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Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies
Abstract Background Polyomavirus BK (BKV) infection of the renal allograft causes destructive tissue injury with inflammation and subsequent fibrosis. Methods Using a prospective cohort of patients after kidney transplantation performed between 2003 and 2012, we investigated the role of BKV viraemia...
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| Published in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2019-11, Vol.34 (11), p.1970-1978 |
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| Main Authors: | , , , , , , , |
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| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073 |
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| cites | cdi_FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073 |
| container_end_page | 1978 |
| container_issue | 11 |
| container_start_page | 1970 |
| container_title | Nephrology, dialysis, transplantation |
| container_volume | 34 |
| creator | Reischig, Tomas Kacer, Martin Hes, Ondrej Machova, Jana Nemcova, Jana Kormunda, Stanislav Pivovarcikova, Kristyna Bouda, Mirko |
| description | Abstract
Background
Polyomavirus BK (BKV) infection of the renal allograft causes destructive tissue injury with inflammation and subsequent fibrosis.
Methods
Using a prospective cohort of patients after kidney transplantation performed between 2003 and 2012, we investigated the role of BKV viraemia in the development and progression of interstitial fibrosis and tubular atrophy (IFTA). The primary outcome was moderate-to-severe IFTA assessed by protocol biopsy at 36 months.
Results
A total of 207 consecutive recipients were enrolled. Of these, 57 (28%) developed BKV viraemia with 10 (5%) cases of polyomavirus-associated nephropathy (PVAN). Transient ( |
| doi_str_mv | 10.1093/ndt/gfz061 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2231928347</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfz061</oup_id><sourcerecordid>2231928347</sourcerecordid><originalsourceid>FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EokvhwgMgX5AQUug4zq4dblDxp2qlXoBrNLHHi5ETB9upVF6CV8arLT324jn4m08z82PspYB3Anp5Nttytnd_YCcesY3odtC0Um8fs039FA1soT9hz3L-BQB9q9RTdiIFKNGC3rC_P3zCwENEy3G23K4Ji48zj45_vORLDLdxwhuf1szrizR55JYKpcnPxBPNtXuf0BXu_Jhi9pkvKe4T5Vw17_lPn0sMce8NpxsM6709YKEDWqKJgY8-LtlTfs6eOAyZXtzVU_b986dv51-bq-svF-cfrhojhSpNp9seJDoE6KQRnTJOWWHlqF1n5c6M2Elt7HardC8NakFgxr4dte1JASh5yt4cvXWC3yvlMkw-GwoBZ4prHtpWir7Vsjugb4-oqevlRG5Ykp8w3Q4ChkMAQw1gOAZQ4Vd33nWcyN6j_y9egddHIK7LQ6J_GSeSOg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2231928347</pqid></control><display><type>article</type><title>Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies</title><source>Oxford Journals Online</source><creator>Reischig, Tomas ; Kacer, Martin ; Hes, Ondrej ; Machova, Jana ; Nemcova, Jana ; Kormunda, Stanislav ; Pivovarcikova, Kristyna ; Bouda, Mirko</creator><creatorcontrib>Reischig, Tomas ; Kacer, Martin ; Hes, Ondrej ; Machova, Jana ; Nemcova, Jana ; Kormunda, Stanislav ; Pivovarcikova, Kristyna ; Bouda, Mirko</creatorcontrib><description>Abstract
Background
Polyomavirus BK (BKV) infection of the renal allograft causes destructive tissue injury with inflammation and subsequent fibrosis.
Methods
Using a prospective cohort of patients after kidney transplantation performed between 2003 and 2012, we investigated the role of BKV viraemia in the development and progression of interstitial fibrosis and tubular atrophy (IFTA). The primary outcome was moderate-to-severe IFTA assessed by protocol biopsy at 36 months.
Results
A total of 207 consecutive recipients were enrolled. Of these, 57 (28%) developed BKV viraemia with 10 (5%) cases of polyomavirus-associated nephropathy (PVAN). Transient (<3 months) BKV viraemia occurred in 70% of patients, and persistent (≥3 months) BKV viraemia in 30%. A high viral load (≥10 000 copies/mL) was detected in 18% and a low viral load (<10 000 copies/mL) in 61%, while the viral load could not be determined in 21%. Moderate-to-severe IFTA was significantly increased in high [71%; odds ratio (OR) = 12.1; 95% confidence interval (CI) 1.62–90.0; P = 0.015] or persistent BKV viraemia (67%; OR = 6.33; 95% CI 1.19–33.7; P = 0.031) with corresponding rise in ‘interstitial fibrosis + tubular atrophy’ scores. Only patients with transient low BKV viraemia showed similar incidence and progression of IFTA to the no-BKV group. Persistent low BKV viraemia was uncommon yet the progression of fibrosis was significant. Only recipients with PVAN experienced inferior graft survival at 5 years.
Conclusions
These data suggest that only transient low BKV viraemia does not negatively affect the progression of allograft fibrosis in contrast to excessive risk of severe fibrosis after high or persistent BKV viraemia.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfz061</identifier><identifier>PMID: 31071208</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>BK Virus - isolation & purification ; BK Virus - pathogenicity ; Disease Progression ; Female ; Fibrosis - etiology ; Fibrosis - pathology ; Graft Survival ; Humans ; Kidney Diseases - etiology ; Kidney Diseases - pathology ; Kidney Transplantation - adverse effects ; Male ; Middle Aged ; Polyomavirus Infections - complications ; Polyomavirus Infections - virology ; Prospective Studies ; Transplantation, Homologous ; Tumor Virus Infections - complications ; Tumor Virus Infections - virology ; Viral Load ; Viremia - complications ; Viremia - virology ; Virus Replication</subject><ispartof>Nephrology, dialysis, transplantation, 2019-11, Vol.34 (11), p.1970-1978</ispartof><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073</citedby><cites>FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073</cites><orcidid>0000-0002-5404-598X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31071208$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reischig, Tomas</creatorcontrib><creatorcontrib>Kacer, Martin</creatorcontrib><creatorcontrib>Hes, Ondrej</creatorcontrib><creatorcontrib>Machova, Jana</creatorcontrib><creatorcontrib>Nemcova, Jana</creatorcontrib><creatorcontrib>Kormunda, Stanislav</creatorcontrib><creatorcontrib>Pivovarcikova, Kristyna</creatorcontrib><creatorcontrib>Bouda, Mirko</creatorcontrib><title>Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Abstract
Background
Polyomavirus BK (BKV) infection of the renal allograft causes destructive tissue injury with inflammation and subsequent fibrosis.
Methods
Using a prospective cohort of patients after kidney transplantation performed between 2003 and 2012, we investigated the role of BKV viraemia in the development and progression of interstitial fibrosis and tubular atrophy (IFTA). The primary outcome was moderate-to-severe IFTA assessed by protocol biopsy at 36 months.
Results
A total of 207 consecutive recipients were enrolled. Of these, 57 (28%) developed BKV viraemia with 10 (5%) cases of polyomavirus-associated nephropathy (PVAN). Transient (<3 months) BKV viraemia occurred in 70% of patients, and persistent (≥3 months) BKV viraemia in 30%. A high viral load (≥10 000 copies/mL) was detected in 18% and a low viral load (<10 000 copies/mL) in 61%, while the viral load could not be determined in 21%. Moderate-to-severe IFTA was significantly increased in high [71%; odds ratio (OR) = 12.1; 95% confidence interval (CI) 1.62–90.0; P = 0.015] or persistent BKV viraemia (67%; OR = 6.33; 95% CI 1.19–33.7; P = 0.031) with corresponding rise in ‘interstitial fibrosis + tubular atrophy’ scores. Only patients with transient low BKV viraemia showed similar incidence and progression of IFTA to the no-BKV group. Persistent low BKV viraemia was uncommon yet the progression of fibrosis was significant. Only recipients with PVAN experienced inferior graft survival at 5 years.
Conclusions
These data suggest that only transient low BKV viraemia does not negatively affect the progression of allograft fibrosis in contrast to excessive risk of severe fibrosis after high or persistent BKV viraemia.</description><subject>BK Virus - isolation & purification</subject><subject>BK Virus - pathogenicity</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Fibrosis - etiology</subject><subject>Fibrosis - pathology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Kidney Diseases - etiology</subject><subject>Kidney Diseases - pathology</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Polyomavirus Infections - complications</subject><subject>Polyomavirus Infections - virology</subject><subject>Prospective Studies</subject><subject>Transplantation, Homologous</subject><subject>Tumor Virus Infections - complications</subject><subject>Tumor Virus Infections - virology</subject><subject>Viral Load</subject><subject>Viremia - complications</subject><subject>Viremia - virology</subject><subject>Virus Replication</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EokvhwgMgX5AQUug4zq4dblDxp2qlXoBrNLHHi5ETB9upVF6CV8arLT324jn4m08z82PspYB3Anp5Nttytnd_YCcesY3odtC0Um8fs039FA1soT9hz3L-BQB9q9RTdiIFKNGC3rC_P3zCwENEy3G23K4Ji48zj45_vORLDLdxwhuf1szrizR55JYKpcnPxBPNtXuf0BXu_Jhi9pkvKe4T5Vw17_lPn0sMce8NpxsM6709YKEDWqKJgY8-LtlTfs6eOAyZXtzVU_b986dv51-bq-svF-cfrhojhSpNp9seJDoE6KQRnTJOWWHlqF1n5c6M2Elt7HardC8NakFgxr4dte1JASh5yt4cvXWC3yvlMkw-GwoBZ4prHtpWir7Vsjugb4-oqevlRG5Ykp8w3Q4ChkMAQw1gOAZQ4Vd33nWcyN6j_y9egddHIK7LQ6J_GSeSOg</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Reischig, Tomas</creator><creator>Kacer, Martin</creator><creator>Hes, Ondrej</creator><creator>Machova, Jana</creator><creator>Nemcova, Jana</creator><creator>Kormunda, Stanislav</creator><creator>Pivovarcikova, Kristyna</creator><creator>Bouda, Mirko</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5404-598X</orcidid></search><sort><creationdate>20191101</creationdate><title>Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies</title><author>Reischig, Tomas ; Kacer, Martin ; Hes, Ondrej ; Machova, Jana ; Nemcova, Jana ; Kormunda, Stanislav ; Pivovarcikova, Kristyna ; Bouda, Mirko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c317t-482903afa0043c147cf7d1d3b8f4d36cba438cd557893ca81e0cb92b8d9e70073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>BK Virus - isolation & purification</topic><topic>BK Virus - pathogenicity</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Fibrosis - etiology</topic><topic>Fibrosis - pathology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Kidney Diseases - etiology</topic><topic>Kidney Diseases - pathology</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Polyomavirus Infections - complications</topic><topic>Polyomavirus Infections - virology</topic><topic>Prospective Studies</topic><topic>Transplantation, Homologous</topic><topic>Tumor Virus Infections - complications</topic><topic>Tumor Virus Infections - virology</topic><topic>Viral Load</topic><topic>Viremia - complications</topic><topic>Viremia - virology</topic><topic>Virus Replication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reischig, Tomas</creatorcontrib><creatorcontrib>Kacer, Martin</creatorcontrib><creatorcontrib>Hes, Ondrej</creatorcontrib><creatorcontrib>Machova, Jana</creatorcontrib><creatorcontrib>Nemcova, Jana</creatorcontrib><creatorcontrib>Kormunda, Stanislav</creatorcontrib><creatorcontrib>Pivovarcikova, Kristyna</creatorcontrib><creatorcontrib>Bouda, Mirko</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reischig, Tomas</au><au>Kacer, Martin</au><au>Hes, Ondrej</au><au>Machova, Jana</au><au>Nemcova, Jana</au><au>Kormunda, Stanislav</au><au>Pivovarcikova, Kristyna</au><au>Bouda, Mirko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>34</volume><issue>11</issue><spage>1970</spage><epage>1978</epage><pages>1970-1978</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract
Background
Polyomavirus BK (BKV) infection of the renal allograft causes destructive tissue injury with inflammation and subsequent fibrosis.
Methods
Using a prospective cohort of patients after kidney transplantation performed between 2003 and 2012, we investigated the role of BKV viraemia in the development and progression of interstitial fibrosis and tubular atrophy (IFTA). The primary outcome was moderate-to-severe IFTA assessed by protocol biopsy at 36 months.
Results
A total of 207 consecutive recipients were enrolled. Of these, 57 (28%) developed BKV viraemia with 10 (5%) cases of polyomavirus-associated nephropathy (PVAN). Transient (<3 months) BKV viraemia occurred in 70% of patients, and persistent (≥3 months) BKV viraemia in 30%. A high viral load (≥10 000 copies/mL) was detected in 18% and a low viral load (<10 000 copies/mL) in 61%, while the viral load could not be determined in 21%. Moderate-to-severe IFTA was significantly increased in high [71%; odds ratio (OR) = 12.1; 95% confidence interval (CI) 1.62–90.0; P = 0.015] or persistent BKV viraemia (67%; OR = 6.33; 95% CI 1.19–33.7; P = 0.031) with corresponding rise in ‘interstitial fibrosis + tubular atrophy’ scores. Only patients with transient low BKV viraemia showed similar incidence and progression of IFTA to the no-BKV group. Persistent low BKV viraemia was uncommon yet the progression of fibrosis was significant. Only recipients with PVAN experienced inferior graft survival at 5 years.
Conclusions
These data suggest that only transient low BKV viraemia does not negatively affect the progression of allograft fibrosis in contrast to excessive risk of severe fibrosis after high or persistent BKV viraemia.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31071208</pmid><doi>10.1093/ndt/gfz061</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5404-598X</orcidid></addata></record> |
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| ispartof | Nephrology, dialysis, transplantation, 2019-11, Vol.34 (11), p.1970-1978 |
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| source | Oxford Journals Online |
| subjects | BK Virus - isolation & purification BK Virus - pathogenicity Disease Progression Female Fibrosis - etiology Fibrosis - pathology Graft Survival Humans Kidney Diseases - etiology Kidney Diseases - pathology Kidney Transplantation - adverse effects Male Middle Aged Polyomavirus Infections - complications Polyomavirus Infections - virology Prospective Studies Transplantation, Homologous Tumor Virus Infections - complications Tumor Virus Infections - virology Viral Load Viremia - complications Viremia - virology Virus Replication |
| title | Viral load and duration of BK polyomavirus viraemia determine renal graft fibrosis progression: histologic evaluation of late protocol biopsies |
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