Polyomavirus PCR monitoring in renal transplant recipients: detection in blood is associated with higher creatinine values

Cirocco, Robert; Markou, M.; Rosén, Anne; Goldsmith, L. A.; Cianco, G; Roth, David; Kupin, Warren; Burke, George W.; Esquenazi, Violet; Tzakis, A; Miller, Joshua

doi:10.1016/s0041-1345(00)02689-0

Cited by 20 publications

(15 citation statements)

References 5 publications

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“…The overall prevalence of DNAuria and DNAemia was, respectively, 57% and 29%, as assessed by our real-time PCR. Such a high prevalence of BKV excretion in the urine of RT recipients has also been described elsewhere, by using cell culture (44% of patients), qualitative PCR (39% patients) and more recently by real-time PCR (77% of patients) (14,30,31). A recent prospective study including 78 patients, found a 13% prevalence of DNAemia during the first year posttransplantation (21).…”

Section: Discussionmentioning

confidence: 62%

A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients

Bressollette-Bodin¹,

Coste‐Burel²,

Hourmant³

et al. 2005

American Journal of Transplantation

188

125

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BK virus (BKV) infection during the first year after renal transplantation was studied prospectively in 104 unselected consecutive patients. Viral DNA in urine (DNAuria) and plasma (DNAemia) samples was detected and quantified by real-time PCR. The noncoding control region (NCCR) of BKV isolates was sequenced.DNAuria and DNAemia occurred in 57% and 29% of patients, respectively. Three groups were defined, uninfected patients (group 1, n = 45), patients with DNAuria (group 2, n = 29) and patients with positive DNAemia (group 3, n = 30). Active infection started within the first 3 months in 80% of patients. Cold ischemia duration over 24 h and the administration of tacrolimus were identified as significant risks factors for DNAuria, whereas it remains more frequently negative in patients receiving cyclosporine A. The risk for positive DNAemia was higher in patients with DNAuria (notably for viral load (VL) >4 log/mL) or treated with tacrolimus. No relationship was found with genetic variability in the NCCR sequence.Our data highlight the high frequency of active BKV infection after renal transplantation. Although high VL was detected in some patients, none developed a BKV nephropathy. A prospective follow-up of the whole population during the first year post renal transplantation is thus not useful to predict BKV disease.

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Section: Discussionmentioning

confidence: 62%

A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients

Bressollette-Bodin¹,

Coste‐Burel²,

Hourmant³

et al. 2005

American Journal of Transplantation

188

125

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“…It may correlate with slowly progressive renal function impairment in 45% of infected patients, leading to a presumptive diagnosis of rejection [7,28]. Furthermore, a relation between nephropathy and BKV-DNA detection in peripheral blood has been described in these patients [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…It has been used in the detection of BKV-DNA in urine from renal transplant recipients [5,17], and a relation between nephropathy and BKV-DNA detection in peripheral blood has also been described in these patients [18][19][20]. The clinical utility of qualitative viral DNA detection by PCR, however, is limited owing to the ubiquity of the virus.…”

Section: Introductionmentioning

confidence: 99%

Human Polyomavirus BK Monitoring by Quantitative PCR in Renal Transplant Recipients

et al. 2004

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Objective: To study the relation between human polyomavirus BK (BKV) infection and the risk of developing nephropathy, we monthly investigated the BKV load in urine and serum samples from 15 renal transplant recipients during 6 months in relation with immunosuppressive treatment and renal function. Methods: BKV-DNA in serum samples was detected by nested PCR. BKV-DNA in urine and positive serum samples was quantified by a PCR protocol developed in our laboratory. Results: Fifty-three percent of the patients had quantifiable BKV-DNA both in urine and serum samples but there was no relation between viruria and viraemia. Seventy-five percent of the patients on FK506 therapy and 71.4% of those on CyA therapy showed activation of BKV infection. No patients developed interstitial nephritis during the study. In ten patients serum creatinine levels were <2 mg/dl for the whole study, even if 80% presented BKV viruria and/ or viraemia. On the other hand, in 4 patients serum creatinine levels reached higher values, but they were BKV viruria and/or viraemia negative during the study. Conclusions: Our results suggest that viruria and viraemia may reflect independent BKV reactivation in different tissues. The activation of the infection does not seem to be related to the type of immunosuppressive treatment nor to impairment of renal function. To better understand the pathogenetic role of BKV infection in renal transplant recipients further investigations are needed.

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“…Falsepositive reactions can be a problem, especially in urine samples; however, PCR has been determined to be a sensitive and specific method for identifying active polyoma virus viremia. Detection of BK virus in blood is associated with higher serum creatinine levels [24]. Studies addressing the role of PCR in the diagnosis of BKV infection in tissue samples have not been published.…”

Section: Polymerase Chain Reaction (Pcr) and In Situ Hybridization (Ish)mentioning

confidence: 99%

Electron Microscopy in the Diagnosis of BK-Polyoma Virus Infection in the Transplanted Kidney

Herrera

Veeramachaneni

Turbat‐Herrera

2005

Ultrastructural Pathology

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BK polyomavirus has become an important etiologic agent responsible for significant morbidity in renal transplant recipients. This virus can be detected in transitional cells in the urine (decoy cells) using cytology, but correlation with allograft function status and histologic evidence of renal involvement is poor. Accurate diagnosis of BK polyomavirus infection requires a high index of suspicion and utilization of ancillary diagnostic techniques in many cases. Electron microscopy is very sensitive in depicting the presence of BK virions, but the finding of viral particles is not by itself diagnostic of BK interstitial nephritis. Management of patients with polyoma virus nephropathy is difficult since there is no specific antiviral therapy available at this time.

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Polyomavirus PCR monitoring in renal transplant recipients: detection in blood is associated with higher creatinine values

Cited by 20 publications

References 5 publications

A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients

A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients

Human Polyomavirus BK Monitoring by Quantitative PCR in Renal Transplant Recipients

Electron Microscopy in the Diagnosis of BK-Polyoma Virus Infection in the Transplanted Kidney

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