Polyomavirus Polymerase Chain Reaction as a Surrogate Marker of Polyomavirus-Associated Nephropathy

Viscount, Helen B.; Eid, Albert J.; Espy, Mark J.; Griffin, Matthew D.; Thomsen, Kristine M.; Harmsen, William S.; Razonable, Raymund R.; Smith, Thomas F.

doi:10.1097/01.tp.0000275205.41078.51

Cited by 137 publications

(147 citation statements)

References 28 publications

(38 reference statements)

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

“…High titers in urine and plasma can be considered as predictive markers for BKV-associated nephropathy. The proposed threshold for viruria as a predictive value for BKVAN is >2.5Eþ07 BKV copies/ ml, and the viremic threshold is >1.6Eþ04 BKV copies/ ml [Drachenberg et al, 2004[Drachenberg et al, , 2007Bressollette-Bodin et al, 2005;Funk et al, 2006;Viscount et al, 2007;Costa et al, 2008]. The reasons for the reactivation of BKV are not well understood.…”

Section: Introductionmentioning

confidence: 99%

“…At present there is no efficient antiviral therapy available and the treatment of reactivated BKV infection is limited to reducing the immunosuppressive regimen [Almeras et al, 2008;Saad et al, 2008]. In about one-quarter to one-third of kidney transplant (KTx) patients, the virus was found in the urine, about 10-15% of BKV-infected patients reveal viremia and about 5% of BKV-infected patients develop BKVassociated nephropathy [Hirsch et al, 2002;Viscount et al, 2007]. High titers in urine and plasma can be considered as predictive markers for BKV-associated nephropathy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mutations in the BC‐loop of the BKV VP1 region do not influence viral load in renal transplant patients

Krautkrämer

Klein

Sommerer

et al. 2008

Journal of Medical Virology

View full text Add to dashboard Cite

The reactivation and replication of the BK polyomavirus (BKV) leading to BKV-associated nephropathy (BKVAN) is one of the major complications in renal transplantation patients. BKV isolates were classified into four subtypes (I-IV) based on genotype variations within the VP1-coding region. The type-specific amino acid differences cluster within the BC-loop of the major capsid protein VP1. As demonstrated in vitro, mutations in this region also play a role in the infectivity, attachment and stability of viral particles. Therefore, we analyzed the prevalence of BC-loop mutations in isolates of kidney transplant patients and compared their viral load in the urine. The VP1 subtyping regions of BKV isolates obtained from urine samples of 45 renal transplant patients were sequenced. The phylogenetic analysis of these sequences revealed that subtype I (66.67%) is the most prevalent genotype. The remaining isolates belong to subtype IV (33.33%). A high frequency of changes to specific amino acids within the BC-loop was identified among the BKV isolates from renal transplant patients. Patients with BKVAN exhibited a higher viral replication than patients without nephropathy. Although titers of isolates of subtype I were higher than titers of subtype IV isolates, the difference did not reach statistical significance. In addition, amino acid changes in the BC-loop did not influence the viral load and the incidence of BKVAN. These in vivo results demonstrate that high replication rates which serve as a predictive marker for BKVAN are not caused by altered receptor binding or affinity via mutated BC-loops.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mutations in the BC‐loop of the BKV VP1 region do not influence viral load in renal transplant patients

Krautkrämer

Klein

Sommerer

et al. 2008

Journal of Medical Virology

View full text Add to dashboard Cite

show abstract

“…El monitoreo del virus BK urinario (decoy cells), cuya sensibilidad puede llegar hasta a 100% (3,12,15) (figura 2), es lo recomendable, antes que ocurra daño histológico renal (1,2,19,23) . Sin embargo, las decoy cells urinarias también han sido descritas en cuadros de adenovirus, citomegalovirus (CMV) y células malignas (24) .…”

Section: Discussionunclassified

“…Sin embargo, las decoy cells urinarias también han sido descritas en cuadros de adenovirus, citomegalovirus (CMV) y células malignas (24) . Definitivamente, la aplicación de técnicas moleculares, reacción en cadena de la polimerasa (PCR), virus BK sérico/orina constituyen el instrumento fundamental de diagnóstico etiológico (3,20) .…”

Section: Discussionunclassified

See 1 more Smart Citation

Nefropatía asociada a poliomavirus BK en trasplante renal

et al. 2016

View full text Add to dashboard Cite

ResumenEl objetivo del presente reporte es dar a conocer los dos primeros casos de nefropatía del injerto asociada a poliomavirus BK (NPBK) ocurridos en el Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Perú. El diagnóstico definitivo de la NPBK se corroboró mediante biopsia renal y estudio de microscopia electrónica. En el caso 1, el deterioro funcional renal no se controló a pesar de reducir la inmunosupresión y añadir drogas antivirales (leflunamide y ciprofloxacina), evolucionando a falla renal y su posterior acceso a retrasplante renal. En el caso 2, la alternativa terapéutica se basó en infusión de inmunoglobulina endovenosa asociada a reducción de la inmunosupresión, resultando en moderada mejora histológica y estabilización de la función renal. En ambos injertos renales hubo concomitantemente NPBK y lesiones histológicas compatibles con rechazo agudo celular pendientes de interpretar. En conclusión, la presencia del poliomavirus BK representa serio problema en el riñón trasplantado. La mejor conducta terapéutica se basa en el diagnóstico precoz y subsecuente reducción de la inmunosupresión. Es imprescindible disponer de metodología apropiada que posibilite un diagnóstico preciso. Se utiliza tamizaje de células señuelo o marcadoras (decoy cells) en orina, reacción de cadena polimerasa (PCR), biopsia renal o la microscopia electrónica como método valioso de ayuda en el diagnóstico etiológico viral. Se considera el retrasplante como opción ante la pérdida del injerto por NPBK (caso 1). Palabras clave. Poliomavirus BK; Nefropatía; Trasplante de riñón; Inmunología. Abstract Two documented cases of BK polyomavirus-associated nephropathy (BKVN) seen at Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Peru are reported. Final BKVN diagnosis was confirmed by renal biopsy and electron microscopy study. Case 1: Renal functional deterioration was not controlled despite reduction of immunosuppression and addition of antiviral drugs (leflunomide and ciprofloxacin), evolving to renal failure and subsequent kidney retransplantation. Case 2: The therapeutical management consisted in intravenous immunoglobulin infusion linked to reduction of immunosuppression; this resulted in modest histological improvement and stabilization of renal function. Both renal grafts concomitantly presented BKVN and histological lesions consistent with acute rejection, pending interpretation. In conclusion presence of BK polyomavirus is a serious problem for transplanted kidneys. The best treatment is based on early diagnosis and subsequent reduction of immunosuppression. It is essential to have an appropriate methodology for precise diagnosis. Early electron microscopy is a valuable method for viral etiologic diagnosis. Retransplantation is considered a treatment option when faced with possible BKVN-related graft loss (Case 1). Keywords. BK polyomavirus; Nephropathy; Kidney transplantation; Immunology.

show abstract

Interventions for BK virus infection in kidney transplant recipients

Christiadi

Karpe

Walters

2019

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Polyomavirus Polymerase Chain Reaction as a Surrogate Marker of Polyomavirus-Associated Nephropathy

Abstract: BKV PCR may be a clinically useful noninvasive test to identify renal recipients with concurrent PVAN. BKV DNA >1.6E+04 copies/mL of plasma and >2.5E+07 copies/mL of urine were highly associated with concurrent PVAN whereas a negative PCR test makes the diagnosis of PVAN highly unlikely.

Cited by 137 publications

References 28 publications

Mutations in the BC‐loop of the BKV VP1 region do not influence viral load in renal transplant patients

Mutations in the BC‐loop of the BKV VP1 region do not influence viral load in renal transplant patients

Nefropatía asociada a poliomavirus BK en trasplante renal

Interventions for BK virus infection in kidney transplant recipients

Contact Info

Product

Resources

About