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Investigation of polyomaviruses replication in pediatric patients with nephropathy receiving rituximab
Author(s) -
Delbue Serena,
Ferraresso Mariano,
Elia Francesca,
Belingheri Mirco,
Carloni Camilla,
Signorini Lucia,
Carluccio Silvia,
Dallari Simone,
Ghio Luciana,
Ferrante Pasquale
Publication year - 2012
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23339
Subject(s) - rituximab , progressive multifocal leukoencephalopathy , medicine , jc virus , focal segmental glomerulosclerosis , bk virus , virology , immunology , nephropathy , nephrotic syndrome , antibody , virus , glomerulonephritis , transplantation , kidney , kidney transplantation , diabetes mellitus , endocrinology
Rituximab is a chimeric monoclonal antibody reacting with the CD20 antigen on B cells. It has been proposed as treatment for the idiopathic nephrotic syndrome, recurrent idiopathic nephropathy, and focal segmental glomerulosclerosis refractory to steroids. Rituximab influences T‐cell immunity and may predispose the patients to opportunistic infections, such as progressive multifocal leukoencephalopathy caused by the polyomavirus JC (JCV). The risk of latent viruses infections/reactivations in pediatric patients receiving monoclonal antibodies is not well known yet. In this longitudinal 6‐month study, the effects of rituximab on JCV and BK virus (BKV) replication have been investigated. Blood, serum, and urine samples have been collected monthly from 11 pediatric patients (mean age: 11 years) with the idiopathic nephrotic syndrome and recurrent idiopathic nephropathy, under rituximab therapy. JCV and BKV real‐time PCRs and sequencing of the viral protein 1 and the non‐coding control region have been conducted. The same investigations have been undertaken on samples collected from eight pediatric patients (controls, mean age: 6 years), with idiopathic nephrotic syndrome or focal segmental glomerulosclerosis, treated with conventional chemotherapy. JCV was detected in the urine of one patient (9%), and one control (12.5%); BKV was found in the urine of 7/11 patients (63.6%) and 2/8 controls (25%) and in blood samples from four patients. No significant difference was found in the mean viral loads and in the viral molecular characterizations between the two groups. The polyomaviruses replication was not associated with rituximab therapy in children. J. Med. Virol. 84:1464–1470, 2012. © 2012 Wiley Periodicals, Inc.