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The risk factors as...
The risk factors associated with post-transplantation BKPyV nephropathy and BKPyV DNAemia : a prospective study in kidney transplant recipients
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- Lorant, Camilla (author)
- Uppsala universitet,Infektionsmedicin
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- Zigmantaviciute, Justina (author)
- Uppsala universitet,Klinisk mikrobiologi,Uppsala Univ Hosp, Clin Microbiol & Infect Control, Uppsala, Sweden.
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- Ali, Naima (author)
- Uppsala Univ Hosp, Clin Microbiol & Infect Control, Uppsala, Sweden.
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- Bonnevier, Ursa (author)
- Gävle Cent Hosp, Dept Nephrol, Gävle, Sweden.
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- Tejde, Mattias (author)
- Falun Cent Hosp, Dept Nephrol, Falun, Sweden.
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- von Zur-Mühlen, Bengt, Docent, 1966- (author)
- Uppsala universitet,Transplantationskirurgi
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- Eriksson, Britt-Marie, Docent, 1952- (author)
- Uppsala universitet,Infektionsmedicin
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- Bergqvist, Anders (author)
- Uppsala universitet,Klinisk mikrobiologi,Uppsala Univ Hosp, Clin Microbiol & Infect Control, Uppsala, Sweden.
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- Westman, Gabriel, 1977- (author)
- Uppsala universitet,Infektionsmedicin
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(creator_code:org_t)
- BioMed Central (BMC), 2024
- 2024
- English.
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In: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 24
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Abstract
Subject headings
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- Background: BK polyomavirus (BKPyV) infection after kidney transplantation can lead to serious complications such as BKPyV-associated nephropathy (BKPyVAN) and graft loss. The aim of this study was to investigate the incidence of BKPyVAN after implementing a BKPyV screening program, to map the distribution of BKPyV genotypes and subtypes in the Uppsala-orebro region and to identify host and viral risk factors for clinically significant events.Methods This single-center prospective cohort study included kidney transplant patients aged >= 18 years at the Uppsala University Hospital in Sweden between 2016 and 2018. BKPyV DNA was analyzed in plasma and urine every 3 months until 18 months after transplantation. Also genotype and subtype were determined. A logistic regression model was used to analyze selected risk factors including recipient sex and age, AB0 incompatibility and rejection treatment prior to BKPyVAN or high-level BKPyV DNAemia.Results: In total, 205 patients were included. Of these, 151 (73.7%) followed the screening protocol with 6 plasma samples, while184 (89.8%) were sampled at least 5 times. Ten (4.9%) patients developed biopsy confirmed BKPyVAN and 33 (16.1%) patients met criteria for high-level BKPyV DNAemia. Male sex (OR 2.85, p = 0.025) and age (OR 1.03 per year, p = 0.020) were identified as significant risk factors for developing BKPyVAN or high-level BKPyV DNAemia. BKPyVAN was associated with increased viral load at 3 months post transplantation (82,000 vs. < 400 copies/mL; p = 0.0029) and with transient, high-level DNAemia (n = 7 (27%); p < 0.0001). The most common genotypes were subtype Ib2 (n = 50 (65.8%)) and IVc2 (n = 20 (26.3%)).Conclusions: Male sex and increasing age are related to an increased risk of BKPyVAN or high-level BKPyV DNAemia. BKPyVAN is associated with transient, high-level DNAemia but no differences related to viral genotype were detected.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- BK Polyomavirus (BKPyV)
- BKPyV-associated nephropathy (BKPyVAN)
- BKPyV genotype
- BKPyV risk factors
- Kidney transplantation
- Immunosuppression
Publication and Content Type
- ref (subject category)
- art (subject category)
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