High-level JCPyV viruria after kidney transplantation-Clinical and histopathological findings.
- Helanterä I Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland. Electronic address: Ilkka.helantera@helsinki.fi.
- Hirsch HH Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland; Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
- Auvinen E Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
- Mannonen L Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
- Nummi M Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
- Wernli M Transplantation and Clinical Virology, Department of Biomedicine, University of Basel, Petersplatz 10, CH-4009 Basel, Switzerland.
- Ortiz F Department of Nephrology, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland.
- Räisänen-Sokolowski A Department of Pathology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
- Lempinen M Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, PO Box 372, FI 00029 HUS, Helsinki, Finland.
- Lautenschlager I Department of Virology, University of Helsinki and Helsinki University Hospital (HUSLAB), PO Box 400, FI 00029 HUS, Helsinki, Finland.
- 2016-11-15
Published in:
- Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. - 2016
JC polyomavirus
Kidney transplantation
Polyomavirus-associated nephropathy
Adult
Aged
Biopsy
Female
Histocytochemistry
Humans
JC Virus
Kidney
Kidney Transplantation
Male
Middle Aged
Polyomavirus Infections
Real-Time Polymerase Chain Reaction
Transplant Recipients
Treatment Outcome
Urine
Viral Load
English
BACKGROUND
The significance of JC polyomavirus (JCPyV) after kidney transplantation ranges from irrelevant to full-blown nephropathy or PML.
OBJECTIVES
To investigate the clinical significance of high-level JCPyV viruria and JCPyV primary infections after kidney transplantation.
STUDY DESIGN
JCPyV viruria was detected in routine screening by quantitative real-time PCR in 40/238 kidney transplant recipients and was high-level (>107 copies/ml) in 17 patients. A protocol biopsy at the time of JCPyV viruria was available from 10 patients.
RESULTS
Peak urine viral loads were 1.0×107-2.5×109 copies/ml in the 17 high-level viruria patients. 6/15 (40%) patients with high-level JCPyV viruria with pretransplant sera available were JCPyV IgG negative suggesting that JCPyV viruria resulted from the donor graft in most cases. No acute graft dysfunction was associated with JCPyV viruria. No positive SV40 staining was detected in protocol biopsies, and no specific histopathology was associated with high-level viruria; JCPyV nephropathy was not found. No differences were seen in histopathology or graft function at 3 years in patients with high-level viruria compared to non-JCPyV viruric patients transplanted during the same time period, and outcome was similar in patients with presumably primary and reactivated JCPyV. The mean estimated GFR at last follow-up was 44ml/min (range 12-60ml/min). One graft with high-level viruria was lost 9 years posttransplant due to recurrent IgA nephropathy CONCLUSIONS: High-level JCPyV viruria seems to be associated with primary JCPyV infection reflecting the average seroprevalence of 60%, but is not stringently associated with inferior graft function or survival, or histopathological changes.
The significance of JC polyomavirus (JCPyV) after kidney transplantation ranges from irrelevant to full-blown nephropathy or PML.
OBJECTIVES
To investigate the clinical significance of high-level JCPyV viruria and JCPyV primary infections after kidney transplantation.
STUDY DESIGN
JCPyV viruria was detected in routine screening by quantitative real-time PCR in 40/238 kidney transplant recipients and was high-level (>107 copies/ml) in 17 patients. A protocol biopsy at the time of JCPyV viruria was available from 10 patients.
RESULTS
Peak urine viral loads were 1.0×107-2.5×109 copies/ml in the 17 high-level viruria patients. 6/15 (40%) patients with high-level JCPyV viruria with pretransplant sera available were JCPyV IgG negative suggesting that JCPyV viruria resulted from the donor graft in most cases. No acute graft dysfunction was associated with JCPyV viruria. No positive SV40 staining was detected in protocol biopsies, and no specific histopathology was associated with high-level viruria; JCPyV nephropathy was not found. No differences were seen in histopathology or graft function at 3 years in patients with high-level viruria compared to non-JCPyV viruric patients transplanted during the same time period, and outcome was similar in patients with presumably primary and reactivated JCPyV. The mean estimated GFR at last follow-up was 44ml/min (range 12-60ml/min). One graft with high-level viruria was lost 9 years posttransplant due to recurrent IgA nephropathy CONCLUSIONS: High-level JCPyV viruria seems to be associated with primary JCPyV infection reflecting the average seroprevalence of 60%, but is not stringently associated with inferior graft function or survival, or histopathological changes.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.jcv.2016.10.018
- PMID 27842264
- Persistent URL
- https://sonar.ch/global/documents/90676
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