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A case‐control study to assess the role of polyomavirus in transplant complications: Where do we stand?
Author(s) -
Garcia Urbán Julia,
Gurrado Katia,
Brea Rivas Paola C.,
Abou Elrous Dina,
Zubimendi Machain Mónica,
Romero Gómez María,
García Rodríguez Julio,
Vicandi Plaza Blanca,
Yébenes Gregorio Laura,
García Fernández Eugenia,
Jiménez Martín Carlos,
López Oliva MaríaOvidia,
González García Elena,
Ledesma Sánchez Gabriel,
Carreño Cornejo Gilda,
Selgas Gutiérrez Rafael,
Zarauza Santoveña Alejandro,
Melgosa Hijosa Marta,
Fernández Camblor Carlota,
Mozo del Castillo Yasmina,
Sisinni Luisa,
Bueno Sánchez David,
PérezMartínez Antonio,
Sánchez Zapardiel Elena,
López Granados Eduardo,
Monserrat Villatoro Jaime,
Hernández Zabala Rafael,
Borobia Alberto M.,
Frías Jesús,
Ramírez Elena
Publication year - 2020
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.13432
Subject(s) - viremia , medicine , immunosuppression , odds ratio , retrospective cohort study , transplantation , hematopoietic stem cell transplantation , concomitant , gastroenterology , oncology , immunology , virus
Purpose The study's aim was to assess whether polyomavirus DNAemia screening was associated with different outcomes in patients with positive viremia compared with negative viremia. Methods Case‐control retrospective study of patients with polyomavirus DNAemia (viremia > 1000 copies/mL) matched 1:1 with controls. Control group consists of the patient who received a transplant immediately before or after each identified case and did have nil viremia. Finding Ultimately, 120 cases of BK polyomavirus (BKPyV) were detected and matched with 130 controls. Of these, 54 were adult kidney transplant recipients (KTRs), 43 were pediatric KTRs, and 23 were undergoing hemato‐oncologic therapy, of which 20 were undergoing hematopoietic stem cell transplantation. The odds ratio (OR) for overall risk of poorer outcomes in cases versus controls was 16.07 (95% CI: 5.55‐46.54). The unfavorable outcome of switching the immunosuppressive drug (ISD) (14/40,35%) was no different from that of those treated with reduced ISD doses (31/71, 43.6%, P = .250). Acute rejection or graft‐versus‐host disease, previous transplant, and intensity of immunosuppression (4 ISDs plus induction or conditioning) were risk factors for BKPyV‐DNAemia (OR: 13.96, 95% CI: 11.25‐15.18, P < .001; OR: 6.14, 95% CI: 3.91‐8.80, P < .001; OR: 5.53, 95% CI: 3.37‐7.30, P < .001, respectively). Conclusions Despite viremia screening, dose reduction, and change in therapeutic protocol, patients with positive BKPyV‐DNAemia present poorer outcomes and unfavorable results.