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

Research output: Contribution to journalArticle

72 Citations (Scopus)

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
Externally publishedYes

Fingerprint

BK Virus
Virus Replication
Allografts
Epidemiology
Kidney
Mycophenolic Acid
Granzymes
Messenger RNA
Antilymphocyte Serum
Transforming Growth Factors
Tacrolimus
Immunosuppressive Agents
Real-Time Polymerase Chain Reaction
Steroids
Transplants

Keywords

  • BK virus
  • Kidney transplantation
  • Risk factors

ASJC Scopus subject areas

  • Transplantation

Cite this

Epidemiology of BK virus in renal allograft recipients : Independent risk factors for bk virus replication. / Dadhania, Darshana; Snopkowski, Catherine; Ding, Ruchuang; Muthukumar, Thangamani; Chang, Christina; Aull, Meredith; Lee, Jun; Sharma, Vijay K.; Kapur, Sandip; Suthanthiran, Manikkam.

In: Transplantation, Vol. 86, No. 4, 27.08.2008, p. 521-528.

Research output: Contribution to journalArticle

Dadhania, D, Snopkowski, C, Ding, R, Muthukumar, T, Chang, C, Aull, M, Lee, J, Sharma, VK, Kapur, S & Suthanthiran, M 2008, 'Epidemiology of BK virus in renal allograft recipients: Independent risk factors for bk virus replication', Transplantation, vol. 86, no. 4, pp. 521-528. https://doi.org/10.1097/TP.0b013e31817c6447
Dadhania, Darshana ; Snopkowski, Catherine ; Ding, Ruchuang ; Muthukumar, Thangamani ; Chang, Christina ; Aull, Meredith ; Lee, Jun ; Sharma, Vijay K. ; Kapur, Sandip ; Suthanthiran, Manikkam. / Epidemiology of BK virus in renal allograft recipients : Independent risk factors for bk virus replication. In: Transplantation. 2008 ; Vol. 86, No. 4. pp. 521-528.
@article{7f273dd2584f46b2be44a155273a5835,
title = "Epidemiology of BK virus in renal allograft recipients: Independent risk factors for bk virus replication",
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.",
keywords = "BK virus, Kidney transplantation, Risk factors",
author = "Darshana Dadhania and Catherine Snopkowski and Ruchuang Ding and Thangamani Muthukumar and Christina Chang and Meredith Aull and Jun Lee and Sharma, {Vijay K.} and Sandip Kapur and Manikkam Suthanthiran",
year = "2008",
month = "8",
day = "27",
doi = "10.1097/TP.0b013e31817c6447",
language = "English",
volume = "86",
pages = "521--528",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Epidemiology of BK virus in renal allograft recipients

T2 - Independent risk factors for bk virus replication

AU - Dadhania, Darshana

AU - Snopkowski, Catherine

AU - Ding, Ruchuang

AU - Muthukumar, Thangamani

AU - Chang, Christina

AU - Aull, Meredith

AU - Lee, Jun

AU - Sharma, Vijay K.

AU - Kapur, Sandip

AU - Suthanthiran, Manikkam

PY - 2008/8/27

Y1 - 2008/8/27

N2 - 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.

AB - 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.

KW - BK virus

KW - Kidney transplantation

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=52449116522&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=52449116522&partnerID=8YFLogxK

U2 - 10.1097/TP.0b013e31817c6447

DO - 10.1097/TP.0b013e31817c6447

M3 - Article

VL - 86

SP - 521

EP - 528

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 4

ER -