Author(s): Querido, Sara ; Weigert, André ; Pinto, Iola ; Papoila, A.L. ; Pessanha, Maria Ana ; Gomes, Perpétua ; Adragão, Teresa ; Paixão, Paulo
Date: 2023
Persistent ID: http://hdl.handle.net/10362/158432
Origin: Repositório Institucional da UNL
Subject(s): BK virus; JC virus; kidney transplantation; Infectious Diseases; Virology; SDG 3 - Good Health and Well-being
Funding Information: Ana Luisa Papoila work is partially financed by national funds through FCT—Fundação para a Ciência e a Tecnologia under the project UIDB/00006/2020. Iola Pinto work is funded by national funds through the FCT—Fundação para a Ciência e a Tecnologia, I.P., under the scope of the projects UIDB/00297/2020 and UIDP/00297/2020 (Center for Mathematics and Applications). Publisher Copyright: © 2023 Wiley Periodicals LLC.
Studies analyzing the relationship between BK polyomavirus (BKV) or JC polyomavirus (JCV) infection and kidney transplant (KT) long term clinical outcomes are scarce. Therefore, we evaluated this relationship in a single-center retrospective cohort of 288 KT patients followed for 45.4(27.5; 62.5) months. Detection of BKV viremia in two consecutive analyses led to discontinuation of antimetabolite and initiation of mammalian target of rapamycin inhibitor. Outcome data included de novo BKV and/or JCV viremia and/or viruria after KT, death-censored graft survival and patient survival. BKV viruria and viremia were detected in 42.4% and 22.2% of KT recipients, respectively. BKV viremic patients had higher urinary BKV viral loads at the onset of viruria, when compared to nonviremic patients (7 log10 vs. 4.9 log10 cp/mL, p < 0.001). JCV viruria was identified in 38.5% of KT patients; the 5.9% of KT recipients who developed JCV viremia had higher JCV urinary viral loads at the onset of viruria, when compared to non-viremic patients (5.3 vs. 3.7 log10 cp/mL, p = 0.034). No differences were found in estimated glomerular filtration rate at the end of follow up, when comparing BKV or JCV viruric or viremic patients with nonviremic patients. No association was found between JCV or BKV viruria or viremia and death/graft failure. Therefore, higher BKV urinary viral loads at the onset could serve as an early maker of over immunosuppression. JCV and BKV replication was not associated with inferior clinical outcomes in KT patients with the above-mentioned immunosuppression strategy.
