% CI: 0.153–0.764), in a model adjusted for age, gender, presence of hypertension, and eGFR <80 mL/min. Prevalence of JCV viruria was higher in LKD candidates when compared with LKR candidates (40.0% vs 1.7%, p < 0.001 ). Among the 26 LKR, 14 (53.8%) KT patients evolved with JCV viruria; 71.4% received a graft from a JCV viruric donor. Conclusion. Our data corroborate the recent findings of an eventual protective association between JCV viruria and kidney disease, and we extrapolated this concept to a South European population.

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

“…Although an association was found between BKV viremia and renal damage in selected individuals, there is limited evidence to show an association between BKV viruria or JCV viruria and/or viremia and clinical outcomes. Since a low level of JCV viruria is common in immunocompetent individuals, including in kidney donors, 16 the association between JCV viruria and poor KT outcomes remains controversial. Other than immunosuppression, risks factors for JCV viremia are not known 17 .…”

The oncogenic roles of JC polyomavirus in cancer

“…T and t antigens are responsible for DNA replication, and the VP proteins for assemble with viral DNA to form virions (1). JCPyV may be activated for cell lysis under immunosuppressive conditions (e.g., HIV infection or the transplantation of bone marrow, liver, lung or kidney), and therefore is an established etiologic factor of demyelinating progressive multifocal leukoencephalopathy (PML) (3)(4)(5)(6)(7). Moreover, JCPyV could infect the enteric glia and cause chronic idiopathic intestinal pseudo-obstruction (8), or result in male lower urinary tract symptoms (9).…”