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Impact of low‐level BK polyomavirus viremia on intermediate‐term renal allograft function
Author(s) -
Korth Johannes,
Widera Marek,
Dolff Sebastian,
Guberina Hana,
Bienholz Anja,
Brinkhoff Alexandra,
Anastasiou Olympia Evdoxia,
Kribben Andreas,
Dittmer Ulf,
Verheyen Jens,
Wilde Benjamin,
Witzke Oliver
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12817
Subject(s) - viremia , medicine , renal function , gastroenterology , urology , immunology , human immunodeficiency virus (hiv)
Background BK polyomavirus ( BKP yV)‐associated nephropathy (Py VAN ) is a significant cause of premature renal transplant failure. High‐level BKP yV viremia is predictive for Py VAN ; however, low‐level BKP yV viremia does not necessarily exclude the presence of Py VAN . As data are limited regarding whether or not low‐level BKP yV viremia has an effect on intermediate‐term graft outcome, this study analyzes the impact of low‐level BKP yV viremia on intermediate‐term graft function and outcome compared with high‐level viremia and non‐viremic patients. Methods All renal transplant patients received follow‐up examinations at the Department of Nephrology, University Hospital Essen. Patients were screened for BKP yV viremia and stratified into three groups according to their maximum BKP yV load in serum (low‐level viremia, high‐level viremia, and no viremia). Results In 142 of 213 (67%) patients, BKP yV was never detected in serum; 42 of 213 (20%) patients were found positive for low‐level viremia (≤10 4 copies/mL); and 29 of 213 (13%) patients showed high‐level viremia (>10 4 copies/mL). No significant differences regarding transplant function and graft failure were observed between patients without BKP yV viremia (delta estimated glomerular filtration rate [ eGFR ] +0.1 mL/min [month 1 vs last visit at month 44]) and patients with low‐level BKP yV viremia (delta eGFR −1.7 mL/min). In patients with high‐level viremia, transplant function was significantly restricted (delta eGFR −6.5 mL/min) compared with low‐level viremia until the last visit at 44 ± 9.7 months after transplantation. Although the graft function and graft loss were worse in the high‐level viremia group compared with no viremia ( eGFR 37 vs 45 mL/min), the difference was not significant. Conclusions High‐level viremia was associated with impaired graft function. In contrast, low‐level BKP yV viremia had no significant impact on intermediate‐term graft function.