1. Impact of pre-graft serology on risk of BKPyV infection post-renal transplantation.
- Author
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François C, Tinez C, Brochot E, Duverlie G, Castelain S, Helle F, Fiore T, Morel V, Touzé A, Sater FA, Dakroub F, Akl H, Presne C, Choukroun G, and Guillaume N
- Subjects
- Female, Humans, Male, Retrospective Studies, Transplant Recipients, Viremia diagnosis, Viremia epidemiology, Viremia etiology, BK Virus, Kidney Transplantation adverse effects, Polyomavirus Infections diagnosis, Polyomavirus Infections epidemiology, Polyomavirus Infections etiology, Tumor Virus Infections diagnosis, Tumor Virus Infections epidemiology, Tumor Virus Infections etiology
- Abstract
Objectives: BK polyomavirus-associated nephropathy is a troublesome disease caused by BK polyomavirus (BKPyV) infection in immunocompromised renal graft recipients. There are no effective treatments available, making immunosuppression reduction the only management option. Thus, pre-graft predictive BKPyV replication markers are needed for identification of patients at high risk of viraemia., Methods: We conducted a retrospective study to assess the correlation between pre-transplantation BKPyV serostatus and post-transplantation incidence of BKPyV infection. Sera from 329 recipients and 222 matched donors were tested for anti-BKPyV antibodies against BKPyV serotypes I and IV by using a virus-like particle-based immunoglobulin G enzyme-linked immunosorbent assay, and BKPyV DNA load was monitored for at least 1 year post-transplantation., Results: Eighty recipients were viruric and 59 recipients were viraemic post-transplantation. In the post-transplantation period, the probability of developing viraemia for serotype I increased from 4.3% for the D-/R+ group to 12.1% for the D+/R+ group, climbing to 37.5% for the D+/R- group (P < 0.05). When calculating recipient mean titres for serotypes I and IV, we observed a clear difference in the proportions of viraemia, decreasing from 50% for mean titres <400 to 13.5% for titres ≥400 (P < 0.001), as well as a higher proportion of presumptive nephropathy (50% versus 23.1%, respectively; P < 0.05). In univariate analysis, this parameter had an odds ratio of 6.41 for the risk of developing post-transplantation BKPyV viraemia (95% confidence interval 3.16-13.07; P < 0.0001)., Conclusions: Determination of both donor and recipient BKPyV seropositivity before transplantation and antibody titre measurements may serve as a predictive tool to manage clinical BKPyV infection by identification of patients at high risk., (© The Author(s) 2021. Published by Oxford University Press on behalf of the ERA.)
- Published
- 2022
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