Epidemiology of BK virus in renal allograft recipients: Independent risk factors for bk virus replication

Darshana Dadhania, Catherine Snopkowski, Ruchuang Ding, Thangamani Muthukumar, Christina Chang, Meredith Aull, Jun Lee, Vijay K. Sharma, Sandip Kapur, Manikkam Suthanthiran

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Abstract

BACKGROUND: Identification of risk factors for BK virus (BKV) replication may improve transplant outcome. We investigated the impact of immunosuppressive drugs on the prevalence of BKV replication in recipients of human renal allografts. METHODS.: One hundred twenty renal allograft recipients were studied prospectively at 1, 3, and 6 months posttransplantation to identify risk factors for BKV replication. BKV replication was quantified by measurement of urinary cell BKV VP1 mRNA levels using BKV specific primers and TaqMan probe in a real-time quantitative polymerase chain reaction assay. Levels of urinary cell mRNA for granzyme B, CD103, and transforming growth factor-β 1 were measured to ascertain whether BKV replication is associated with an inflammatory signature. RESULTS.: The prevalence of BKV replication increased over time and was highest at 6 months compared with 1 or 3 months posttransplantation (P<0.001). A logistic regression model analysis demonstrated that steroid maintenance therapy (odds ratio: 8.3, P≤0.003) and induction with rabbit anti-human thymocyte globulin (odds ratio: 5.8, P≤0.008) were independent risk factors for BKV replication. Neither mycophenolate mofetil dose nor tacrolimus dose or trough levels were different between those with or without BKV replication. The development of acute rejection or antirejection treatment with methylprednisolone did not increase the risk of BKV replication. BKV replication was associated with heightened levels of urinary cell mRNA for granzyme B (P<0.002), CD103 (P<0.005) but not for transforming growth factor-β 1 (P>0.05). CONCLUSIONS.: Steroid maintenance therapy and induction with antithymocyte globulin are independent risk factors for BKV replication in renal allograft recipients treated with tacrolimus and mycophenolate mofetil.

Original languageEnglish
Pages (from-to)521-528
Number of pages8
JournalTransplantation
Volume86
Issue number4
DOIs
Publication statusPublished - 27 Aug 2008

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Keywords

  • BK virus
  • Kidney transplantation
  • Risk factors

ASJC Scopus subject areas

  • Transplantation

Cite this

Dadhania, D., Snopkowski, C., Ding, R., Muthukumar, T., Chang, C., Aull, M., Lee, J., Sharma, V. K., Kapur, S., & Suthanthiran, M. (2008). Epidemiology of BK virus in renal allograft recipients: Independent risk factors for bk virus replication. Transplantation, 86(4), 521-528. https://doi.org/10.1097/TP.0b013e31817c6447